Diagnostic workup of febrile children under 24 months of age: a clinical review.

One of the most challenging situations encountered by primary care physicians is the diagnostic workup of a febrile child. Several studies have shown the surprisingly high incidence of clinically unsuspected, potentially major illness in febrile children. Bacteremia, pneumonia and urinary tract infection are particularly likely to present in an occult manner, while meningitis is more likely to be clinically suspected.An examination of the literature regarding febrile children under two years of age is necessary in order to synthesize the relevant information. Although there are large gaps in our knowledge, it is possible to make specific recommendations for a treatment plan, keeping in mind that areas of controversy and other reasonable approaches exist.