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Diagnostic clues to evaluating the febrile child

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Infection & Immunity, Specials Mind Map on Diagnostic clues to evaluating the febrile child, created by v.djabatey on 18/01/2014.
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Mind Map by v.djabatey, updated more than 1 year ago
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Created by v.djabatey over 10 years ago
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Resource summary

Diagnostic clues to evaluating the febrile child
  1. URTI
    1. very common
      1. may be coincidental w/ another serious illness
      2. otitis media
        1. always examine tympanic mb in febrile kids
        2. tonsillitis
          1. erythema/exudate on tonsils?
          2. stridor
            1. epiglottitis?
              1. viral croup?
                1. bacterial tracheitis
                2. pneumonia
                  1. fever
                    1. cough
                      1. raised resp rate
                        1. chest recession
                          1. abnormal auscultation
                            1. in infants auscultation may be normal
                              1. diag may need CXR
                          2. septicaemia
                            1. hard to recog if no rash before shock develops
                              1. early signs
                                1. raised HR
                                  1. raised breathing rate
                                    1. poor perfusion
                                    2. need to start Abx on clinical suspicion
                                      1. don't wait for results
                                    3. meningitis/encephalitis
                                      1. lethargy
                                        1. loss of interest in surroundings
                                          1. drowsiness or coma
                                            1. seizures
                                              1. older kids
                                                1. headache
                                                  1. photophobia
                                                    1. neck stiffness
                                                      1. +ve Kernig sign
                                                        1. pain on leg straightening
                                                      2. younger kids & infants
                                                        1. non-specific sx & signs
                                                        2. raised ICP
                                                          1. reduced conscious level
                                                            1. abnormal pupillary responses
                                                              1. abnormal posturing
                                                              2. Cushing triad
                                                                1. bradycardia
                                                                  1. hypertension
                                                                    1. abnormal pattern of breathing
                                                                    2. late signs
                                                                      1. papilloedema
                                                                        1. bulging fontanelle in infants
                                                                          1. opisthotonus
                                                                            1. hyperextension of head & back
                                                                        2. seizure
                                                                          1. febrile convulsion?
                                                                            1. meningitis?
                                                                              1. encephalitis?
                                                                              2. periorbital cellulitis
                                                                                1. redness & swelling of eyelids
                                                                                  1. may spread to orbit
                                                                                  2. rash
                                                                                    1. viral exanthem?
                                                                                      1. purpura from meningococcal infection
                                                                                      2. UTI
                                                                                        1. urine sample needed for any seriously ill young child or febrile illness that doesn't settle
                                                                                        2. abdominal pain
                                                                                          1. appendicitis?
                                                                                            1. pyelonephritis?
                                                                                              1. hepatitis?
                                                                                              2. diarrhoea
                                                                                                1. gastroenteritis
                                                                                                  1. fever w/ blood & mucus in stool
                                                                                                    1. Shigella
                                                                                                      1. Salmonella
                                                                                                        1. Campylobacter
                                                                                                      2. osteomyelitis or septic arthritis
                                                                                                        1. suspect if painful bone or joint
                                                                                                          1. or reluctance to move limb
                                                                                                        2. prolonged fever
                                                                                                          1. bacterial infection
                                                                                                            1. UTI
                                                                                                              1. bacterial endocarditis
                                                                                                              2. other infections
                                                                                                                1. viral
                                                                                                                  1. fungi
                                                                                                                    1. protozoal
                                                                                                                    2. Kawasaki disease
                                                                                                                      1. drug rxn
                                                                                                                        1. malignant disease
                                                                                                                          1. connective tissue disorder
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