Further Outpatient Care
All children and infants with a febrile illness without a focus of bacterial infection require close follow-up care and instructions to return if the patient's condition deteriorates. Follow-up visits should be arranged within 24-48 hours after the initial visit.
Tailor medication choice to the source of infection, if known. Administer empiric treatment based on the most likely organisms.
Patients with fever without a focus who fail to improve with outpatient treatment may require hospital admission for further evaluation and treatment.
Tables
Observation Items |
1 (Normal) |
3 (Moderate Impairment) |
5 (Severe Impairment) |
Quality of cry |
Strong with normal tone or contentment without crying |
Whimpering or sobbing |
Weak cry, moaning, or high-pitched cry |
Reaction to parent stimulation |
Brief crying that stops or contentment without crying |
Intermittent crying |
Continual crying or limited response |
Color |
Pink |
Acrocyanotic or pale extremities |
Pale or cyanotic or mottled or ashen |
State variation |
If awake, stays awake; if asleep, wakes up quickly upon stimulation |
Eyes closed briefly while awake or awake with prolonged stimulation |
Falls asleep or will not arouse |
Hydration |
Skin normal, eyes normal, and mucous membranes moist |
Skin and eyes normal and mouth slightly dry |
Skin doughy or tented, dry mucous membranes, and/or sunken eyes |
Response (eg, talk, smile) to social overtures |
Smiling or alert (< 2 mo) |
Briefly smiling or alert briefly (< 2 mo) |
Unsmiling anxious face or dull, expressionless, or not alert (< 2 mo) |
