Spectrum of Acute Febrile Illness in Children Presenting in Emergency of a Tertiary Care Hospital and its Clinico - Laboratorial Correlation

Apply

Spectrum of Acute Febrile Illness in Children Presenting in Emergency of a Tertiary Care Hospital and its Clinico - Laboratorial Correlation

Journal Title: Indian Journal of Emergency Medicine - Year 2017, Vol 3, Issue 2

Abstract

In a clinical setting, Fever is the most common sign of illness in infants and children and accounts for as many as 20% of pediatric emergency department (ED) visits. Clinical evaluation of febrile illness is guided by history and physical examination, along with judiciously selected screening test. Most of the studies have been done at ambulatory care setting with lack of proper follow up of the patients and accurate data regarding bacterial and viral aetiologies because of the difficulty in making microbiological diagnosis in ambulatory care settings. In this study all children more than 3 months and under the age of 15 years presenting to ED with fever and warranting hospitalization were included and analyzed as regards the spectrum of febrile illness and its correlation with clinical findings at presentation and laboratory investigations at and during the entire hospital stay. Objectives: To study the spectrum of acute febrile illnesses and develop a Clinical and laboratorial correlation in children more than 3 months and under the age of 15 years warranting ER visit and subsequent hospitalization. Methods and Material: It was a Prospective observational unicentric study done at Max Super Speciality Hospital, Shalimarbagh, New Delhi. Data was collected over a period September 2016 to May 2017 from 580 pediatric patients visited to ED and got admitted, as per data collection sheet after the approval by scientific and ethics committee of the institute. Statistical Analysis Used: The collected data was entered in the Excel spreadsheet using Microsoft Excel Software and transferred to Statistics Package for Social Sciences (SPSS) version 20, IBM Inc. for analysis. It was subjected to descriptive statistics for calculation of mean, standard deviation, frequencies and percentages. Summarized data was presented using Tables and Graphs. Shapiro Wilk test was used to check which all variables were following normal distribution. Chisquare test was used for comparison between categorical variables. Pearson’s correlation coefficient (ordinal data) was calculated to measure the strength of a relationship between provisional diagnosis and final diagnosis. Level of statistical significance was set at pvalue less than 0.05. Results: This study was done at a tertiary care hospital where yearly about 14200 patients visited to Emergency, 40% of all attendance is pediatric and among them 60% were prompt by fever. This data was also supported by the previous studies . The majority of the children who presented with fever and got admitted fall under the age group of 415 years which accounts or 76% of the total study population. Male outnumbered females .Male accounts for 67% (n=389) and Female accounts for 33% (n=191) among all total pediatrics hospital admissions. Out of 580 study population in presenting symptoms respiratory predominance was seen (29.1%) which was followed by fever with rash (26.8%). Most common diagnosis documented in our pediatric patients with acute febrile illness were URTI, majority of them presumably viral rhinopharyngitis (26.4%). This was followed by Dengue and dengue like illness and chikungunya each accounts for 13.4% and 21.5% respectively. Enteric fever was the most common diagnosis documented (24.7%) in among all specific bacterial diseases. Electrolyte disturbances specially hyponatremia was observed in 58% of pediatrics patients and was invariably associated with dehydration. Dehydration accounts for 5.7% of total study population. Conclusions: In conclusion, Emergency services are an integrable part of any healthcare infrastructure with almost 40% of being pediatrics attendance. Fever constituted 60% (almost 2/3 rd patients) of febrile illness. Infectious diseases still accounts for the majority of ER attendance. The standard protocol of diagnosis and management if applied well, confirms the diagnosis with accuracy resulting in a favorable outcome

Authors and Affiliations

Kishalay Datta

Keywords

Fever without Source (FWS); Serious Bacterial Infection (SBI); Urinary Tract Infection (UTI); Febril Seizure

EP ID EP453283
DOI 10.21088/ijem.2395.311X.3217.6
Views 97
Downloads 0