Pediatric Fever: Diagnostic Testing by Jess Monas, MD

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Key Points and Recommendations

1. Tactile fevers should be regarded as real fevers, even if afebrile in the ED.
2. CBC as a screening test has a sensitivity below 50% for SBI.
3. The sensitivity of CRP ranges from 34%75% depending on cutoff levels.
4. The sensitivity of PCT ranges from 30%82% depending on severity of illness and cutoff.
5. Messenger RNA biosignatures are both highly sensitive and specific.
6. LP rarely identifies meningitis in children 2960 days of age who meet lowrisk criteria.
7. Long term sequelae of missed UTI are rare.
8. UTI can be screened for with a urine dipstick positive for either nitrites or leukocyte esterase.

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