ETIOLOGICAL PROFILE OF FEVER OF SHORT DURATION WITHOUT FOCUS IN CHILDREN AGED 1–36 MONTHS: A TERTIARY CARE HOSPITAL-BASED STUDY
DOI:
https://doi.org/10.69980/ajpr.v29i1.830Keywords:
Fever without focus, Serious bacterial infection, Urinary tract infection, Bacteremia, PediatricsAbstract
Background: Fever without focus (FWS) in children aged 1–36 months presents a significant diagnostic challenge to pediatricians. Although most cases are due to self-limiting viral infections, a subset represents serious bacterial infections (SBI), including urinary tract infections (UTI), bacteremia, pneumonia, meningitis, and enteric fever. Early identification is essential to prevent morbidity and mortality while avoiding unnecessary hospitalization and antibiotic exposure.
Objectives: To determine the etiological profile of fever of short duration (<7 days) without localizing signs in children aged 1–36 months and to identify common organisms causing septicemia and urinary infections.
Methods: This prospective observational study was conducted in a tertiary care hospital. Children aged 1–36 months presenting with fever ≥38°C without identifiable focus on clinical examination were enrolled. Detailed clinical evaluation and laboratory investigations including complete blood count, blood culture, urine analysis and culture, chest radiography, cerebrospinal fluid analysis (when indicated), and serological tests were performed.
Results: The majority of cases were viral or self-limiting illnesses. Among serious bacterial infections, urinary tract infection was the most common cause, followed by bacteremia and pneumonia. Escherichia coli was the predominant organism in urine cultures, while Streptococcus pneumoniae and Staphylococcus aureus were common isolates in blood cultures. Younger infants had a higher incidence of serious bacterial infection.
Conclusion: While most cases of fever without focus are benign, urinary tract infection remains the most frequent serious bacterial infection in children 1–36 months. Rational use of investigations and close follow-up are crucial to balance early diagnosis and antimicrobial stewardship.
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