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Occult Bacteremia in Children With Simple Febrile Seizures FREE

James M. Chamberlain, MD; Richard L. Gorman, MD
[+] Author Affiliations

Accepted for publication June 24, 1988.

Reprint requests to 1363 Templeton Pl, Rockville, MD 20852 (Dr Chamberlain).


Am J Dis Child. 1988;142(10):1073-1076. doi:10.1001/archpedi.1988.02150100067028.
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• The controversy surrounding the diagnostic workup for simple febrile seizures has centered around the lumbar puncture. This focus has obscured the potential importance of other tests. A retrospective study was performed to determine the frequency of occult bacteremia in simple febrile seizures. In a pediatric emergency department, we identified 115 cases of simple febrile seizures in children treated as outpatients. Blood cultures were performed in 93 (81%) of 115 patients; five (5.4%) were positive. Children were less likely to have blood cultures performed if they were older than 24 months or had a medical history of simple febrile seizures. However, neither age nor history of febrile seizures affected the risk of bacteremia. These data suggest that patients with simple febrile seizures are at approximately the same risk for bacteremia as children with fever alone. Patients with simple febrile seizures should be treated in the same manner as other patients of the same age with regard to the performance of blood cultures.

(AJDC 1988;142:1073-1076)

REFERENCES

Nelson KB, Ellenberg JH:  Prognosis in children with febrile seizures . Pediatrics 1978;; 61:720-727.
Gerber MA, Berliner BC:  The child with a 'simple' febrile seizure . AJDC 1981;;135:431-433.
Asnes RS, Novick LF, Nealis J, et al:  The first febrile seizure: A study of current pediatric practice . J Pediatr 1975;;87:485-488.
Link to Article
Chessare JB, Berwick DM:  Variation in clinical practice in the management of febrile seizures . Pediatr Emerg Care 1985;;1:19-21.
Link to Article
Vining EPG, Freeman JM:  Seizures which are not epilepsy . Pediatr Ann 1985;;14:711-718.
Surpure JS:  Febrile convulsions: What happens to the infant admitted to the hospital? Clin Pediatr 1981;;19:361-362.
Link to Article
National Institutes of Health:  Febrile seizures: Long-term management of children with fever-associated seizures . Pediatrics 1980;;66: 1009-1012.
McGowan JE, Bratton L, Klein JO, et al:  Bacteremia in febrile children seen in a 'walk-in' pediatric clinic . N Engl J Med 1973;;288:1310-1312.
Link to Article
Teele DW, Pelton SI, Grant MJA, et al:  Bacteremia in febrile children under 2 years of age: Results of cultures of blood of 600 consecutive febrile children seen in a 'walk-in' clinic . J Pediatr 1975;;87:227-230.
Link to Article
McCarthy PL, Jekel JF, Dolan TF:  Temperature greater than or equal to 40°C in children less than 24 months of age: A prospective study . Pediatrics 1977;;59:663-668.
Hamrick HJ, Murphy TF:  Bacteremia in 28 ambulatory children: Relationship to pneumonitis and meningitis . Clin Pediatr 1978;;17: 109-112.
Link to Article
McCarthy PL, Grundy GW, Spiesel SZ, et al:  Bacteremia in children: An outpatient clinical review . Pediatrics 1976;;57:861-868.
McIntyre P, Kennedy R, Harris F:  Occult pneumococcal bacteremia and febrile convulsions . Br Med J 1983;;286:203-206.
Link to Article
Lewis HJ, Parry JV, Parry RP, et al:  Role of viruses in febrile convulsions . Arch Dis Child 1979;;54:869-876.
Link to Article
Rutter N, Smales ORC:  Role of routine investigations in children presenting with their first febrile convulsion . Arch Dis Child 1977;;52: 188-191.
Link to Article
Wolf SM:  Laboratory evaluation of the child with a febrile convulsion . Pediatrics 1978;;62: 1074-1076.
Joffe A, McCormick M, DeAngelis C:  Which child with febrile seizures needs lumbar puncture? AJDC 1983;;137:1153-1156.
Carroll WL, Farrell MK, Singer JI, et al:  Treatment of occult bacteremia: A prospective randomized clinical trial . Pediatrics 1983;;72:608-612.
Feldman W:  Treatment of occult bacteremia . Pediatrics 1984;;74:1131-1133.
Jaffe DM, Tanz RR, Davis AP, et al:  Antibiotic administration to treat possible occult bacteremia in febrile children . N Engl J Med 1987;; 317:1175-1180.
Link to Article

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References

Nelson KB, Ellenberg JH:  Prognosis in children with febrile seizures . Pediatrics 1978;; 61:720-727.
Gerber MA, Berliner BC:  The child with a 'simple' febrile seizure . AJDC 1981;;135:431-433.
Asnes RS, Novick LF, Nealis J, et al:  The first febrile seizure: A study of current pediatric practice . J Pediatr 1975;;87:485-488.
Link to Article
Chessare JB, Berwick DM:  Variation in clinical practice in the management of febrile seizures . Pediatr Emerg Care 1985;;1:19-21.
Link to Article
Vining EPG, Freeman JM:  Seizures which are not epilepsy . Pediatr Ann 1985;;14:711-718.
Surpure JS:  Febrile convulsions: What happens to the infant admitted to the hospital? Clin Pediatr 1981;;19:361-362.
Link to Article
National Institutes of Health:  Febrile seizures: Long-term management of children with fever-associated seizures . Pediatrics 1980;;66: 1009-1012.
McGowan JE, Bratton L, Klein JO, et al:  Bacteremia in febrile children seen in a 'walk-in' pediatric clinic . N Engl J Med 1973;;288:1310-1312.
Link to Article
Teele DW, Pelton SI, Grant MJA, et al:  Bacteremia in febrile children under 2 years of age: Results of cultures of blood of 600 consecutive febrile children seen in a 'walk-in' clinic . J Pediatr 1975;;87:227-230.
Link to Article
McCarthy PL, Jekel JF, Dolan TF:  Temperature greater than or equal to 40°C in children less than 24 months of age: A prospective study . Pediatrics 1977;;59:663-668.
Hamrick HJ, Murphy TF:  Bacteremia in 28 ambulatory children: Relationship to pneumonitis and meningitis . Clin Pediatr 1978;;17: 109-112.
Link to Article
McCarthy PL, Grundy GW, Spiesel SZ, et al:  Bacteremia in children: An outpatient clinical review . Pediatrics 1976;;57:861-868.
McIntyre P, Kennedy R, Harris F:  Occult pneumococcal bacteremia and febrile convulsions . Br Med J 1983;;286:203-206.
Link to Article
Lewis HJ, Parry JV, Parry RP, et al:  Role of viruses in febrile convulsions . Arch Dis Child 1979;;54:869-876.
Link to Article
Rutter N, Smales ORC:  Role of routine investigations in children presenting with their first febrile convulsion . Arch Dis Child 1977;;52: 188-191.
Link to Article
Wolf SM:  Laboratory evaluation of the child with a febrile convulsion . Pediatrics 1978;;62: 1074-1076.
Joffe A, McCormick M, DeAngelis C:  Which child with febrile seizures needs lumbar puncture? AJDC 1983;;137:1153-1156.
Carroll WL, Farrell MK, Singer JI, et al:  Treatment of occult bacteremia: A prospective randomized clinical trial . Pediatrics 1983;;72:608-612.
Feldman W:  Treatment of occult bacteremia . Pediatrics 1984;;74:1131-1133.
Jaffe DM, Tanz RR, Davis AP, et al:  Antibiotic administration to treat possible occult bacteremia in febrile children . N Engl J Med 1987;; 317:1175-1180.
Link to Article

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