Sir.—The recent article by Chamberlain and Gorman in AJDC examined the incidence of bacteremia in children with simple febrile convulsions. Of note was that all five instances of bacteremia documented were caused by Streptococcus pneumoniae. Similarly, Hamrick and Murphy1 found a high rate (80%) of S pneumoniae isolated in bacteremic children who experienced febrile convulsions, and McIntyre et al2 found that a high percentage of children with S pneumoniae occult bacteremia experienced seizures with fever.
I surveyed the results of blood cultures performed on children evaluated from 1985 to 1988 in the Emergency Department of Children's Hospital of Wisconsin, Milwaukee, for febrile convulsions. During this time, there were 17 instances of bacteremia in those children who fulfilled criteria for simple febrile convulsions (patient age between 6 months and 5 years, generalized seizure activity of <15 minutes duration, presence of high fever [>39°C], and no underlying neurologic disorder identified [including