Fiebre sin foco aparente en menores de 36 meses en un servicio de urgencias de un hospital de tercer nivel de Bogotá, Colombia

BackgroundFever without an apparent focus in children under 36 months is a frequent pathology. So far there is a knowledge gap about the characteristics of this entity in our setting.ObjectiveTo determine the prevalence of fever without an apparent focus in children less than 36 months of age, its causes and characteristics, and the practices toward this condition.MethodsA cross-sectional descriptive study at the Hospital Simón Bolívar in Bogotá between October 2007 and October 2008 was carried out, with patients under 36 months of age, with fever without an apparent source; it was not possible to establish the origin of fever after medical history and complete physical examination. Information regarding clinical and demographic characteristics, frequency and results of diagnostic and outcomes was obtained from medical records. Patients were classified according to the outcome into three groups: severe bacterial disease, benign focal infection, and possible viral infection.ResultsOn hundred and one patients (representing 1% of all pediatric visits per year) were analyzed. Mean age was 11.6 months, and 86% of patients were between 3 and 36 months old. Blood counts were obtained in 91% of patients, urine analysis in 86.1%, Gram of urine in 62.4%, and blood or urine cultures in 7.9% and 13.9%, respectively. Forty two patients had chest X-rays. The cause of fever without focus was distributed as follows: 68%, possible viral etiology; 25%, severe bacterial disease, and 7%, benign focal disease. Severe bacterial disease comprised urinary tract infection (11.9%), pneumonia of likely bacterial etiology (10.9%), and meningitis (1%).ConclusionsThis study is a first step for approaching this condition at local settings, and poses many challenges for future researchers