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@article{van:2023:10.1007/s00431-022-04642-1,
author = {van, der Velden FJS and de, Vries G and Martin, A and Lim, E and von, Both U and Kolberg, L and Carrol, ED and Khanijau, A and Herberg, JA and De, T and Galassini, R and Kuijpers, TW and Martinon-Torres, F and Rivero-Calle, I and Vermont, CL and Hagedoorn, NN and Pokorn, M and Pollard, AJ and Schlapbach, LJ and Tsolia, M and Elefhteriou, I and Yeung, S and Zavadska, D and Fink, C and Voice, M and Zenz, W and Kohlmaier, B and Agyeman, PKA and Usuf, E and Secka, F and de, Groot R and Levin, M and van, der Flier M and Emonts, M},
doi = {10.1007/s00431-022-04642-1},
journal = {European Journal of Pediatrics},
pages = {543--554},
title = {Febrile illness in high-risk children: a prospective, international observational study},
url = {http://dx.doi.org/10.1007/s00431-022-04642-1},
volume = {182},
year = {2023}
}

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TY  - JOUR
AB  - To assess and describe the aetiology and management of febrile illness in children with primary or acquired immunodeficiency at high risk of serious bacterial infection, as seen in emergency departments in tertiary hospitals. Prospective data on demographics, presenting features, investigations, microbiology, management, and outcome of patients within the ‘Biomarker Validation in HR patients’ database in PERFORM, were analysed. Immunocompromised children (< 18 years old) presented to fifteen European hospitals in nine countries, and one Gambian hospital, with fever or suspected infection and clinical indication for blood investigations. Febrile episodes were assigned clinical phenotypes using the validated PERFORM algorithm. Logistic regression was used to assess the effect size of predictive features of proven/presumed bacterial or viral infection. A total of 599 episodes in 482 children were analysed. Seventy-eight episodes (13.0%) were definite bacterial, 67 episodes probable bacterial (11.2%), and 29 bacterial syndrome (4.8%). Fifty-five were definite viral (9.2%), 49 probable viral (8.2%), and 23 viral syndrome (3.8%). One hundred ninety were unknown bacterial or viral infections (31.7%), and 108 had inflammatory or other non-infectious causes of fever (18.1%). Predictive features of proven/presumed bacterial infection were ill appearance (OR 3.1 (95% CI 2.1–4.6)) and HIV (OR 10.4 (95% CI 2.0–54.4)). Ill appearance reduced the odds of having a proven/presumed viral infection (OR 0.5 (95% CI 0.3–0.9)). A total of 82.1% had new empirical antibiotics started on admission (N = 492); 94.3% proven/presumed bacterial (N = 164), 66.1% proven/presumed viral (N = 84), and 93.2% unknown bacterial or viral infections (N = 177). Mortality was 1.9% (N = 11) and 87.1% made full recovery (N = 522).
AU  - van,der Velden FJS
AU  - de,Vries G
AU  - Martin,A
AU  - Lim,E
AU  - von,Both U
AU  - Kolberg,L
AU  - Carrol,ED
AU  - Khanijau,A
AU  - Herberg,JA
AU  - De,T
AU  - Galassini,R
AU  - Kuijpers,TW
AU  - Martinon-Torres,F
AU  - Rivero-Calle,I
AU  - Vermont,CL
AU  - Hagedoorn,NN
AU  - Pokorn,M
AU  - Pollard,AJ
AU  - Schlapbach,LJ
AU  - Tsolia,M
AU  - Elefhteriou,I
AU  - Yeung,S
AU  - Zavadska,D
AU  - Fink,C
AU  - Voice,M
AU  - Zenz,W
AU  - Kohlmaier,B
AU  - Agyeman,PKA
AU  - Usuf,E
AU  - Secka,F
AU  - de,Groot R
AU  - Levin,M
AU  - van,der Flier M
AU  - Emonts,M
DO  - 10.1007/s00431-022-04642-1
EP  - 554
PY  - 2023///
SN  - 0340-6199
SP  - 543
TI  - Febrile illness in high-risk children: a prospective, international observational study
T2  - European Journal of Pediatrics
UR  - http://dx.doi.org/10.1007/s00431-022-04642-1
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000868375100001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
UR  - https://link.springer.com/article/10.1007/s00431-022-04642-1
UR  - http://hdl.handle.net/10044/1/106581
VL  - 182
ER  -

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