Finding the fever

Jed is a thriving 8 month old brought in by his parents with a fever of 38.8oC; he’s tachycardic and grumpy. His fever began twelve hours ago, and aside from crankiness, he is otherwise well. He is fully immunised and there are no sick contacts at home. You get a call from your Mixed Emergency…

Needing a Diagnostic Kick-start

A 4 year-old boy has been brought to the emergency department by his worried parents. He has had fevers for the past 6 days. They are concerned because he is not getting better despite repeated visits to a number of doctors. Each time they were told he had a viral illness.

Empiric antibiotics for general infection

Age if meningitis excluded if meningitis is NOT excluded if Staphylococcus aureus suspected < 3 months Amoxicillin 50 mg/kg q6hrGentamycin 7.5 mg/kg q24hr Amoxicillin 50 mg/kg q6hrGentamycin 7.5 mg/kg q24hr Cefotaxime 50 mg/kg q6hr Consider especially in infants aciclovir 20mg/kg q8hr Amoxicillin 50 mg/kg q6hrCefotaxime 50 mg/kg q6hr Vancomycin 15 mg/kg q6hr Clindamycin 15 mg/kg…

Febrile neutropenia

You’re working as the paeds reg overnight at a regional centre when ED phones you about an incoming patient – Josef, 8 – who’s in a delayed intensification cycle of his treatment for ALL and has a fever of 38.6oC. Josef’s last chemotherapy was last week, and an FBC done 2 days ago showed WCC…