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Editorial: Further Comments on the Evaluation of Febrile Children

In a recent review in PIR, a sequence for the clinical and laboratory evaluation of Children 24 months with high fever was detailed.¹ A key skill in assessing febrile children was described and termed "optimal observation." This assessment is performed prior to physical examination and, combined with laboratory evaluation, supplements data gathered from the physical examination. The review stimulated many comments from readers who questioned the need for such a vigorous approach. This interest is not surprising since fever in the young child is a common pediatric problem and also a diagnostic challenge.

Most discussion focused on three issues: (1) the occurrence of bacteremia in patients seen in private practice: most practitioners doubt that it occurs as frequently among private patients as among clinic patients; (2) the cost of a laboratory evaluation of a young, febrile child; (3) the data on which optimal assessment is based.