A Novel Framework for Phenotyping Children With Suspected or Confirmed Infection for Future Biomarker Studies

Journal article

Funding Information: This project received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement no. 668303. The research was supported by the National Institute for Health Research Biomedical Research Centres at Imperial College London, Newcastle Hospitals NHS Foundation Trust and Newcastle University. Publisher Copyright: © 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.AIM: This study investigated febrile children with petechial rashes who presented to European emergency departments (EDs) and investigated the role that mechanical causes played in diagnoses. METHODS: Consecutive patients with fever presenting to EDs in 11 European emergency departments in 2017-2018 were enrolled. The cause and focus of infection were identified and a detailed analysis was performed on children with petechial rashes. The results are presented as odds ratios (OR) with 95% confidence intervals (CI). RESULTS: We found that 453/34,010 (1.3%) febrile children had petechial rashes. The focus of the infection included sepsis (10/453, 2.2%) and meningitis (14/453, 3.1%). Children with a petechial rash were more likely than other febrile children to have sepsis or meningitis (OR 8.5, 95% CI 5.3-13.1) and bacterial infections (OR 1.4, 95% CI 1.0-1.8) as well as need for immediate life-saving interventions (OR 6.6, 95% CI 4.4-9.5) and intensive care unit admissions (OR 6.5, 95% CI 3.0-12.5). CONCLUSION: The combination of fever and petechial rash is still an important warning sign for childhood sepsis and meningitis. Ruling out coughing and/or vomiting was insufficient to safely identify low-risk patients.publishersversionPeer reviewe

Authors: Nijman, RG; Oostenbrink, R; Moll, HA; Casals-Pascual, C; von Both, U

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Frontiers Media
• Journal: Frontiers in Pediatrics
• Volume: 9
• Pages: 688272-688272
• Article number: 688272
• Publication date: 2021-07-28
• DOI: 10.3389/fped.2021.688272
• EISSN: 2296-2360
• ISSN: 2296-2360
• Language: English
• Keywords: Internal medicine; Receiver operating characteristic; Biomarker; Prospective cohort study; Procalcitonin; Emergency department; Sepsis; Medicine