Red Flags for Serious Infection in Children Highlighted

Parental concern, doctor's instinct and clinical symptoms all play a role
By Jane Parry
HealthDay Reporter

WEDNESDAY, Feb. 3 (HealthDay News) -- Cyanosis, rapid breathing and poor peripheral circulation are all significant red flags for serious infection in children in developed country settings, while physicians' instinct and parental concern also play a role, according to a review published online Feb. 3 in The Lancet.

Ann Van den Bruel, M.D., of the Katholieke Universiteit Leuven in Belgium, and colleagues analyzed 30 studies that assessed the clinical features of serious infection to identify the most significant red flags for a serious infection in a developed country setting.

Several studies identified cyanosis, rapid breathing, poor peripheral perfusion and petechial rash as significant clinical features indicating serious illness, the researchers found. In addition, doctor's instinct and parental concern were highlighted by one primary care study, while in situations where there is a low prevalence of serious infection, fever at or above 40 degrees Celcius was a valuable red flag, the investigators note.

"Most of the red flags already recommended by the World Health Organization for use in developing countries can be used in the initial assessment of children presenting to ambulatory care settings in developed countries. There should be more emphasis on parental concern in the diagnostic process," the authors write. "The relative inability of any combination of clinical features to effectively exclude the possibility of serious illness in a one-off consultation means that parents need to be more actively involved in monitoring red flags and taking precautionary measures."

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