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Mon bébé a de la fièvre

1ère Consultation

Vous avez répondu NON à toutes les questions essentielles


1. Le traitement symptomatique

Vous pouvez vous permettre de donner un traitement symptomatique de la fièvre, sans pratiquer d’investigations et sans donner d’antibiotiques. 3 Le diagnostic de présomption est celui d’une affection virale, qui doit être confirmé par l’évolution favorable spontanée sous surveillance. Il n’y a pas lieu d’hospitaliser l’enfant.

  traitement symptomatique


 Vous devez revoir l’enfant chaque jour pour vous assurer que la situation ne s’aggrave pas. Vous devez demander aux parents de consulter en urgence si un élément nouveau apparaît (altération de l’état de conscience, lésions cutanées).


1Krauss BS, Harakal T, Fleischer GR. The spectrum and frequency of illness presenting to a pediatric emergency department. Pediatr Emerg Care 1991; 7:67-71


2Slater M, Krug SE. Evaluation of the infant with fever without source: an evidence based approach. Emerg Med Clin N Amer 1999; 17:97-126


3Teele DW, Pelton SI, Grant MJA, et al. Bacteremia in febrile children under two years of age : Results of cultures of blood of 600 consecutive febrile children seen in a « walk-in » clinic. J Pediatr. 1975; 87:227-230


4Baraff LJ, Oslund S, Schriger DL, Stephen ML. Probability of bacterial infections in infants less than three months of age: a meta-analysis Pediatr Infect Dis J 1992; 11:257-265


5McCarthy PL, Sharpe MR, Spiesel et al. Observation scales to identify serious illness in febrile children. Pediatrics 1982;70:802-809.


6Jaffe DM, Fleisher GR. Temperature and total white blood cell counts as indicators of bacteremia. Pediatrics 1991; 87:670-674.


7Hamoudi AC, Bubis SC, Thompson C. Can the cost savings of eliminating urine microscopy in biochemically negative urines be extended to the pediatric population ? Am J Clin Pathol 1986; 86:658-660.


8 M Caflisch. La protéine C-réactive et l’état fébrile sans foyer chez l’enfant de moins de 24 mois. Med Hyg 2000;58:366-370.


9Galetto Lacour A, Zamora S A, Gervaix A. Bedside procalcitonin and C-reactive protein tests in children with fever without localizing signs of infection seen in a referral center. Pediatrics 2003; 112:1054.


10Van Rossum AMC, Wulkan RW, Oudesluys-Murphy AM. Procalcitonin as an early marker of infection in neonates and children. The Lancet infectious diseases 2004; 4:620-630.


11 Gervaix A. Valeurs et interprétations des marqueurs biologiques d’infection bactérienne aux urgences » dans « Fièvre et urgences» Editions Scientifiques L&C, Paris, 2006 chapitre 23, p 345-357


12Baraff LJ, Bass JW, Fleisher GR et al. Practice guideline for the management of infants and children 0 to 36 months of age with fever without source. Pediatrics 1993; 82:1-12.


13Stoll ML, Rubin LG. Incidence of occult bacteremia among highly febrile joung children in the era of the pneumococcal conjugate vaccine: a study from a Children’s Hospital Emergency Department and Urgent Care Center. Arch Pediatr Adolesc Med 2004; 158(7):671-5.


14Herz AM, Greenhow TL, Alcantara J, Hansen J, Baxter RP, Black SB, Shinefield HR. Changing epidemiology of outpatient bacteremia in 3- to 36-month-old children after the introduction of the heptavalent-conjugated pneumococcal vaccine. Pediatr Infect Dis J 2006; 25(4):293-300.


15Galetto Lacour A, Gervaix A, Zamora SA, Vadas L, Lombard PR, Dayer JM, Suter S. Procalcitonin, IL-6, IL-8, IL-1 receptor antagonist and C-reactive protein as identificators of serious bacterial infections in children with fever without localising signs. Eur J of Ped 2001 ; 160(2) :95-100.