Relative importance of bacteremia and viremia in the course of acute fevers of unknown origin in outpatient children

During a 12-month period 80 children >3 months of age seen at an emergency room with acute fevers ≥39.7 C (103.5 F) and no localizing signs of infection were studied using blood and buffy coat cultures to isolate bacteria and viruses. Bacteremia was identified in three children (3.8%): two with Streptococcus pneumoniae and one with Neisseria meningitidis. Two children with viremia were identified: both isolates were ECHO virus, types 11 and 21, respectively. Fifty-eight of the study children (72%) were seen again in 24 to 48 hours and 27/58 (46%) were afebrile and completely well. No differences in sex, age or initial WBC count existed among those children who returned afebrile and well and those with either localized disease or those persistently febrile.