Presentation

Fever

Key Conditions

Key conditions are the core conditions that the Paediatric Undergraduate and Clerkship Directors of Canada (PUPDOC) felt are essential for graduating medical students to know. The Key Conditions are neither a differential diagnosis nor a clinical approach. They highlight conditions that may be unique to paediatrics, that are essential, or that are common. Key Conditions can present in a number of ways – each is listed as under the most common Clinical Presentation.

Clinical Approach

Clinical approaches represent one of many methods to think through a clinical presentation, and narrow down a differential diagnosis. There are many conditions that can present with similar symptomatology. These presentations are not meant to contain an exhaustive list of differential diagnoses, but rather outline how to think through patient signs and symptoms, and understand some of the most common and important Paediatric conditions. There are many different ways to approach any clinical presentation, and these approaches are not meant to replace clinical judgement.

Vignette

A 3 year old girl is brought to the emergency department due to 4 days of fever

Diagrams

Pre-Clerkship

Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.

Lectures

Small Groups

  • Pediatric Infectious Diseases Small Group Course 6
  • Pediatric Nephrology Small Group Course 6
  • Headache and CNS infections Course 5

Clerkship

Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.

Objectives

By the end of the Paediatric Clerkship, a medical student will be able to:

  1. Propose a differential diagnosis and an investigation and management plan for febrile patients in the following age groups: Less than 1 month old 1-3 months old Greater than 3 months old.
  2. Clinically recognize and propose an investigation and management plan for patients with: Kawasaki disease, meningitis, ocult bacteremia / sepsis, and urinary tract infection.
  3. List common viruses that cause fever in paediatric patients.

Half Day Cases

  • A 4 year old boy presents with a 6 day history of fever, conjunctivitis, and irritability.
  • A 2 year old girl presents with a 2 day history of fever and a sore ear.
  • A 6 year old boy presents with a 1 day history of fever and sore throat.
  • A 6 year old girl presents with an acute history of fever and a swollen right eye.

Resources

The following resources have been reviewed and collated by canuc-paeds. These resources are aimed to provide information at the level of the medical student. These include overviews of topics, clinical resources, and useful guidelines that contain relevant materials.

Papers 

  • Meningitis. Mann, K et al. .
    Pediatrics in Review 2008; 29(12): 417-430.
    Overview on bacterial, viral, TB and fungal meningitis, management, complications and long term sequelae.
  • Kawasaki Disease. Son MB et al. .
    Pediatrics in Review 2013; 34(4): 151-162. .
    Overview article on Kawasaki disease, manifestations, differential diagnosis, treatment, cardiac complications- good pictures and tables. .
  • Urinary tract infection: Clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months.
    Pediatrics 2011; 128(3): 595-610. .
    Clinical practice guideline from the Subcommittee on UTI, steering committee on quality improvement and management. .

Videos 

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Last updated 08 August 2021.