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Review Spotlights Clues to Serious Childhood Infection

Signs may not be recognized because they are rare in developed countries, authors say

THURSDAY, Feb. 4 (HealthDay News) -- Rapid breathing, poor blood circulation and, possibly, parental concern and a doctor's instinct are potential warning signs of serious infection among children in developed countries, according to a review of published research.

The researchers analyzed the findings of 30 studies assessing clinical features of serious infection in children and found that cyanosis (blue skin resulting from lack of oxygen), rapid breathing, poor blood circulation and petechial rash (small purple/red spots) were identified as red flags in several of the studies.

One study said parental concern and a doctor's instinct were strong warning signs.

"The main strength of this systematic review is that it highlights the nature and difficulty of the diagnostic task facing primary care and hospital clinicians responsible for identifying seriously ill children at initial presentation in countries where serious childhood illness is now rare," wrote Dr. Ann Van den Bruel, of the department of general practice at Katholieke Universiteit Leuven, Belgium, and colleagues.

"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," they concluded.

"However, we now need to identify the level of risk at which clinical action should be taken. Additionally, 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," the authors wrote.

The review is published in the Feb. 3 online edition of The Lancet.

"What is clear is that in 2010 we do not know how to effectively recognize or rule out severe disease in ill children and what is more, we do not even have a cohesive national or a global research strategy to address this problem. Notably, of the 30 studies included in today's review, only one was in primary care, where the problem is most frequently present," Dr. Martin Dawes of McGill University in Montreal, Canada, wrote in an accompanying editorial.

More information

The Nemours Foundation has more about children and infections.

-- Robert Preidt

SOURCE: The Lancet, news release, Feb. 2, 2010

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