Duration of fever and course of symptoms in young febrile children presenting with uncomplicated illness

Purpose: it is important to advise parents when to consult a doctor when their child has fever. to provide evidence-based,safety-net advice for young febrile children,we studied the risk of complications,the occurrence of alarm symptoms,the duration of fever. methods: in a 7-day prospective follow-up study,we included 463 consecutive children aged 3 months to 6 years who presented with fever at a general practitioner out-of-hours service. we excluded 43 children with complicated illnesses at presentation. in a structured assessment,the duration of fever before presentation was noted and a physical examination was performed. parents reported alarming symptoms and rectal temperature in a diary for 1 week. the total duration of fever included its duration before presentation. median duration of fever was estimated using the kaplan-meier test. results: during follow-up,3.2% of the children with uncomplicated illness at presentation developed a complicated illness. the presence of alarming symptoms dropped from 79.3% at day 2 of the fever episode to 36.7% at day 9. the estimated median duration of the total fever episode was 4.0 days (95% confidence interval,3.6-4.4). conclusions: in children with uncomplicated illnesses,the daily occurrence of alarming symptoms reported by parents was high. the median duration of fever was 4 days. the predictive value of alarming symptoms reported by parents for complicated illness should be reconsidered. (j am board fam med 2013;26:445- 452.).