788 FEBRILE SEIZDRES: NOT A BHNIGN EVENT

Abstract

While pediatricians have considered febrile seizures (FS) benign, recent literature shows a correlation between FS, outpatient baoteremia, and late meningitis. To study the overall morbidity of FS, 161 outpatient children from 2 months - 5 years were analyzed by complete blood count (CBC), blood culture (BC), and complete cerebrospinal fluid analysis (CSFA). Results: 9/161 positive BC (S. pneumoniae), 1 clinically unsuspected meningitis, 5 aseptic meningitities, and 1 late meningitis. 16/161 children febrile without source on initial exam had significant disease on re-evaluation done because of a positive CBC ( > 20,000 or > 20% band forms): 2 urinary tract infections, 9 pneumonias, 3 positive BC, 1 otitis media, and 1 adenitis. Diarrhea in 5 children with increased band forms indicated the “toxic shigella syndrome.” In 3 children with otitis media on initial exam, markedly abnormal CBC's correlated with a positive BC.

FS are not benign. 5.5% of children are bacteremic and 15-20% have clinically inapparent disease. A FS necessitates CSFA, CBC, and BC. Positive CBC's require re-evaluation, with possible chest X-ray and urinalysis. A minimum of 48 hours of intravenous therapy is required for children with a positive BC.

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