What is the likelihood of positive blood cultures in children with fever and acute lower extremity pain?
In children with acute lower extremity pain not due to trauma, blood cultures will be positive in approximately 1 in 7 (13.7%).
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This study determined the diagnostic yield of blood cultures obtained from 689 children aged 1 to 18 years (median age 5.3 years) who presented to an emergency department with fever and acute (< 14 days; median 2 days) lower extremity pain not due to trauma. The study was conducted in a single pediatric emergency department in Lebanon. Of these children, 76% had blood cultures, which were positive in 13.7% (95% CI 10.9 - 17.0). The most common pathogens were Staphylococcus aureus (71.6%) and methicillin-susceptible S. aureus (15.7%). Localized physical examination findings, such as body tenderness or clinical arthritis, were present in a majority of patients and were also predictive of bacteremia.
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine