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, Pour mémoire, les signes de gravité chez un enfant fébrile sont neurologiques (trouble de conscience), hémodynamiques (tachycardie et hypoperfusion périphérique), respiratoires (polypnée, désaturation), cutanés (purpura > 3 mm, extensif

, Les antécédents doivent également être pris en compte (cardiopathie ou autre malformation congénitale, maladie métabolique, hypotrophie, prématurité?)

. Le-choix-de-l'âge-;-mois-ici)-est-discuté-par and . Gomez, Les auteurs incitent pourtant à la prudence avec ce choix, ce qui nous a fait proposer ici plutôt 1 mois. Il n'y a pas de spécificité propre aux infections néonatales précoces ni tardives, puisque dans tous les cas, il faut documenter l'infection par une hémoculture, un examen cytobactériologique des urines (ECBU) et une ponction lombaire (PL) selon les cas, un traitement probabiliste par céphalosporine de troisième génération (C3G) étant adapté aux infections à streptocoque B comme celles à Escherichia coli

, Les recommandations du Groupe de pathologie infectieuse pédiatrique (GPIP) sont en faveur de l'utilisation de la bandelette urinaire chez l'enfant âgé de plus de 1 mois, vol.4

, Compte tenu de la proportion importante d'enfants consultant pour des fièvres évoluant depuis moins de 6 heures (54 % avant 1 mois et 43 % avant 3 mois dans l'étude au CHU de Nantes), la performance diagnostique des biomarqueurs peut être diminuée, justifiant de proposer une observation hospitalière et/ou un second dosage sanguin à distance selon la situation clinique