Return to Scenario ListShow Learning Points most relevant to Phase 1:

Febrile infant

Clinical Discipline(s)/Organ System(s)
Emergency Medicine, General Practice, Infectious Diseases, Paediatrics
Progress Test Topic(s)
Child health
A 6 month old Chinese/Samoan baby girl is brought in as she has a fever of 39°C. She has been unwell for 2 days, has a rapid pulse and has not had a wet nappy for 24 hours.
Progress Test-Type Questions:   Question 1 | Question 2
Applied Science for Medicine 
   - Common pathogens and microbiology of perinatal infection (differences between neonates and older infants/children)
   - Pharmacology of antibiotic activity: pharmacokinetics/pharmacodynamics
   - Physiology of fluid balance and blood gas
Clinical and Communication Skills 
   - Recognition of the acutely unwell child; knowledge of vital signs (pulse rate, respiratory rate) of children of differing age groups
   - Resuscitation, management of dehydration and sepsis
   - History and examination to distinguish serious bacterial infections from intercurrent viral infections; include antenatal history and 20-week anatomy ultrasound
   - Interpretation of blood cultures, cerebrospinal fluid and urine microbiology/dipstick
   - Awareness of differences in urine collection in children (catheter, suprapubic bladder aspirate)
   - Management of urinary tract infections in infants including investigation with further imaging
   - Recognise the signs and symptoms of vaccine preventable disease including but not limited to measles, mumps, pertussis and pneumococcal disease
   - Recognise rashes commonly associated with infection
   - Evaluation of prolonged fever or pyrexia of unknown origin
   - Managment and complications of meningitis
Personal and Professional Skills 
   - Communicate empathetically with child and caregivers
   - Consider the need for an interpreter
Hauora Māori 
   - Inequitable access to health care and the role of kaupapa Maori health services to improve access; telephone and travel access, remote community access if discharged
   - Unequal burden of infectious diseases on Māori
   - Acknowledgement of the disproportionate impact of illness on whānau employment/income, and therefore availability and models of caregiving
Population Health 
   - Epidemiology of pyrexia in infancy
   - Vaccination to prevent infectious disease in childhood and ability to check National Immunisation Register
   - Appropriate prescribing of antibiotics in the community
   - Wider health determinants for children’s health including poverty, overcrowding, poor housing
Conditions to be considered relating to this scenario
upper respiratory tract infection, acute otitis media, influenza, gastroenteritis, urinary tract infection, bacterial pneumonia
Less common but 'important not to miss'
encephalitis, meningitis, septicaemia, septic arthritis, osteomyelitis, measles, meningococcaemia
Kawasaki disease
Related Scenarios
[Unwell neonate]