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GPs should 'listen to parent's concerns' on child infections

By Yvette Martyn

GPs should consider parent's concerns over their child's behaviour and their own instinct when diagnosing serious childhood infections, says a new analysis.

The systematic review - published in the Lancet today - identified clinical features that could confirm or exclude serious infection in children who present to general practice.

They did not find any one feature that could rule-out a serious infections, but did generate a set of red flags could aid general practitioners in their diagnosis of serious infections in children.

The British and Belgian researchers analysed 30 studies and found cyanosis, rapid breathing, poor peripheral perfusion and petechial rash were red flags in several studies. They also said that 'parental concern' over their child's behaviour and doctor's 'instinct' were important diagnostic features. A temperature above 40ºc was found to be useful in general practice.

Despite this, the study authors warned that relying on these factors alone could miss some serious infections. They found that parental concern was absent in 46.4% of serious infection and poor peripheral circulation absent in 90%.

Lead author, Dr Ann Van den Bruel, professor of general practice, Katholieke Universiteit Leuven, Belgium said: ‘The red flags for serious infection that we identified should be used routinely, but serious illness will still be missed without effective use of precautionary measures.'

And added: ‘Early and accurate diagnosis of serious infection in children is essential to reduce morbidity and mortality.'

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