What have we learned today?

#PEMTweetsID Q10: What is the most common cause of a temperature >38 C in infants age 1-3 months presenting to the ED?
Viral syndrome at 54% is far and away the #1 cause

#PEMTweetsID Q11: When fever rises about what temperature (centigrade) does the risk of bacteremia increase four fold?
40 C has a risk of 38%, <40 the risk is only 8.8% as noted in http://www.ncbi.nlm.nih.gov/pubmed/15874809

#PEMTweetsID Q12: What is the most common cause of bacterial sepsis in newborns?Group B strep

#PEMTweetsID Q13: How do the bacteria that cause preseptal vs orbital cellulitis differ?Preseptal is usually secondary to extension from local skin infections or direct trauma. Spread form the ethmoid sinus can occur. Staph and Strep species predominate. Treat with MRSA coverage.


Orbital cellulitis extends most typically from the sinuses (75%) S pneumo and Moraxella. These patients need IV therapy - Ceftriaxone or Cefotaxime.

#PEMTweetsID Q14: What is ophthalmia neonatorum?neonatal conjunctivitis occurring in the first month. It can be concerning for gonorrhea, chlamydia, HSV and other bacterial organisms.Gonorrhea usually occurs 24-48 hours after birth whereas chlamydia starts slower within the first 3 weeks.

#PEMTweetsID Q15: A 2 year old with high fever, difficulty swallowing, who won’t look up with the following XRay likely has what? This is a classic XRay for a retropharyngeal cellulitis or abscess. The prevertebral space is greater than one half the width of the vertebral body. Current evidence suggests that most of these kids can be initially treated with IV antibiotics, even if a phlegmon or early abscess is present.