Investigation of the Febrile Child

A Blood culture
B Urine culture
C Chest x-ray
D Throat swab
E Stool culture
F Stool electron microscopy
G Lumbar puncture
H CT brain
I Culture of joint aspirate
J ESR
K C-reactive protein
L EEG

For each of the following patients choose the SINGLE most discriminating
investigation in the acute management from the above list of options. Each option
may be used once, more than once or not at all.

1 A 3 year old girl is febrile & has been unwell for 12 hours. She complains
of a headache & is drowsy but otherwise neurologically intact.

2 A 2 month old child has had a fever & cough for 3 days. He is
tachypnoeic with grunting & has nasal flaring.

3 A 3 year old has had a high fever & sore throat for 2 days. This evening
he had a generalised convulsion lasting 2 minutes. He is now drowsy but
rousable with no localising signs.

4 An 8 year old has developed a painful, swollen knee over the last day. On
examination, there is a tender, warm effusion of the left knee. She also has
a pyrexia of 380C.

5 A 12 month old boy has a 24 hour history of profuse diarrhoea &

irritability. He has a low grade fever.

GCDIE