The Epidemiology of Co-Infections in Febrile Children Younger Than 5-Years-old in Emergency Department; A Cross-Sectional Hospital -Based Study

Background Fever is one of the most common causes of children's referral to pediatric emergency department (ED), and almost 20% of General ED referrals relate to febrile children. When it comes to febrile pediatrics patients, co-infection is a very important issue to discuss. This topic has been considered in current literature so, we considered to examine the epidemiology of these co-infections in febrile children younger than 5 years in emergency department. Materials and Methods: This cross-sectional study was carried out retrospectively with the enrollment of children younger than 5-years-old (accessible sampling) in the emergency department of Mofid Hospital, Tehran, Iran, during November 2017 to December 2018. After designing and completing a check list. Results: Totally, 388 patients with the mean age of 25.4 +/- 12.4 months were studied (51.5% Girl). The source of infection was unclear after using all of the diagnostic tools in 27.5% of cases. Based on the findings fever-associated diarrhea (132 patients, 46.9%), and cellulitis (1 patient, 0.4%) were the most and least frequent source of infections, respectively. The co-incidence of different source of infections showed that the most frequent co-infections were sepsis and UTI; otitis and UTI; pneumonia and UTI; pneumonia and URI; and sepsis and otitis. Conclusion It seems that co-infections have been significantly increased in girls and in the age range of 6-36 months. The most and least prevalent infections were fever-associated diarrhea and cellulitis among the patients with at least one type of infection. The co-incidence of different source of infection showed that the most frequent co-infection were sepsis and UTI; otitis and UTI: pneumonia and UTI; pneumonia and URI: and sepsis and otitis.