Impact of the Rapid Influenza Test on Evaluation of the Febrile Child in the Emergency Setting

The ability to diagnose viral infections has improved substantially in recent years, and rapid testing for viral infection is considered an option in the emergency setting. The most available and practical point-of-care test for viral infection is the test for influenza. Studies in febrile infants and children reveal a substantial reduction in the rates for bacteremia, urinary tract infection, and meningitis in infants with a known viral infection. This knowledge has led the clinician to develop a modified approach to evaluating the febrile infant with a viral infection. Infants who test positive for influenza may be considered at very low risk for serious bacterial infection and may not require extensive testing and empiric antibiotics. The role of vaccination policies for pneumococcal infection and influenza is further explored as it impacts on this practice.