{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:01:22Z","timestamp":1760745682068,"version":"build-2065373602"},"reference-count":59,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","theclinics.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Emergency Medicine Clinics of North America"],"published-print":{"date-parts":[[2025,11]]},"DOI":"10.1016\/j.emc.2025.06.012","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T20:11:33Z","timestamp":1756152693000},"page":"697-714","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fever in the Not-So-Typical Pediatric Patient"],"prefix":"10.1016","volume":"43","author":[{"given":"Amanda D.","family":"Russo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dane","family":"Nickel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew D.","family":"Thornton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"issue":"4","key":"10.1016\/j.emc.2025.06.012_bib1","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1179\/acb.2006.027","article-title":"Spectrum and frequency of illness presenting to a pediatric emergency department","volume":"61","author":"Massin","year":"2006","journal-title":"Acta Clin Belg"},{"key":"10.1016\/j.emc.2025.06.012_bib2","series-title":"StatPearls [Internet]","first-page":"1","article-title":"Physiology, fever","author":"Balli","year":"2024"},{"issue":"4","key":"10.1016\/j.emc.2025.06.012_bib3","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofz032","article-title":"Normal body temperature: a systematic review","volume":"6","author":"Geneva","year":"2019","journal-title":"Open Forum Infect Dis"},{"year":"2024","series-title":"Data and statistics on sickle cell disease","key":"10.1016\/j.emc.2025.06.012_bib4"},{"issue":"4","key":"10.1016\/j.emc.2025.06.012_bib5","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2022-061061","article-title":"BACT-SPRING study group; invasive bacterial infections in children with sickle cell disease: 2014\u20132019","volume":"152","author":"Gaschignard","year":"2023","journal-title":"Pediatrics"},{"issue":"9","key":"10.1016\/j.emc.2025.06.012_bib6","article-title":"Causes and recommendations for fever in sickle cell pediatric patients in the emergency department: a single-center study","volume":"15","author":"Halwani","year":"2023","journal-title":"Cureus"},{"issue":"6","key":"10.1016\/j.emc.2025.06.012_bib7","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2023.18837","article-title":"Fever in children with sickle cell disease\u2014rethinking the approach when bacteremia is rare","volume":"6","author":"Noronha","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"1","key":"10.1016\/j.emc.2025.06.012_bib8","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2021-051892","article-title":"Bloodstream infections in children with sickle cell disease: 2010-2019","volume":"149","author":"Yee","year":"2022","journal-title":"Pediatrics"},{"issue":"1","key":"10.1016\/j.emc.2025.06.012_bib9","doi-asserted-by":"crossref","first-page":"e2","DOI":"10.1016\/j.ijid.2009.03.010","article-title":"Infection in sickle cell disease: a review","volume":"14","author":"Booth","year":"2010","journal-title":"Int J Infect Dis"},{"issue":"6","key":"10.1016\/j.emc.2025.06.012_bib10","first-page":"37","article-title":"Evidence-based management of sickle cell disease: expert panel report, 2014","volume":"134","year":"2014","journal-title":"Pediatrics"},{"key":"10.1016\/j.emc.2025.06.012_bib11","unstructured":"Ellison A, Witmer C, Lavelle J, et al, Sickle cell disease with fever clinical pathway - emergency department. Clinical Pathways Team, editor. Children's Hospital of Philadelphia. 2010. Available at: pathways.chop.edu (Revised November 2024)."},{"issue":"11","key":"10.1016\/j.emc.2025.06.012_bib12","doi-asserted-by":"crossref","DOI":"10.1002\/pbc.27379","article-title":"Outcomes of febrile events in pediatric patients with sickle cell anemia","volume":"65","author":"Sirigaddi","year":"2018","journal-title":"Pediatr Blood Cancer"},{"key":"10.1016\/j.emc.2025.06.012_bib13","doi-asserted-by":"crossref","DOI":"10.1155\/2018\/1739831","article-title":"Pediatric adrenal insufficiency: diagnosis, management, and new therapies","volume":"2018","author":"Bowden","year":"2018","journal-title":"Int J Pediatr"},{"key":"10.1016\/j.emc.2025.06.012_bib14","doi-asserted-by":"crossref","first-page":"47","DOI":"10.2147\/TCRM.S294065","article-title":"Pediatric adrenal insufficiency: challenges and solutions","volume":"18","author":"Nistic\u00f2","year":"2022","journal-title":"Ther Clin Risk Manag"},{"issue":"9","key":"10.1016\/j.emc.2025.06.012_bib15","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/j.tips.2013.07.003","article-title":"Glucocorticoid receptor signaling in health and disease","volume":"34","author":"Kadmiel","year":"2013","journal-title":"Trends Pharmacol Sci"},{"issue":"2","key":"10.1016\/j.emc.2025.06.012_bib16","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.jemermed.2022.06.005","article-title":"Diagnosis and management of adrenal insufficiency and adrenal crisis in the emergency department","volume":"63","author":"Lentz","year":"2022","journal-title":"J Emerg Med"},{"key":"10.1016\/j.emc.2025.06.012_bib17","first-page":"25","article-title":"Hypothalamic-pituitary-adrenal insufficiency","volume":"vol. 17","author":"Zaloga","year":"2001"},{"key":"10.1016\/j.emc.2025.06.012_bib18","series-title":"StatPearls Internet","first-page":"1","article-title":"Adrenal crisis","author":"Elshimy","year":"2024"},{"key":"10.1016\/j.emc.2025.06.012_bib19","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s13052-023-01475-y","article-title":"Adrenal insufficiency management in the pediatric emergency setting and risk factors for adrenal crisis development","volume":"49","author":"Abrigo","year":"2023","journal-title":"Ital J Pediatr"},{"issue":"9","key":"10.1016\/j.emc.2025.06.012_bib20","doi-asserted-by":"crossref","first-page":"81","DOI":"10.3390\/children4090081","article-title":"Fever in children: pearls and pitfalls","volume":"4","author":"Barbi","year":"2017","journal-title":"Children"},{"issue":"1","key":"10.1016\/j.emc.2025.06.012_bib21","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1136\/jim-2019-000999","article-title":"Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings","volume":"68","author":"Miller","year":"2020","journal-title":"J Invest Med"},{"issue":"5","key":"10.1016\/j.emc.2025.06.012_bib22","doi-asserted-by":"crossref","first-page":"393","DOI":"10.3390\/pathogens13050393","article-title":"Medical device-associated biofilm infections and multidrug-resistant pathogens","volume":"13","author":"Bouhrour","year":"2024","journal-title":"Pathogens"},{"issue":"2","key":"10.1016\/j.emc.2025.06.012_bib23","doi-asserted-by":"crossref","first-page":"277","DOI":"10.3201\/eid0702.010226","article-title":"Biofilms and device-associated infections","volume":"7","author":"Donlan","year":"2001","journal-title":"Emerg Infect Dis"},{"issue":"2","key":"10.1016\/j.emc.2025.06.012_bib24","doi-asserted-by":"crossref","first-page":"179","DOI":"10.2165\/00003495-200565020-00003","article-title":"Infections associated with medical devices: pathogenesis, management and prophylaxis","volume":"65","author":"von Eiff","year":"2005","journal-title":"Drugs"},{"issue":"1151","key":"10.1016\/j.emc.2025.06.012_bib25","doi-asserted-by":"crossref","DOI":"10.1259\/bjr.20220894","article-title":"Central venous catheters: which, when and how","volume":"96","author":"Kehagias","year":"2023","journal-title":"Br J Radiol"},{"key":"10.1016\/j.emc.2025.06.012_bib26","series-title":"StatPearls [Internet]","article-title":"Vascular tunneled central catheter access","author":"Flick","year":"2025"},{"issue":"3","key":"10.1016\/j.emc.2025.06.012_bib27","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0282290","article-title":"Risk factors of catheter- associated bloodstream infection: systematic review and meta-analysis","volume":"18","author":"Lafuente Cabrero","year":"2023","journal-title":"PLoS One"},{"issue":"5","key":"10.1016\/j.emc.2025.06.012_bib28","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1001\/jamapediatrics.2013.775","article-title":"Risk factors for peripherally inserted central venous catheter complications in children","volume":"167","author":"Jumani","year":"2013","journal-title":"JAMA Pediatr"},{"issue":"12","key":"10.1016\/j.emc.2025.06.012_bib29","first-page":"1","article-title":"Management of fever and suspected infection in pediatric patients with central venous catheters","volume":"12","author":"Brennan","year":"2015","journal-title":"Pediatr Emerg Med Pract"},{"issue":"1","key":"10.1016\/j.emc.2025.06.012_bib30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1086\/599376","article-title":"Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America","volume":"49","author":"Mermel","year":"2009","journal-title":"Clin Infect Dis"},{"key":"10.1016\/j.emc.2025.06.012_bib31","first-page":"18","article-title":"Pharmacology of shunt infections","volume":"4","author":"Benner","year":"2014","journal-title":"US Pharm"},{"issue":"12","key":"10.1016\/j.emc.2025.06.012_bib32","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.3346\/jkms.2012.27.12.1563","article-title":"Incidence and risk factors of ventriculoperitoneal shunt infections in children: a study of 333 consecutive shunts in 6 years","volume":"27","author":"Lee","year":"2012","journal-title":"J Korean Med Sci"},{"issue":"7","key":"10.1016\/j.emc.2025.06.012_bib33","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1086\/368191","article-title":"Risk factors for pediatric ventriculoperitoneal shunt infection and predictors of infectious pathogens","volume":"36","author":"McGirt","year":"2003","journal-title":"Clin Infect Dis"},{"issue":"6","key":"10.1016\/j.emc.2025.06.012_bib34","doi-asserted-by":"crossref","first-page":"e34","DOI":"10.1093\/cid\/ciw861","article-title":"2017 infectious diseases society of America\u2019s clinical practice guidelines for healthcare-associated ventriculitis and meningitis","volume":"64","author":"Tunkel","year":"2017","journal-title":"Clin Infect Dis"},{"issue":"3","key":"10.1016\/j.emc.2025.06.012_bib35","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/00005082-199204000-00004","article-title":"An overview of artificial heart valve replacement in infants and children","volume":"6","author":"Tong","year":"1992","journal-title":"J Cardiovasc Nurs"},{"issue":"7","key":"10.1016\/j.emc.2025.06.012_bib36","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1136\/hrt.2003.025049","article-title":"Management and follow up of prosthetic heart valves","volume":"90","author":"Seiler","year":"2004","journal-title":"Heart"},{"issue":"15","key":"10.1016\/j.emc.2025.06.012_bib37","doi-asserted-by":"crossref","first-page":"4941","DOI":"10.3390\/jcm12154941","article-title":"Infective endocarditis among pediatric patients with prosthetic valves and cardiac devices: a review and update of recent emerging diagnostic and management strategies","volume":"12","author":"Dardari","year":"2023","journal-title":"J Clin Med"},{"issue":"11","key":"10.1016\/j.emc.2025.06.012_bib38","doi-asserted-by":"crossref","first-page":"3217","DOI":"10.3390\/jcm11113217","article-title":"Pediatric infective endocarditis: a literature review","volume":"11","author":"Vicent","year":"2022","journal-title":"J Clin Med"},{"issue":"1","key":"10.1016\/j.emc.2025.06.012_bib39","first-page":"21","article-title":"Edward Jenner and the history of smallpox and vaccination","volume":"18","author":"Riedel","year":"2005","journal-title":"SAVE Proc"},{"issue":"6","key":"10.1016\/j.emc.2025.06.012_bib40","doi-asserted-by":"crossref","first-page":"137","DOI":"10.15585\/mmwr.mm7206a1","article-title":"Advisory committee on immunization practices recommended immunization schedule for children and adolescents aged 18 Years or younger - United States, 2023","volume":"72","author":"Wodi","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"4","key":"10.1016\/j.emc.2025.06.012_bib41","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2020-0768","article-title":"A complicated case of vaccine refusal","volume":"146","author":"Rossi","year":"2020","journal-title":"Pediatrics"},{"issue":"18","key":"10.1016\/j.emc.2025.06.012_bib42","doi-asserted-by":"crossref","first-page":"2525","DOI":"10.1016\/j.vaccine.2022.03.033","article-title":"Decreasing routine vaccination rates in children in the COVID-19 era","volume":"40","author":"Maltezou","year":"2022","journal-title":"Vaccine"},{"issue":"12","key":"10.1016\/j.emc.2025.06.012_bib43","doi-asserted-by":"crossref","first-page":"e882","DOI":"10.1097\/PEC.0000000000002249","article-title":"Fever without source in unvaccinated children aged 3 to 24 Months: what workup is recommended?","volume":"37","author":"Finkel","year":"2021","journal-title":"Pediatr Emerg Care"},{"issue":"1","key":"10.1016\/j.emc.2025.06.012_bib44","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/PEC.0000000000002864","article-title":"Immunization status and the management of febrile children in the pediatric emergency department: what are we doing?","volume":"39","author":"Curtis","year":"2023","journal-title":"Pediatr Emerg Care"},{"issue":"4","key":"10.1016\/j.emc.2025.06.012_bib45","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1097\/01.inf.0000207485.39112.bf","article-title":"Changing epidemiology of outpatient bacteremia in 3- to 36-month-old children after the introduction of the heptavalent-conjugated pneumococcal vaccine","volume":"25","author":"Herz","year":"2006","journal-title":"Pediatr Infect Dis J"},{"issue":"4","key":"10.1016\/j.emc.2025.06.012_bib46","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1007\/s40138-018-0168-3","article-title":"Challenges encountered in the emergency department in the unimmunized pediatric population","volume":"6","author":"Haut","year":"2018","journal-title":"Curr Emerg Hosp Med Rep"},{"issue":"3","key":"10.1016\/j.emc.2025.06.012_bib47","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/jpc.13427","article-title":"Characteristics of Bordetella pertussis infection among infants and children admitted to paediatric intensive care units in Greece: a multicentre, 11-year study","volume":"53","author":"Kazantzi","year":"2017","journal-title":"J Paediatr Child Health"},{"issue":"2","key":"10.1016\/j.emc.2025.06.012_bib48","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1542\/peds.2008-1559","article-title":"Management of childhood onset nephrotic syndrome","volume":"124","author":"Gipson","year":"2009","journal-title":"Pediatrics"},{"issue":"3","key":"10.1016\/j.emc.2025.06.012_bib49","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1542\/pir.36-3-117","article-title":"Nephrotic syndrome","volume":"36","author":"Andolino","year":"2015","journal-title":"Pediatr Rev"},{"issue":"9384","key":"10.1016\/j.emc.2025.06.012_bib50","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0140-6736(03)14184-0","article-title":"Nephrotic syndrome in childhood","volume":"362","author":"Eddy","year":"2003","journal-title":"Lancet"},{"issue":"7","key":"10.1016\/j.emc.2025.06.012_bib51","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1177\/0009922820908583","article-title":"Infections in children with nephrotic syndrome: twenty years of experience","volume":"59","author":"Lebel","year":"2020","journal-title":"Clin Pediatr (Phila)"},{"issue":"3","key":"10.1016\/j.emc.2025.06.012_bib52","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/S0272-6386(12)80899-7","article-title":"Risk factors for infection and immunoglobulin replacement therapy in adult nephrotic syndrome","volume":"24","author":"Ogi","year":"1994","journal-title":"Am J Kidney Dis"},{"issue":"1","key":"10.1016\/j.emc.2025.06.012_bib53","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1186\/s12882-019-1509-5","article-title":"Complement activation products in the circulation and urine of primary membranous nephropathy","volume":"20","author":"Zhang","year":"2019","journal-title":"BMC Nephrol"},{"issue":"3","key":"10.1016\/j.emc.2025.06.012_bib54","doi-asserted-by":"crossref","first-page":"445","DOI":"10.2215\/CJN.03531006","article-title":"Adult minimal-change disease: clinical characteristics, treatment, and outcomes","volume":"2","author":"Waldman","year":"2007","journal-title":"Clin J Am Soc Nephrol"},{"issue":"1","key":"10.1016\/j.emc.2025.06.012_bib55","first-page":"13","article-title":"Nephrotic syndrome in children","volume":"122","author":"Bagga","year":"2005","journal-title":"Indian J Med Res"},{"issue":"4","key":"10.1016\/j.emc.2025.06.012_bib56","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1046\/j.1440-1754.1998.00232.x","article-title":"Prevention of serious bacterial infection in children with nephrotic syndrome","volume":"34","author":"McIntyre","year":"1998","journal-title":"J Paediatr Child Health"},{"issue":"7","key":"10.1016\/j.emc.2025.06.012_bib57","article-title":"The clinical spectrum and occurrence of major infections in hospitalized children with nephrotic syndrome","volume":"15","author":"Sheikh","year":"2023","journal-title":"Cureus"},{"issue":"4","key":"10.1016\/j.emc.2025.06.012_bib58","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1007\/BF00866719","article-title":"Spectrum of infections in Indian children with nephrotic syndrome","volume":"9","author":"Gulati","year":"1995","journal-title":"Pediatr Nephrol"},{"issue":"8","key":"10.1016\/j.emc.2025.06.012_bib59","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1111\/j.1440-1797.2012.01650.x","article-title":"Occurrence of infection among children with nephrotic syndrome during hospitalizations","volume":"17","author":"Wei","year":"2012","journal-title":"Nephrology"}],"container-title":["Emergency Medicine Clinics of North America"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0733862725000501?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0733862725000501?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T23:39:33Z","timestamp":1760657973000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0733862725000501"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":59,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["S0733862725000501"],"URL":"https:\/\/doi.org\/10.1016\/j.emc.2025.06.012","relation":{},"ISSN":["0733-8627"],"issn-type":[{"type":"print","value":"0733-8627"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Fever in the Not-So-Typical Pediatric Patient","name":"articletitle","label":"Article Title"},{"value":"Emergency Medicine Clinics of North America","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.emc.2025.06.012","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}