Abnormal Blood Glucose Levels in Febrile Children Not Associated With Bacterial Infection

November 3, 2021

By Louise Gagnon

VIRTUAL -- November 3, 2021 -- Abnormal blood glucose levels in young children presenting to the emergency department with fever was not indicative of a serious bacterial infection, according to a study presented at the 2021 Annual Meeting of the American College of Emergency Physicians (ACEP).

“We conducted this study because fever is the most common complaint in the paediatric emergency department and serious bacterial infection remains a significant cause of morbidity in this age group,” said Matthew Piazza, MD, Good Samaritan Hospital Medical Center, West Islip, New York. “It is very important that the emergency physician stratifies febrile infants as low risk so they can be managed at home with follow-up by their pediatrician, and identify those at serious risk who need aggressive management and admission.”

For the current study, the researchers looked at 179 vaccinated children 3 to 36 months who presented to the emergency department between September 2018 and September 2019 with fever, and whose blood glucose levels were measured. Of the children, 81 had a serious bacterial infection and 98 had a viral infection. Ten children were ultimately admitted to the intensive care unit (ICU).

There was no statistically significant difference between blood glucose levels in children presenting with a viral infection versus those who had a serious bacterial infection, (115.2 vs 110.8 mg/dL; P = .199). They did find that there was a higher mean presenting blood glucose value between children who were admitted to the ICU compared with those who were not (143.4 vs 111 mg/dL), but the difference was not statistically significant. 

There was no significant association between blood glucose levels at emergency department presentation and temperature.

This research suggests no benefit in screening for blood glucose in febrile children in the emergency department to detect children at risk for serious bacterial infection, said Dr. Piazza. 

“There was a slight association between hyperglycaemia and those children requiring intensive care; however, we only had 10 children in the paediatric intensive care unit,” he said. “A larger study with a larger sample size is needed to confirm the association between hyperglycaemia and the need to admit children to intensive care.”

[Presentation title: Abnormal Blood Glucose Testing in Febrile Children Has No Association With Serious Bacterial Infection: a Retrospective Chart Review. Abstract 395]