Key result
Blood PCR testing identified at least one pathogen in 53.9% of children under five with acute undifferentiated fever, predominantly enterovirus (31.1%) and human herpesvirus 6 (12.6%).
Why the study?
The study was conducted to investigate the aetiology of acute undifferentiated fever among children under the age of five in Vietnam.
What is the aetiology of acute undifferentiated fever among children under five in Vietnam using real-time PCR?
Observational (n=286)
No
What is the aetiology of acute undifferentiated fever among children under five in Vietnam using real-time PCR?
Real-time PCR of blood samples identified a viral aetiology in over half of children presenting with acute undifferentiated fever in Vietnam, predominantly Enterovirus.
BACKGROUND: To investigate the aetiology of acute undifferentiated fever (AUF) among children under the age of five in Vietnam. METHODS: This prospective study was conducted in the Thai Binh paediatric hospital, between July 2020 and July 2021 among children with AUF at admission. Real-time PCR testing 18 microbial pathogens were done on blood samples. RESULTS: 286 children were included, with median age of 16 months. 64.7% were male. 53.9% were positive for at least one pathogen by PCR. Enterovirus, human herpesvirus 6, adenovirus, and varicella zoster virus PCR were positive for 31.1, 12.6, 1.4, and 1.0% patients, respectively. Other pathogens tested negative by PCR. During the hospital stay, based on clinical criteria 47.2% children secondarily presented with signs of respiratory tract infections, 18.9% had hand, foot and mouth disease, 4.6% had chickenpox. 4.2% presented signs of central nervous system infections, 1.0% had dengue (antigenic test) and 1.0% had signs of gastrointestinal infection. Finally, 23.1% patients presented a fever with or without a rash and no other symptoms and ultimately received a diagnosis of AUF. CONCLUSION: Real-time PCR of blood is useful for detecting pathogens and diagnosing infectious causes of AUF. Further prospective studies with blood and urine culture testing and PCR investigation of not only blood but also cerebrospinal fluid, throat, and skin samples according to symptoms would be of interest to confirm the predominance of viral infections in children with AUF and to guide therapeutic options.
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Tran et al. (2023) conducted an observational in Acute undifferentiated fever (n=286). Microbial pathogens was evaluated on Positive for at least one pathogen by PCR. Blood PCR testing identified at least one pathogen in 53.9% of children under five with acute undifferentiated fever, predominantly enterovirus (31.1%) and human herpesvirus 6 (12.6%).
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