Fever and Leucocytosis in Children in Clinical Practice in South East Nigeria: The Roles Played by Malaria and Bacterial Infection

Objective: The study was conducted with a view to determining the veracity of the assumption in clinical practice in the tropics that fever with a neutrophilic leucocytosis is more likely due to bacterial infection than to malaria. Method: A retrospective analysis of case files of children aged over 3 months who had fever of >38.5 oC and leucocytosis with a final empirical therapeutic diagnosis of either malaria or bacterial infection, seen over a 3yr period in a paediatric private practice was done. A total of 186 patients comprising 118 treated for malaria and 68 treated for bacterial infection fitted the criteria and were analyzed. Results: In all the patients with leucocytosis of 11 to 1 4x I09/l, malaria accounted for 81.7% and a further 60.5% of those with leucocytosis greater than14 to 17x109/1. Bacterial infection accounted for 52% and 53.2% of patients with leucocytosis of>17 to 20x109/1 and >20x109/1 respectively (X2=18.64, X23,0.05=7.81.