High Fever: In Reply.

Dr DiTraglia's letter raises some important issues with regard to the use of antibiotics and the utility of complete blood counts in evaluating children with hyperpyrexia. It should be emphasized that our study on febrile children was restricted to a cohort of children with hyperpyrexia.¹ Subanalyses were limited by virtue of the small sample size.

In our cohort, 19 of 103 subjects had an underlying chronic illness; thus, to our knowledge, 84 subjects were previously healthy. Of the 19 children with underlying disease, 7 (37%) were diagnosed with a serious bacterial illness (SBI). Also, of the 20 children who were diagnosed with an SBI, 7 (35%) had an underlying illness. The presence of a preexisting chronic condition in the child may have affected the physician's decision whether to treat with …