315 ARTIGO ORIGINAL / ORIGINAL ARTICLE Portuguese Journal of Pediatrics The persistence of fever 72 hours afer startng ant- biotc therapy in pediatric community-acquired pneu- monia (CAP) is, according to the guidelines, a criterion for clinical reassessment and the possible use of com- plementary diagnostc studies. 1,2 Despite a reducton in the incidence and number of hospitalisatons by CAP in high-income countries since the introducton of pneumococcal conjugate vaccines, 3-7 the severity and frequency of complicatons (pleural efusion, empyema, lung abscess, necrotsaton) have increased, usually associated with a longer duraton of fever. 7 However, there are no clear guidelines for diagnostc and therapeutc guidance, and persistent fever is known to induce drug prescripton. 8 This study aimed to evaluate the duraton of fever in hospitalised children with CAP as a marker of complica- tons and a prescripton inducer. 54 medical records of hospitalised children aged ≥ 24 months with a diagnosis of CAP (from February 2012 to July 2014) were reviewed. Patents with chronic diseases (neuromuscular diseases, cystc fbrosis and immunode- fciency) were excluded. A descriptve analysis of the demographic and clinical variables, complementary studies and prescripton of antbiotc therapy were performed. A bivariate associ- aton analysis of the duraton of fever (< 72 hours and ≥ 72 hours) with complicated and uncomplicated CAP was made using chi-square and Fisher’s exact tests for categorical variables and Mann-Whitney U test for the comparison of means, with a signifcance level of 5% (IBM SPSS® v20.0). The demographic characterisaton, the therapeutc interventons and aetological results of the cases of children in the study can be found in Table 1. Complicated CAP patents had a signifcantly longer duraton of fever during their hospitalisaton (7 days vs 1 EDITORIAL / EDITORIAL LETTER TO EDITOR Fever in Pediatric Complicated Pneumonia Joana Oliveira 1 , Cristina Novais 2 , Bárbara Marques 1 , Teresa Bandeira 1,3 Port J Pediatr 2018;49:315-7 DOI: htps://doi.org/10.25754/pjp.2018.14248 1. Unidade de Pneumologia. Departamento de Pediatria, Hospital de Santa Maria, Centro Académico de Medicina de Lisboa, Lisbon, Portugal 2. Serviço de Pediatria, Hospital de Caldas da Rainha, Centro Hospitalar do Oeste, Caldas da Rainha, Portugal 3. Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal Corresponding Author Joana A. Oliveira joana.a.oliveira@hotmail.com Departamento de Pediatria, Hospital de Santa Maria, Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal Received: 15/05/2018 | Accepted: 05/06/2018 h – hours; CAP – community-acquired pneumonia. Table 1. Demographic characteristcs. Descripton of therapeutc interventons and aetological results of the cases of the study (n=54) Males, n (%) 24 (44.4) Age in years, median (minimum-maximum) 4 (2-15) Antbiotc therapy started on admission Ampicillin, n (%) 33 (61.1) Amoxicillin/clavulanic acid, n (%) 14 (25.9) Complicatons, n (%) 22 (40.7) Pleural efusion, n (%) 15 (68.2) Empyema, n (%) 6 (27.3) Necrotsaton, n (%) 5 (22.7) Interventon Thoracentesis, n (%) 14 (66.7) Pleural drain, n (%) 11 (52.3) Bacterial identfcaton, n (%) 6 (11.1) Blood culture, n (%) 3 (5.6) Streptococcus pneumoniae, n (%) 1 (1.9) Haemophilus infuenzae, n (%) 1 (1.9) Streptococcus agalactae, n (%) 1 (1.9) Positve polymerase chain reacton for Streptococcus pneumoniae in pleural fuid, n (%) 3 (5.6)