In Reply.—

Our recent study of children with fever and petechiae included all children admitted to the Emergency Department during the 1 year of the study. Therefore, the 7% incidence of meningococcemia is a true incidence of meningococcemia in children admitted to an emergency facility with fever and petechiae.

Although we agree that including the patients in whom an organism was not documented would have enhanced the statistical power of our results, we chose to exclude them due to the wide spectrum of illness represented in this group, both in severity of illness (ranging from viral syndrome to partially treated, presumed bacterial meningitis) and in presumed organism (viral versus bacterial).

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