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Bacteremia was documented in 14 of 156 previously healthy children with temperatures of at least 40.0 degrees C but without focal signs, seen in an emergency department; 116 children had malaria, and no infections were identified in 26. Concurrent malaria infection was frequent in children with bacteremia. The highly febrile child without focal signs in the tropics requires evaluation for bacteremia even when a diagnosis of malaria has been confirmed.
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