TY - JOUR
T1 - Fever in infants less than two months of age
T2 - Spectrum of disease and predictors of outcome
AU - Berkowitz, Carol D.
AU - Uchiyama, Naomi
AU - Tully, Susan B.
AU - Marble, Richard D.
AU - Spencer, Mary
AU - Stein, Martin T.
AU - Orr, Donald P.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1985/9
Y1 - 1985/9
N2 - Four hundred thirty-four febrile infants two months of age or younger were evaluated in the emergency departments of five major teaching hospitals over a one-year period. A culture-proven bacterial infection was present in 3.5% of the infants; bacteremia was detected in 3.3%. Bacterial meningitis was present in 2.4%, and aseptic meningitis was noted in 13.4%. Twenty-one percent had clinically apparent serious disease including pneumonia, otitis media, and gastroenteritis with dehydration. Six variables (age <1 month, lethargy, no contact with an ill individual, breast-feeding, total polymorphonuclear > 10,000/mm3 and band count > 500/ mm3) were correlated with bacterial infection by stepwise discriminant analysis. However, these findings were neither sensitive nor specific enough to be clinically useful. Management varied, and 62% of the infants were hospitalized. Fifty-four percent, some of whom were managed as outpatients, received antibiotics. Febrile infants two months of age or younger require a comprehensive emergency department assessment, including appropriate laboratory studies (CBC, differential, urinalysis and culture, lumbar puncture, and blood culture), since 3.5% have bacterial infection that may be life-threatening. Hospitalization is warranted if the infant appears ill, laboratory studies indicate serious infection, or follow-up care is uncertain.
AB - Four hundred thirty-four febrile infants two months of age or younger were evaluated in the emergency departments of five major teaching hospitals over a one-year period. A culture-proven bacterial infection was present in 3.5% of the infants; bacteremia was detected in 3.3%. Bacterial meningitis was present in 2.4%, and aseptic meningitis was noted in 13.4%. Twenty-one percent had clinically apparent serious disease including pneumonia, otitis media, and gastroenteritis with dehydration. Six variables (age <1 month, lethargy, no contact with an ill individual, breast-feeding, total polymorphonuclear > 10,000/mm3 and band count > 500/ mm3) were correlated with bacterial infection by stepwise discriminant analysis. However, these findings were neither sensitive nor specific enough to be clinically useful. Management varied, and 62% of the infants were hospitalized. Fifty-four percent, some of whom were managed as outpatients, received antibiotics. Febrile infants two months of age or younger require a comprehensive emergency department assessment, including appropriate laboratory studies (CBC, differential, urinalysis and culture, lumbar puncture, and blood culture), since 3.5% have bacterial infection that may be life-threatening. Hospitalization is warranted if the infant appears ill, laboratory studies indicate serious infection, or follow-up care is uncertain.
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U2 - 10.1097/00006565-198509000-00005
DO - 10.1097/00006565-198509000-00005
M3 - Article
C2 - 3842882
AN - SCOPUS:0022285022
SN - 0749-5161
VL - 1
SP - 128
EP - 135
JO - Pediatric emergency care
JF - Pediatric emergency care
IS - 3
ER -