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Bottom Line Recommendations English (3) French (1) All (4)

Bottom Line Recommendations: Fever in Young infants

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Beer, D and TREKK Network

Bottom line recommendations for the treatment and management of fever in neonates and infants. Published online: June 2019, Version 2.0.

Clinical Pathway: ED Pathway for Evaluation/Treatment of Febrile Young Infant (0-56 Days Old)

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Scarfone R, Gala R, Murray A, Funari MK, Lavelle J, Bell L

The clinical pathway for treating and evaluating febrile infants is built upon publicly available medical evidence and/or a consensus of medical practitioners at The Childrens Hospital of Philadelphia.

Clinical Pathway: Febrile Infant Guideline

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BC Children's Hospital

This clinical pathway contains initial screening and management guidance for febrile infants (0 to 60 days).

Recommandations de Base: Fievre - Nouveau-nés et nourrissons

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Beer, D and TREKK Network

Bottom line recommendations for the treatment and management of fever in neonates and infants (French). Published online: June 2019, Version 2.0.

Bottom Line Recommendations: Fever in Young infants

Download

Beer, D and TREKK Network

Bottom line recommendations for the treatment and management of fever in neonates and infants. Published online: June 2019, Version 2.0.

Recommandations de Base: Fievre - Nouveau-nés et nourrissons

Download

Beer, D and TREKK Network

Bottom line recommendations for the treatment and management of fever in neonates and infants (French). Published online: June 2019, Version 2.0.

Clinical Pathway: ED Pathway for Evaluation/Treatment of Febrile Young Infant (0-56 Days Old)

Visit

Scarfone R, Gala R, Murray A, Funari MK, Lavelle J, Bell L

The clinical pathway for treating and evaluating febrile infants is built upon publicly available medical evidence and/or a consensus of medical practitioners at The Childrens Hospital of Philadelphia.

Clinical Pathway: Febrile Infant Guideline

Visit

BC Children's Hospital

This clinical pathway contains initial screening and management guidance for febrile infants (0 to 60 days).

Clinical guidelines English (5) French All (5)

Clinical Pathway: Fever in Infants Less than 60 Days

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Clinical Care Guideline and Measures Review Committee

These pathways and algorithms are intended for febrile infants (0-60 days) and cover initial evaluations and therapeutics.

Clinical Pathway: Neonatal Fever

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Bishop J, Ackley H, Beardsley E, Fenstermacher S, Leu M, Pak D, Stanford S

These pathways and guidelines contain information on the assessment and management of febrile infants (0-30 days old, 31-60 days old) as inpatients and in the ED, with and without bronchiolitis.

Clinical Practice Guidelines for Febrile Infants

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Patrick K, Miller S, Vejzovic J, Wood K, Price N, Al-Gharabeith F, Pepper S

This guideline is to direct care for infants 7 to 60 days of age who present with a temperature of greater than or equal to 38.0C

Clinical Practice Guidelines: Clinical Policy for Well-Appearing Infants and Children Younger Than 2 Years of Age Presenting to the Emergency Department With Fever

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American College of Emergency Physicians Clinical Policies Subcommittee (Writ...

This clinical policy from the American College of Emergency Physicians addresses key issues for well-appearing infants and children younger than 2 years presenting to the emergency department with fever.

Clinical Practice Guideline: Fever in under 5s

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National Institute for Health and Care Excellence

This quality standard covers the assessment and early management of fever with no obvious cause in babies and children (from birth to 5 years).

Clinical Pathway: Fever in Infants Less than 60 Days

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Clinical Care Guideline and Measures Review Committee

These pathways and algorithms are intended for febrile infants (0-60 days) and cover initial evaluations and therapeutics.

Clinical Pathway: Neonatal Fever

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Bishop J, Ackley H, Beardsley E, Fenstermacher S, Leu M, Pak D, Stanford S

These pathways and guidelines contain information on the assessment and management of febrile infants (0-30 days old, 31-60 days old) as inpatients and in the ED, with and without bronchiolitis.

Clinical Practice Guidelines for Febrile Infants

Visit

Patrick K, Miller S, Vejzovic J, Wood K, Price N, Al-Gharabeith F, Pepper S

This guideline is to direct care for infants 7 to 60 days of age who present with a temperature of greater than or equal to 38.0C

Clinical Practice Guidelines: Clinical Policy for Well-Appearing Infants and Children Younger Than 2 Years of Age Presenting to the Emergency Department With Fever

Visit

American College of Emergency Physicians Clinical Policies Subcommittee (Writ...

This clinical policy from the American College of Emergency Physicians addresses key issues for well-appearing infants and children younger than 2 years presenting to the emergency department with fever.

Clinical Practice Guideline: Fever in under 5s

Visit

National Institute for Health and Care Excellence

This quality standard covers the assessment and early management of fever with no obvious cause in babies and children (from birth to 5 years).

Systematic reviews English (11) French All (11)

Review: During the Emergency Department Evaluation of a Well-Appearing Neonate with Fever, Should Empiric Acyclovir Be Initiated?

Visit

Bruno E, Pillus D, Cheng D, Vilke G, Pokrajac N

This review aimed to identify when to initiate testing and treatment for herpes simplex virus infection.

Review: Facing the ongoing challenge of the febrile young infant

Visit

DePorre AG, Aronson PL, McCulloh RJ

The authors highlight the historical context of febrile infant management, review important definitions and terminology, discuss the most clinically relevant viral and bacterial causes of fever in the young infant, describe current risk stratification tools guiding medicaldecision making, and outline research and clinical practice improvement priorities for improving the management of the febrile young infant.

Review: Management of the Febrile Young Infant: Update for the 21st Century

Visit

Woll C, Neuman MI, Aronson PL

Newer laboratory investigations such as C-reactive protein and procalcitonin have favorable test characteristics compared with traditional laboratory studies such as a white blood cell count. These novel biomarkers have not gained widespread acceptance because of lack of robust prospectively collected data, varying thresholds to define positivity, and differing inclusion criteria across studies. However, C-reactive protein and procalcitonin, when combined with other patient characteristics in the step-by-step approach, have a high sensitivity for detection of serious bacterial infection.

Systematic Review: Meta-analysis to Determine Risk for Serious Bacterial Infection in Febrile Outpatient Neonates With RSV Infection

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Bonadio W, Huang F, Nateson S, Okpalaji C, Kodsi A, Sokolovsky S, Homel P

This study aimed to analyze a large group of febrile neonates 28 days or younger who received outpatient sepsis evaluation and nasopharyngeal aspirate antigen testing (NPAT) for respiratory syncytial viral (RSV) infection to determine whether there is a clinically significant association between viral study results and risk for serious bacterial infection (SBI: bacterial meningitis, bacteremia, urinary tract infection, bacterial enteritis).

Systematic Review: Diagnostic utility of biomarkers for neonatal sepsis--a systematic review

Visit

Hedegaard SS, Wisborg K, Hvas AM

The objective of the study was to systematically evaluate existing evidence of the diagnostic utility of biomarkers for prediction of sepsis in neonates.

Review: Neonatal Herpes Simplex Virus Infection

Visit

James SH, Kimberlin DW

This review describes diagnostic and therapeutic advances for infants with herpes simplex virus 1 (HSV-1) and 2 (HSV-2).

Systematic Review: Use of serum procalcitonin in evaluation of febrile infants: a meta-analysis of 2317 patients

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England JT, Del Vecchio MT, Aronoff SC

The objectives of this systematic review and meta-analysis were to determine: 1) the ability of serum procalcitonin concentrations to identify febrile infants < 91 days of age at high and low risk for serious bacterial infections, and 2) to compare its utility with available clinical prediction rules.

Systematic Review: Diagnosis and management of febrile infants (0-3 months)

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Hui C, Neto G, Tsertsvadze A, Yazdi F, Tricco AC, Tsouros S, Skidmore B, Dani...

Objectives: To review the evidence for diagnostic accuracy of screening for serious bacterial illness (SBI) and invasive herpes simplex virus (HSV) infection in febrile infants 3 months or younger; ascertain harms and benefits of various management strategies; compare prevalence of SBI and HSV between different clinical settings; determine how well the presence of viral infection predicts against SBI; and review evidence on parental compliance to return for followup assessments (infants less than 6 months).

Review: Management of the non-toxic-appearing acutely febrile child: a 21st century approach

Visit

Jhaveri R, Byington CL, Klein JO, Shapiro ED

This review discusses challenges and new approaches to assessment and management of febrile children with suspected serious bacterial infections.

Systematic Review: Systematic review of the diagnostic accuracy of C-reactive protein to detect bacterial infection in nonhospitalized infants and children with fever

Visit

Sanders S, Barnett A, Correa-Velez I, Coulthard M, Doust J

The objective of this systematic review was to determine the accuracy of C-reactive protein (CRP) for diagnosing serious bacterial and bacterial infections in infants and children presenting with fever.

Systematic Review: Temperature measured at the axilla compared with rectum in children and young people: systematic review

Visit

Craig JV, Lancaster GA, Williamson PR, Smyth RL

The objective of this systematic review was to evaluate the agreement between temperature measured at the axilla and rectum in children and young people.

Review: During the Emergency Department Evaluation of a Well-Appearing Neonate with Fever, Should Empiric Acyclovir Be Initiated?

Visit

Bruno E, Pillus D, Cheng D, Vilke G, Pokrajac N

This review aimed to identify when to initiate testing and treatment for herpes simplex virus infection.

Review: Facing the ongoing challenge of the febrile young infant

Visit

DePorre AG, Aronson PL, McCulloh RJ

The authors highlight the historical context of febrile infant management, review important definitions and terminology, discuss the most clinically relevant viral and bacterial causes of fever in the young infant, describe current risk stratification tools guiding medicaldecision making, and outline research and clinical practice improvement priorities for improving the management of the febrile young infant.

Review: Management of the Febrile Young Infant: Update for the 21st Century

Visit

Woll C, Neuman MI, Aronson PL

Newer laboratory investigations such as C-reactive protein and procalcitonin have favorable test characteristics compared with traditional laboratory studies such as a white blood cell count. These novel biomarkers have not gained widespread acceptance because of lack of robust prospectively collected data, varying thresholds to define positivity, and differing inclusion criteria across studies. However, C-reactive protein and procalcitonin, when combined with other patient characteristics in the step-by-step approach, have a high sensitivity for detection of serious bacterial infection.

Systematic Review: Meta-analysis to Determine Risk for Serious Bacterial Infection in Febrile Outpatient Neonates With RSV Infection

Visit

Bonadio W, Huang F, Nateson S, Okpalaji C, Kodsi A, Sokolovsky S, Homel P

This study aimed to analyze a large group of febrile neonates 28 days or younger who received outpatient sepsis evaluation and nasopharyngeal aspirate antigen testing (NPAT) for respiratory syncytial viral (RSV) infection to determine whether there is a clinically significant association between viral study results and risk for serious bacterial infection (SBI: bacterial meningitis, bacteremia, urinary tract infection, bacterial enteritis).

Systematic Review: Diagnostic utility of biomarkers for neonatal sepsis--a systematic review

Visit

Hedegaard SS, Wisborg K, Hvas AM

The objective of the study was to systematically evaluate existing evidence of the diagnostic utility of biomarkers for prediction of sepsis in neonates.

Review: Neonatal Herpes Simplex Virus Infection

Visit

James SH, Kimberlin DW

This review describes diagnostic and therapeutic advances for infants with herpes simplex virus 1 (HSV-1) and 2 (HSV-2).

Systematic Review: Use of serum procalcitonin in evaluation of febrile infants: a meta-analysis of 2317 patients

Visit

England JT, Del Vecchio MT, Aronoff SC

The objectives of this systematic review and meta-analysis were to determine: 1) the ability of serum procalcitonin concentrations to identify febrile infants < 91 days of age at high and low risk for serious bacterial infections, and 2) to compare its utility with available clinical prediction rules.

Systematic Review: Diagnosis and management of febrile infants (0-3 months)

Visit

Hui C, Neto G, Tsertsvadze A, Yazdi F, Tricco AC, Tsouros S, Skidmore B, Dani...

Objectives: To review the evidence for diagnostic accuracy of screening for serious bacterial illness (SBI) and invasive herpes simplex virus (HSV) infection in febrile infants 3 months or younger; ascertain harms and benefits of various management strategies; compare prevalence of SBI and HSV between different clinical settings; determine how well the presence of viral infection predicts against SBI; and review evidence on parental compliance to return for followup assessments (infants less than 6 months).

Review: Management of the non-toxic-appearing acutely febrile child: a 21st century approach

Visit

Jhaveri R, Byington CL, Klein JO, Shapiro ED

This review discusses challenges and new approaches to assessment and management of febrile children with suspected serious bacterial infections.

Systematic Review: Systematic review of the diagnostic accuracy of C-reactive protein to detect bacterial infection in nonhospitalized infants and children with fever

Visit

Sanders S, Barnett A, Correa-Velez I, Coulthard M, Doust J

The objective of this systematic review was to determine the accuracy of C-reactive protein (CRP) for diagnosing serious bacterial and bacterial infections in infants and children presenting with fever.

Systematic Review: Temperature measured at the axilla compared with rectum in children and young people: systematic review

Visit

Craig JV, Lancaster GA, Williamson PR, Smyth RL

The objective of this systematic review was to evaluate the agreement between temperature measured at the axilla and rectum in children and young people.

Key studies English (18) French All (18)

Key Study: Point-of-care C reactive protein to identify serious infection in acutely ill children presenting to hospital: prospective cohort study

Visit

Verbakel JY, Lemiengre MB, De Burghgraeve T, De Sutter A, Aertgeerts B, Bulle...

This prospective study aimed to develop improved tools to assess children attending ambulatory hospital care, integrating clinical features with point-of-care C reactive protein (CRP).

Key Study: Clinical prediction models for young febrile infants at the emergency department: an international validation study

Visit

Vos-Kerkhof E, Gomez B, Milcent K, Steyerberg EW, Nijman RG, Smit FJ, Mintegi...

The objective of this study was to assess the diagnostic value of existing clinical prediction models in febrile young infants at risk for serious bacterial infections.

Key Study: Accuracy of Complete Blood Cell Counts to Identify Febrile Infants 60 Days or Younger With Invasive Bacterial Infections

Visit

Cruz AT, Mahajan P, Bonsu BK, Bennett JE, Levine DA, Alpern ER, Nigrovic LE, ...

The objective of this study was to estimate the accuracy of individual complete blood cell count parameters to identify febrile infants with invasive bacterial infections.

Key Study: Clinical Pathway Effectiveness: Febrile Young Infant Clinical Pathway in a Pediatric Emergency Department

Visit

Murray AL, Alpern E, Lavelle J, Mollen C

The objective of this study was to evaluate the impact of a febrile young infant clinical pathway implemented in a large, urban children's hospital ED on the timeliness and consistency of care.

Key Study: The Yale Observation Scale Score and the Risk of Serious Bacterial Infections in Febrile Infants

Visit

Nigrovic LE, Mahajan PV, Blumberg SM, Browne LR, Linakis JG, Ruddy RM, Bennet...

The objectives of this study were to assess the performance of the Yale Observation Scale score and unstructured clinician suspicion to identify febrile infants 60 days of age with and without serious bacterial infections.

Key Study: Lumbar Puncture for All Febrile Infants 29-56 Days Old: A Retrospective Cohort Reassessment Study

Visit

Scarfone R, Murray A, Gala P, Balamuth F

The objectives of this study were to determine the incidence of bacterial meningitis among all febrile infants 29-56 days old undergoing a lumbar puncture in the emergency department of a tertiary care children's hospital and the number of low-risk febrile infants with bacterial meningitis to reassess the need for routine lumbar puncture in these infants.

Key Study: Prevalence of Concomitant Acute Bacterial Meningitis in Neonates with Febrile Urinary Tract Infection: A Retrospective Cross-Sectional Study

Visit

Wallace SS, Brown DN, Cruz AT

The objective of this study was to describe the frequency of concomitant acute bacterial meningitis in neonates with febrile urinary tract infection.

Key Study: Initial Presentation of Neonatal Herpes Simplex Virus Infection

Visit

Curfman AL, Glissmeyer EW, Ahmad FA, Korgenski EK, Blaschke AJ, Byington CL, ...

The objective of this study was to inform the decision to test and empirically treat for herpes simplex virus (HSV) by describing the initial clinical presentation and laboratory findings of infants with a confirmed diagnosis of neonatal HSV.

Key Study: Lack of Accuracy of Biomarkers and Physical Examination to Detect Bacterial Infection in Febrile Infants

Visit

Daz MG, Garca RP, Gamero DB, Gonzlez-Tom MI, Romero PC, Ferrer MM, Contreras JR

The aim of this study was to analyze the usefulness of physical examination, C-reactive protein, procalcitonin, white blood cell count, and absolute neutrophils counts for the diagnosis of invasive bacterial infections and potentially serious bacterial infections in infants younger than the age of 3 months presenting with fever without source to the emergency department.

Key Study: Validation of the "Step-by-Step" Approach in the Management of Young Febrile Infants

Visit

Gomez B, Mintegi S, Bressan S, Da Dalt L, Gervaix A, Lacroix L; European Grou...

The aim of this study was to prospectively validate a sequential approach to young febrile infants on the basis of clinical and laboratory parameters, and compare it with the Rochester criteria and the Lab-score.

Key Study: Use of Procalcitonin Assays to Predict Serious Bacterial Infection in Young Febrile Infants

Visit

Milcent K, Faesch S, Gras-Le Guen C, Dubos F, Poulalhon C, Badier I, Marc E, ...

The objective of this study was to assess the diagnostic characteristics of the procalcitonin assay for detecting serious bacterial infection and invasive bacterial infection in febrile infants aged 7 to 91 days.

Key Study: Value of white cell count in predicting serious bacterial infection in febrile children under 5 years of age

Visit

De S, Williams GJ, Hayen A, Macaskill P, McCaskill M, Isaacs D, Craig JC

The objective of this study was to evaluate the accuracy of leukocyte count for the detection of serious bacterial infections in febrile children.

Key Study: The changing epidemiology of serious bacterial infections in young infants

Visit

Greenhow TL, Hung YY, Herz AM, Losada E, Pantell RH

This study analyzed all cultures of blood, urine and cerebrospinal fluid obtained from full-term infants 1 week to 3 months of age, who presented during a 7-year period. Compared with earlier studies, urinary tract infections (UTIs) are now found significantly more often than bacteremia and meningitis with 92% of occult infections associated with UTIs. These data emphasize the importance of an urinalysis in febrile infants.

Key Study: Predicting severe bacterial infections in well-appearing febrile neonates: laboratory markers accuracy and duration of fever

Visit

Bressan S, Andreola B, Cattelan F, Zangardi T, Perilongo G, Da Dalt L

The objective of this study was to assess the diagnostic accuracy of white blood cell count, absolute neutrophil count, and C-reactive protein in detecting severe bacterial infections in well-appearing neonates with early onset fever without source and in relation to fever duration.

Key Study: Blood culture and bacteremia predictors in infants less than three months of age with fever without source

Visit

Gmez B, Mintegi S, Benito J, Egireun A, Garcia D, Astobiza E

The objectives of this study were (1) to assess the rate of bacteremia in febrile infants less than 3 months of age admitted to a pediatric emergency department at a tertiary hospital; (2) to describe the bacteria isolated; and (3) to analyze factors related to increased probability of having a positive blood culture.

Key Study: C-reactive protein as a marker of serious bacterial infections in hospitalized febrile infants

Visit

Bilavsky E, Yarden-Bilavsky H, Ashkenazi S, Amir J

The objective of this study was to determine the potential predictive power of C-reactive protein as a marker of serious bacterial infection in hospitalized febrile infants aged < or =3 months.

Key Study: Clinical and laboratory features of neonatal herpes simplex virus infection: a case-control study

Visit

Caviness AC, Demmler GJ, Selwyn BJ

The objective of this study was to determine the unique clinical and laboratory features of neonates with and without herpes simplex virus infection admitted to Texas Children's Hospital during a 14-year period.

Key Study: The effects of bundling on infant temperature

Visit

Grover G, Berkowitz CD, Lewis RJ, Thompson M, Berry L, Seidel J

The objective of this study was to determine whether bundling elevates rectal and/or skin temperature of young infants.

Key Study: Point-of-care C reactive protein to identify serious infection in acutely ill children presenting to hospital: prospective cohort study

Visit

Verbakel JY, Lemiengre MB, De Burghgraeve T, De Sutter A, Aertgeerts B, Bulle...

This prospective study aimed to develop improved tools to assess children attending ambulatory hospital care, integrating clinical features with point-of-care C reactive protein (CRP).

Key Study: Clinical prediction models for young febrile infants at the emergency department: an international validation study

Visit

Vos-Kerkhof E, Gomez B, Milcent K, Steyerberg EW, Nijman RG, Smit FJ, Mintegi...

The objective of this study was to assess the diagnostic value of existing clinical prediction models in febrile young infants at risk for serious bacterial infections.

Key Study: Accuracy of Complete Blood Cell Counts to Identify Febrile Infants 60 Days or Younger With Invasive Bacterial Infections

Visit

Cruz AT, Mahajan P, Bonsu BK, Bennett JE, Levine DA, Alpern ER, Nigrovic LE, ...

The objective of this study was to estimate the accuracy of individual complete blood cell count parameters to identify febrile infants with invasive bacterial infections.

Key Study: Clinical Pathway Effectiveness: Febrile Young Infant Clinical Pathway in a Pediatric Emergency Department

Visit

Murray AL, Alpern E, Lavelle J, Mollen C

The objective of this study was to evaluate the impact of a febrile young infant clinical pathway implemented in a large, urban children's hospital ED on the timeliness and consistency of care.

Key Study: The Yale Observation Scale Score and the Risk of Serious Bacterial Infections in Febrile Infants

Visit

Nigrovic LE, Mahajan PV, Blumberg SM, Browne LR, Linakis JG, Ruddy RM, Bennet...

The objectives of this study were to assess the performance of the Yale Observation Scale score and unstructured clinician suspicion to identify febrile infants 60 days of age with and without serious bacterial infections.

Key Study: Lumbar Puncture for All Febrile Infants 29-56 Days Old: A Retrospective Cohort Reassessment Study

Visit

Scarfone R, Murray A, Gala P, Balamuth F

The objectives of this study were to determine the incidence of bacterial meningitis among all febrile infants 29-56 days old undergoing a lumbar puncture in the emergency department of a tertiary care children's hospital and the number of low-risk febrile infants with bacterial meningitis to reassess the need for routine lumbar puncture in these infants.

Key Study: Prevalence of Concomitant Acute Bacterial Meningitis in Neonates with Febrile Urinary Tract Infection: A Retrospective Cross-Sectional Study

Visit

Wallace SS, Brown DN, Cruz AT

The objective of this study was to describe the frequency of concomitant acute bacterial meningitis in neonates with febrile urinary tract infection.

Key Study: Initial Presentation of Neonatal Herpes Simplex Virus Infection

Visit

Curfman AL, Glissmeyer EW, Ahmad FA, Korgenski EK, Blaschke AJ, Byington CL, ...

The objective of this study was to inform the decision to test and empirically treat for herpes simplex virus (HSV) by describing the initial clinical presentation and laboratory findings of infants with a confirmed diagnosis of neonatal HSV.

Key Study: Lack of Accuracy of Biomarkers and Physical Examination to Detect Bacterial Infection in Febrile Infants

Visit

Daz MG, Garca RP, Gamero DB, Gonzlez-Tom MI, Romero PC, Ferrer MM, Contreras JR

The aim of this study was to analyze the usefulness of physical examination, C-reactive protein, procalcitonin, white blood cell count, and absolute neutrophils counts for the diagnosis of invasive bacterial infections and potentially serious bacterial infections in infants younger than the age of 3 months presenting with fever without source to the emergency department.

Key Study: Validation of the "Step-by-Step" Approach in the Management of Young Febrile Infants

Visit

Gomez B, Mintegi S, Bressan S, Da Dalt L, Gervaix A, Lacroix L; European Grou...

The aim of this study was to prospectively validate a sequential approach to young febrile infants on the basis of clinical and laboratory parameters, and compare it with the Rochester criteria and the Lab-score.

Key Study: Use of Procalcitonin Assays to Predict Serious Bacterial Infection in Young Febrile Infants

Visit

Milcent K, Faesch S, Gras-Le Guen C, Dubos F, Poulalhon C, Badier I, Marc E, ...

The objective of this study was to assess the diagnostic characteristics of the procalcitonin assay for detecting serious bacterial infection and invasive bacterial infection in febrile infants aged 7 to 91 days.

Key Study: Value of white cell count in predicting serious bacterial infection in febrile children under 5 years of age

Visit

De S, Williams GJ, Hayen A, Macaskill P, McCaskill M, Isaacs D, Craig JC

The objective of this study was to evaluate the accuracy of leukocyte count for the detection of serious bacterial infections in febrile children.

Key Study: The changing epidemiology of serious bacterial infections in young infants

Visit

Greenhow TL, Hung YY, Herz AM, Losada E, Pantell RH

This study analyzed all cultures of blood, urine and cerebrospinal fluid obtained from full-term infants 1 week to 3 months of age, who presented during a 7-year period. Compared with earlier studies, urinary tract infections (UTIs) are now found significantly more often than bacteremia and meningitis with 92% of occult infections associated with UTIs. These data emphasize the importance of an urinalysis in febrile infants.

Key Study: Predicting severe bacterial infections in well-appearing febrile neonates: laboratory markers accuracy and duration of fever

Visit

Bressan S, Andreola B, Cattelan F, Zangardi T, Perilongo G, Da Dalt L

The objective of this study was to assess the diagnostic accuracy of white blood cell count, absolute neutrophil count, and C-reactive protein in detecting severe bacterial infections in well-appearing neonates with early onset fever without source and in relation to fever duration.

Key Study: Blood culture and bacteremia predictors in infants less than three months of age with fever without source

Visit

Gmez B, Mintegi S, Benito J, Egireun A, Garcia D, Astobiza E

The objectives of this study were (1) to assess the rate of bacteremia in febrile infants less than 3 months of age admitted to a pediatric emergency department at a tertiary hospital; (2) to describe the bacteria isolated; and (3) to analyze factors related to increased probability of having a positive blood culture.

Key Study: C-reactive protein as a marker of serious bacterial infections in hospitalized febrile infants

Visit

Bilavsky E, Yarden-Bilavsky H, Ashkenazi S, Amir J

The objective of this study was to determine the potential predictive power of C-reactive protein as a marker of serious bacterial infection in hospitalized febrile infants aged < or =3 months.

Key Study: Clinical and laboratory features of neonatal herpes simplex virus infection: a case-control study

Visit

Caviness AC, Demmler GJ, Selwyn BJ

The objective of this study was to determine the unique clinical and laboratory features of neonates with and without herpes simplex virus infection admitted to Texas Children's Hospital during a 14-year period.

Key Study: The effects of bundling on infant temperature

Visit

Grover G, Berkowitz CD, Lewis RJ, Thompson M, Berry L, Seidel J

The objective of this study was to determine whether bundling elevates rectal and/or skin temperature of young infants.