Unexplained fever in infants and young children: how to manage.

Unexplained fever in infants and young children: how to manage.

Bower J R; Powell K R

Consultant (00107069)

2001

2001-04-15

If an infant 60 days old or younger who presents with unexplained fever (temperature 38 degrees C [100.4 degrees F] or greater) appears ill, evaluate for sepsis, hospitalize, and give parenteral antibiotics. For well-appearing infants whose temperature is 38 degrees ( (100.4 degrees F) or greater, order a complete blood cell count, urinalysis and, when indicated, stool examination. If the peripheral white blood cell (WBC) count is greater than 15,000/microL or less than 5000/miroL, urine contains more than 10 WBCs per high-power field or a dipstick reagent strip is positive, or fecal analysis shows more than 5 WBCs per high-power field, hospitalize the infant, obtain blood and urine cultures, order lumbar puncture, and administer parenteral antimicrobials. Risk criteria for serious bacterial infection are more flexible for children aged 61 days to 36 months: the cutoff temperature is 39 degrees C (102.2 degrees F) or higher, greater reliance is placed on physical examination findings, and laboratory findings can be interpreted with greater leeway. If the WBC count is less than 15,000/miroL, only follow-up is required; if the count is higher, obtain a blood culture and administer a dose of ceftriaxone.

Child; Infant; Practice Guidelines; Preschool; Bacterial Infections – Diagnosis – In Infancy and Childhood; Fever – Therapy – In Infancy and Childhood; Primary Health Care – In Infancy and Childhood

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

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