Podcast 703: Fever in Infants

<p><strong>Contributor: Neil Cella, MD </strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;"><29 day old well-appearing febrile infant:</span></li> <li style="list-style: none; display: inline;"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">10% of patients <29 days old with a fever (>100.4) have an serious bacterial infection</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Most of these are UTIs, but also consider pneumonia and meningitis</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Requires CXR, LP, labs, and UA to work up cause of fever</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">29-60 day old well-appearing febrile infant: </span></li> <li style="list-style: none; display: inline;"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Can discharge without abx if CXR, lumbar puncture, labs and UA without signs of bacterial infection</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">If UA is positive for UTI a LP is still indicated for febrile infants <29 days old, but may not be required for febrile infants 29-60 days old</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Hamilton JL, Evans SG, Bakshi M. Management of Fever in Infants and Young Children. Am Fam Physician. 2020;101(12):721-729.</span></p> <p><em><span style="font-weight: 400;">Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD</span></em></p>