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Updated: May 3, 2026
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Should infants presenting with an apparent life-threatening event undergo evaluation for serious bacterial infections
Ilene Claudius1, Manoj K Mittal2, Ryan Murray3
1Department of Emergency Medicine, Keck School of Medicine, LAC+USC Medical Center, University of Southern California, Los Angeles, CA; Department of Pediatrics, Keck School of Medicine, LAC+USC Medical Center, University of Southern California.
Insights
Infants with apparent life-threatening events rarely need infectious workups. This study found few infections, like urinary tract infections and pneumonia, in 533 infants evaluated, suggesting targeted testing may be sufficient.
Area of Science:
- Pediatrics
- Infectious Diseases
- Emergency Medicine
Background:
- Apparent life-threatening events (ALTEs) in infants often prompt extensive infectious evaluations.
- Determining which infants require infectious workups for ALTEs is crucial for efficient healthcare resource allocation.
Purpose of the Study:
- To identify the incidence of specific infections in infants presenting with an apparent life-threatening event (ALTE).
- To guide recommendations for infectious evaluations in infants with ALTEs.
Main Methods:
- Retrospective analysis of 533 infants aged 12 months or younger presenting to an emergency department with an ALTE.
- Review of diagnostic findings for meningitis, bacteremia, urinary tract infections, bacterial pneumonia, respiratory syncytial virus, and influenza virus.
Main Results:
- No cases of meningitis were identified.
- One case of bacteremia was detected.
- Seventeen cases of urinary tract infection were diagnosed.
- Twenty-two cases of bacterial pneumonia were confirmed.
- Twenty-two cases of respiratory syncytial virus and two cases of influenza virus were identified in respiratory specimens.
Conclusions:
- Infectious etiologies are uncommon in infants presenting with ALTEs.
- The low incidence of serious bacterial infections suggests that broad infectious evaluations may not be necessary for all infants with ALTEs.
- Further research could refine guidelines for targeted infectious workups in this population.
Abstract:
We sought to identify which patients with an apparent life-threatening event require infectious evaluation through an analysis of infants aged ≤12 months brought to an emergency department with an apparent life-threatening event. Among the 533 children evaluated, there were no cases of meningitis, 1 case of bacteremia, 17 cases of urinary tract infection, 22 cases of bacterial pneumonia, 22 cases of respiratory syncytial virus, and 2 cases of influenza virus identified in respiratory specimens.
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