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Febrile infants aged ≤60 days: evaluation and management in the emergency department

Lauren Palladino1, Christopher Woll2, Paul L Aronson3

  • 1Fellow, Pediatric Emergency Medicine, Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, PA.

Pediatric Emergency Medicine Practice
|January 24, 2024
PubMed

Insights

Fever in infants under 60 days can signal serious bacterial infections. This review covers updated guidelines and tools for evaluating and managing these febrile infants to prevent severe outcomes.

Area of Science:

  • Pediatrics
  • Emergency Medicine
  • Infectious Disease

Background:

  • Febrile infants aged 60 days or younger present a common challenge in emergency departments.
  • Fever in this age group can be the sole indicator of invasive bacterial infection (IBI), potentially leading to severe complications if not promptly addressed.

Purpose of the Study:

  • To review current risk-stratification tools for febrile infants.
  • To provide recommendations for the evaluation and management of febrile infants based on the 2021 American Academy of Pediatrics guidelines.
  • To examine recent literature on the association between IBI and urinary tract infections or viral testing in febrile infants.

Main Methods:

  • Literature review of recent studies and guidelines.
  • Analysis of risk-stratification tools for febrile infants.
  • Synthesis of the 2021 American Academy of Pediatrics clinical practice guideline.

Main Results:

  • Updated risk-stratification tools offer improved methods for assessing IBI risk in febrile infants.
  • The 2021 AAP guideline provides a framework for evidence-based management.
  • Recent data highlight the importance of considering urinary tract infections and viral testing in the diagnostic workup.

Conclusions:

  • Effective management of febrile infants relies on updated risk assessment and adherence to current clinical guidelines.
  • Careful evaluation is crucial to differentiate between serious and non-serious causes of fever in young infants.
  • Further research continues to refine our understanding of IBI risk factors in this vulnerable population.

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