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Incidence of serious infection in infants under age two months with fever
Insights
In young infants, a high temperature may indicate serious illness, but the fever
Area of Science:
- Pediatrics
- Infectious Diseases
- Emergency Medicine
Background:
- Febrile infants under eight weeks old present a diagnostic challenge in emergency settings.
- Prompt identification of serious bacterial infections is crucial for timely treatment and improved outcomes.
Purpose of the Study:
- To investigate the incidence and characteristics of fever in young infants presenting to an urban emergency department.
- To assess the prevalence of bacteremia and other serious infections in febrile infants.
Main Methods:
- Prospective review of infants under eight weeks of age over a six-month period.
- Defined elevated temperature as axillary temperature of 37.8°C or higher.
- Analyzed data on fever, bacteremia, white blood cell counts, and cerebrospinal fluid findings.
Main Results:
- 1,655 infants were evaluated; 7% (122) had elevated temperatures.
- 4% of febrile infants had bacteremia.
- Fever severity did not correlate with illness severity; low white blood cell counts were noted in some bacteremic infants.
Conclusions:
- Fever in young infants necessitates careful evaluation due to the potential for serious infections.
- The study highlights the importance of considering bacteremia even with non-specific clinical signs in febrile infants.
Abstract:
Infants less than eight weeks of age in a busy urban emergency department were prospectively reviewed during a six-month period, from October 1, 1981 to March 31, 1982. An axillary temperature of 37.8 degrees C or higher was arbitrarily defined as significantly elevated. A total of 1,655 young infants were seen during this time period, with 122 having temperatures of 37.8 degrees C or higher (7%). Four percent of the febrile patients were bacteremic. The degree of temperature elevation was not proportional to the severity of the illness. Total white blood cell count was less than 4,000/mm3 in two of the bacteremic patients. Cerebrospinal fluid pleocytosis was present in 13% of the patients undergoing lumbar puncture.