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Fever Severity and Urinary Tract Infection Risk in Well-Appearing Febrile Infants Aged 61-90 Days.
María Suárez-Bustamante Huélamo1, José Antonio Alonso-Cadenas1,2, Andrea Trujillo Montoro3
1Pediatric Emergency Department, Niño Jesús University Children's Hospital, Madrid, Spain.
Acta Paediatrica (Oslo, Norway : 1992)
|August 9, 2025
Summary
Fever severity does not reliably predict urinary tract infections (UTIs) in infants. All febrile infants aged 61-90 days with fever without source (FWS) require urine testing, regardless of temperature.
Area of Science:
- Pediatrics
- Infectious Diseases
- Diagnostic Medicine
Background:
- Urinary tract infections (UTIs) are common in infants.
- Fever without source (FWS) is a frequent presentation in pediatric emergency departments.
- Accurate risk stratification for UTI in febrile infants is crucial for appropriate management.
Purpose of the Study:
- To analyze the relationship between fever severity and the incidence of UTI in well-appearing febrile infants aged 61-90 days with FWS.
- To determine if fever degree can predict UTI in this population.
Main Methods:
- A multicentre retrospective study was conducted between 2011 and 2022.
- Data from 61-90 day old infants presenting with FWS were analyzed.
- Statistical analysis included odds ratios, confidence intervals, and AUC to assess fever severity as a predictor of UTI.
Main Results:
- UTIs were diagnosed in 21.4% of infants.
- Higher fever and longer fever duration were associated with increased UTI risk (OR: 1.6 and 1.02, respectively).
- UTI prevalence varied by temperature: 22.3% (<38.5°C), 12.5% (38.5°C-38.9°C), and 32.3% (≥39°C). The AUC for fever degree was 0.59.
Conclusions:
- Fever severity is a weak predictor of UTI in infants aged 61-90 days with FWS.
- Urine dipstick testing is recommended for all such infants, irrespective of fever degree.
- Blood cultures should be considered for infants with abnormal urine tests, regardless of fever severity.
Keywords:
febrile infantpediatric assessment trianglepediatric emergency departmenturinary tract infectionMore Related Videos
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