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Assessment of Intestinal Transcytosis of Neonatal Escherichia coli Bacteremia Isolates
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Prevalence and Characteristics of Bacteremia in Children With Prolonged Fever and Well Appearance Attending the

Paula Herruzo-Pino1, Alba Vilas-Franquesa1, Eduardo Marín-Elguea2

  • 1From the Paediatric Department.

The Pediatric Infectious Disease Journal
|April 6, 2026
PubMed

Insights

Bacteremia is rare in well-appearing children with prolonged fever, suggesting limited value in routine blood tests. Clinical evaluation is key, with investigations reserved for specific cases.

Area of Science:

  • Pediatric Emergency Medicine
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Prolonged fever in children often raises concerns for serious bacterial infections.
  • Distinguishing benign febrile illnesses from significant infections is a clinical challenge.

Purpose of the Study:

  • To determine the prevalence and characteristics of bacteremia in well-appearing children with prolonged fever.
  • To assess other bacterial infections and the utility of diagnostic tests in this cohort.

Main Methods:

  • Retrospective observational study of children aged 3 months to 18 years with fever lasting ≥5 days.
  • Exclusion of immunocompromised individuals, those with chronic conditions, and those on antibiotics at presentation.
  • Analysis of blood cultures, other bacterial infection diagnoses, and laboratory test utilization.

Main Results:

  • Bacteremia was found in only 0.26% of eligible children (2/742).
  • Pneumonia (11.9%) was the most common bacterial infection, followed by urinary tract infections (2.5%).
  • Antibiotics were prescribed to 33.6% of patients, including many without confirmed bacterial infections.

Conclusions:

  • The extremely low prevalence of bacteremia underscores the limited utility of routine blood cultures in well-appearing children with prolonged fever.
  • Clinical assessment is paramount; investigations should be targeted for specific management decisions.
  • Imaging plays a crucial role in diagnosing infections like pneumonia in this population.
Abstract

Keywords:
antibiotic overusebacterial Infectionschilddiagnostic stewardshipemergency servicehospitalinfantprolonged fever

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