Correlating Infectious Outcome With Clinical Parameters of 1130 Consecutive Febrile Infants Aged Zero to Eight Weeks

Pediatr Emerg Care. 1993 Apr;9(2):84-6. doi: 10.1097/00006565-199304000-00006.

Abstract

The study objectives were to characterize the infectious outcomes and associated clinical parameters of a large group of febrile young infants who received outpatient sepsis evaluation. This retrospective review of consecutive cases during a seven-year period was set in an urban pediatric emergency department. Febrile infants, aged zero to eight weeks, were the participants. All received a standard evaluation for sepsis, including complete blood count/blood culture, lumbar puncture/cerebrospinal fluid culture, and urinalysis/urine culture. Of 1130 patients, 447 (42%) were aged zero to four weeks, and 683 (58%) were aged four to eight weeks. In 96 cases (8.5%), a bacterial pathogen was isolated by culture of cerebrospinal fluid, blood, urine, or stool; 58% were aged zero to four weeks and 42% were aged four to eight weeks. The rate of positive cultures per patient age was doubled in those aged zero to four weeks (12%) compared with those aged four to eight weeks (6%). The 49 cases of invasive bacterial infections (bacterial meningitis/bacteremia) were most commonly associated with lower degrees of fever, as slightly over one half (25/49) had temperature < 39 degrees C. The most common pathogens of invasive bacterial infection were group B streptococcus and Escherichia coli, accounting for 33 of 49 cases (67%); the most common pathogens of invasive bacterial infection in older children (Haemophilus influenzae type b and Streptococcus pneumoniae) were relatively underrepresented, accounting for only five of these 49 (10%) cases.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Bacteremia / diagnosis
  • Bacterial Infections / diagnosis*
  • Bacterial Infections / physiopathology
  • Body Temperature
  • Escherichia coli Infections / diagnosis
  • Fever* / etiology
  • Fever* / physiopathology
  • Humans
  • Infant
  • Infant, Newborn
  • Meningitis, Bacterial / diagnosis
  • Outpatients
  • Retrospective Studies
  • Streptococcal Infections / diagnosis
  • Streptococcus agalactiae
  • Urinary Tract Infections / diagnosis
  • Urinary Tract Infections / therapy