Which febrile infants younger than two weeks of age are likely to have sepsis? A pilot study.
During a 7-year period we prospectively studied 46 infants younger than 2 weeks of age with rectal temperatures of 100.6 degrees F or higher. Before performing a full laboratory evaluation for sepsis, house officers recorded their impressions of whether the infants were likely to have sepsis. Using the combination of impression of sepsis, white blood cell count and erythrocyte sedimentation rate, infants were assigned to one of two sepsis risk groups (high or low). All patients were hospitalized and treated with parenteral antibiotics. Sepsis or meningitis was diagnosed in 8.7% of the patients. Thirty-five of the 46 infants had sufficient data for risk group assignment. Sepsis or meningitis was diagnosed in 3 of 11 high risk infants vs. 0 of 24 low risk patients (P = 0.025). Of the 21 infants initially admitted without an identified bacterial source, 4 subsequently developed a bacterial complication, i.e. a bacterial focus that, although present at the time of admission, became apparent only after hospitalization. A bacterial complication was identified during the hospital course in 3 of 4 high risk infants vs. 1 of 17 low risk patients (P = 0.012).
Crain
E F
EF
Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY.
Gershel
J C
JC
D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000382:microbiology*; D003937:Diagnosis, Differential; D006801:Humans; D007231:Infant, Newborn; D008581:Meningitis / Q000382:microbiology; D010865:Pilot Projects; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000382:microbiology*; D014777:Virus Diseases / Q000382:microbiology