Occult bacteremia in the 3-month-old to 3-year-old age group.
Occult bacteremia precedes many serious infections in children. The vast majority of patients with occult bacteremia have an elevated temperature (> or = 39 degrees C), but fever is an extraordinarily common presenting complaint in the 3- to 36-month-old age group, which is at highest risk for S pneumoniae, H influenzae type b, and N meningitidis bacteremia. On examination, most patients with bacteremia will have no findings that distinguish them from nonbacteremic children. A white blood cell count of > 15,000/microL in a child with fever will identify about two thirds of children with occult bacteremia. Blood culture remains the most definitive test. It is important to establish a rational strategy to identify and treat these children before significant sequelae occur.
Harper
M B
MB
Division of Infectious Diseases, Children's Hospital, Boston, Massachusetts 02115.
Fleisher
G R
GR
D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D002675:Child, Preschool; D005334:Fever / Q000209:etiology; D006801:Humans; D007223:Infant
D000900:Anti-Bacterial Agents