title: Utility of sepsis evaluation in infants 90 days of age or younger with fever and clinical bronchiolitis.
abstract: OBJECTIVE
  To identify the clinical utility of obtaining blood, urine and cerebrospinal fluid for bacterial culture among febrile infants <90 days of age with clinical bronchiolitis.
  
  
  METHODS
  Retrospective chart review from 1995 to 2000.
  
  
  METHODS
  Urban emergency department of a tertiary children's hospital.
  
  
  METHODS
  All infants <90 days of age presenting with fever and clinical bronchiolitis.
  
  
  METHODS
  Result of the cultures of blood, urine and cerebrospinal fluid.
  
  
  RESULTS
  Of 3051 (11%) febrile infants, 329 met criteria for clinical bronchiolitis. Blood for culture was obtained from 309 (94%), urine for culture was obtained from 273 (83%) and cerebrospinal fluid for culture was obtained from 200 (61%). One hundred eighty-seven (57%) infants had all 3 specimens sent for culture. No cases of bacteremia [0%; 95% confidence interval (CI), 0, 1.1%] or meningitis (0%; 95% CI 0, 1.8%) occurred among these infants. However, 6 infants (2%; 95% CI 0.8, 5.7%), all male, had a culture of urine consistent with infection (4 Escherichia coli, 1 Staphylococcus aureus, 1 viridans streptococci).
  
  
  CONCLUSIONS
  The risk of bacteremia or meningitis among infants <90 days with fever and bronchiolitis is low in this age group. The risk of urinary tract infection in this age group is also low, but not negligible, at 2%.
authors.affiliation: Department of Medicine, Children's Hospital Boston, MA 02115, USA.
authors.forename: Elliot
authors.initials: E
authors.lastname: Melendez
authors.forename: Marvin B
authors.initials: MB
authors.lastname: Harper
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D001769:Blood / Q000382:microbiology; D001988:Bronchiolitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014505:Urban Population; D016482:Urinalysis; D014556:Urine / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents