Infections and apparent life-threatening events.
The need for routine sepsis evaluation in patients who have experienced an apparent life-threatening event but lack signs of infection remains controversial. To assess their risk of a serious occult bacterial infection, records were reviewed of 95 infants in whom infections were discovered during their inpatient evaluation after an apparent life-threatening event. Noted for each patient was the presence of any suggestive findings that would have prompted a physician to consider the given type of infection in the differential diagnosis. Thirty patients had bacterial infections; all but 5 had suggestive findings. The exceptions included 1 patient with pneumonia and 4 with urinary tract infections. None of the remaining 25 patients had occult bacterial infections. In patients with an apparent life-threatening event who appear well and lack signs suggestive of a serious bacterial infection, it may be possible to forego routine sepsis evaluation beyond a chest radiograph and urine culture without risking a serious missed diagnosis.
Department of Pediatrics, Section of General Pediatrics, New York Medical College, Valhalla, NY 10595, USA. robin_altman@nymc.edu
Robin L
RL
Altman
Karl I
KI
Li
Donald A
DA
Brand
D001049:Apnea / Q000209:etiology; D016470:Bacteremia / Q000150:complications / Q000175:diagnosis; D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis; D003490:Cyanosis / Q000209:etiology; D003625:Data Collection / Q000706:statistics & numerical data; D003937:Diagnosis, Differential; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007239:Infections / Q000150:complications* / Q000175:diagnosis*; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008581:Meningitis / Q000150:complications / Q000175:diagnosis; D009122:Muscle Hypertonia / Q000209:etiology; D009123:Muscle Hypotonia / Q000209:etiology; D012141:Respiratory Tract Infections / Q000150:complications / Q000175:diagnosis; D012307:Risk Factors; D018805:Sepsis / Q000150:complications / Q000175:diagnosis; D014552:Urinary Tract Infections / Q000150:complications / Q000175:diagnosis; D014777:Virus Diseases / Q000150:complications / Q000175:diagnosis