II. Indications

  1. Assessment of febrile child (>38 C) aged less than 60 days
  2. Reassures against serious infection (Occult Bacteremia)

III. Criteria: Reassuring if all criteria are present

  1. Well appearing infant
  2. No skeletal, soft tissue, skin or ear infections
  3. Full term birth
  4. No prior illness
    1. No prior hospitalizations
    2. Not hospitalized longer than mother after delivery
    3. No prior antibiotics
    4. No Hyperbilirubinemia
    5. No chronic or underlying illness
  5. Complete Blood Count normal
    1. White Blood Cell Count normal (5000 to 15,000/mm3)
    2. Band Neutrophils < 1,500/mm3
  6. Other Lab Findings
    1. If Diarrhea is present, Fecal Leukocytes <5 WBC/hpf
    2. Urine White Blood Cells <10 WBC/hpf

IV. Interpretation: Occult Bacteremia risk

  1. Well-appearing febrile infant risk: 7-9%
  2. All Rochester reassuring criteria present: <1%
    1. Supports discharge to home with close follow-up and no empiric antibiotics

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