II. Indications
- Risk Stratification of Febrile Infants under age 90 days
III. Precautions
- Study focused on infants >21 days, but may be safer to apply to >28 day old infants
- Assumes well appearing infant
IV. Protocol
- Step 0: Ill or toxic appearing infant
- Evaluate and Manage as high risk (see Neonatal Sepsis)
- Step 1: Obtain Urinalysis
- Positive Urinalysis for Leukocytes: Treat as intermediate risk (complete Neonatal Sepsis workup)
- Step 2: Obtain Procalcitonin, CBC, CRP (if Urinalysis negative)
- Negative markers: Treat as low risk with close interval follow-up
- Positive markers: Treat as intermediate risk (complete Neonatal Sepsis workup)
- Procalcitonin >0.5 ng/ml OR
- CRP >20 OR
- Absolute Neutrophil Count >10,000
V. References
- Claudius and Behar in Herbert (2016) EM:Rap 16(12): 1-2
- Gomez (2016) Pediatrics 138(2): e20154381 +PMID: 27382134 [PubMed]
- Martinez (2015) Pediatr Infect Dis J 34(5): 494-8 +PMID: 25461476 [PubMed]
- Steinberg (2018) Am Fam Physician 97(1):45-6 [PubMed]