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Boston Criteria for Febrile Infant 28-89 days
Aka: Boston Criteria for Febrile Infant 28-89 days, Boston Criteria for Febrile Infant, Boston Criteria for Evaluation of the Infant with Fever, Febrile Infant Evaluation with Boston Criteria
- See Also
- Fever Without Focus
- Fever Without Focus Management Birth to 3 Months
- Fever Without Focus Management 3 to 36 months
- Rochester Criteria for Febrile Infant 0 to 60 days
- Philadelphia Criteria for Febrile Infant 29-60 days
- Milwaukee Criteria for Febrile Infant 28-56 days
- Yale Scale for Febrile Child 3 to 36 months
- Pediatric Sepsis
- Neonatal Sepsis
- Fever Without Focus Red Flags
- Indications
- Assessment of febrile child (>38 C) aged 28-89 days
- Reassures against serious infection (Occult Bacteremia)
- Criteria: Reassuring if all criteria are present
- Well appearing infant
- No skeletal, soft tissue, skin or ear infections
- No confounding factors
- No Immunizations in preceding 48 hours
- No antibiotics in preceding 48 hours
- Not dehydrated
- Normal labs
- CSF <10 cells/mm3
- Urinalysis <10 WBC/hpf
- WBC <20,000/mm3
- Chest XRay without infiltrate
- Interpretation
- Higher risk
- Admit and start empiric antibiotics
- Lower risk (all reassuring criteria met)
- Occult Bacteremia occurred in 5% of patients studied and these criteria did not rule-out Occult Bacteremia
- Supports discharge with antibiotics and with close interval follow-up
- Infants with all reassuring criteria present were safely discharged to home in the study
- All discharged infants were given empiric Ceftriaxone and followed up in 24 hours
- Efficacy
- Test Specificity: 94.6%
- References
- Bachur (2001) Pediatrics 108(2): 311-6 [PubMed]
- Baker (2008) Clin Ped Emerg Med 9:213-20 [PubMed]
- Baskin (1992) J Pediatr 120(1): 22-7 [PubMed]