- Fever Without Focus
- Fever Without Focus Management Birth to 3 Months
- Fever Without Focus Management 3 to 36 months
- Philadelphia Criteria for Febrile Infant 29-60 days
- Rochester Criteria for Febrile Infant 0 to 60 days
- Boston Criteria for Febrile Infant 28-89 days
- Yale Scale for Febrile Child 3 to 36 months
- Pediatric Sepsis
- Neonatal Sepsis
- Fever Without Focus Red Flags
- Assessment of febrile infant (>38.0 C or 100.4 F) aged 28-56 days
- Reassures against serious infection (Occult Bacteremia)
- Reassuring if all criteria are present
- Well appearing infant
- Alert and active
- Normal respiratory status
- Normal Muscle tone
- Reassuring examination
- Not dehydrated
- No signs of focal infection
- No Otitis Media
- No soft tissue infection
- No bone or joint infection
- Labs
- White blood count (WBC) <15,000/mm3
- Urinalysis <5-10 WBC/hpf
- Urine Gram Stain Negative for Bacteria
- Urine Leukocyte Esterase and nitrite negative
- CSF <10 WBC/mm3
- Chest XRay no infiltrate (if obtained)
- Higher risk
- Management per local protocol for possible Occult Bacteremia
- Lower risk (all reassuring criteria met)
- Supports discharge with Antibiotics (Ceftriaxone 50 mg/kg IM)
- Close interval follow-up within 24 hours
- Test Sensitivity: 96%
- Test Specificity: 42%
- Negative Predictive Value: 99%
- Herman (2015) Crit Dec Emerg Med 29(12):14-19
- Hui (2012) Evid Rep Technol Assess (205):1-297 +PMID:24422856 [PubMed]