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Philadelphia Criteria for Febrile Infant 29-60 days

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Philadelphia Criteria for Febrile Infant 29-60 days, Philadelphia Criteria for Febrile Infant, Philadelphia Criteria for Infant with Fever, Febrile Infant Evaluation with Philadelphia Criteria

  • See Also
  1. Fever Without Focus
  2. Fever Without Focus Management Birth to 3 Months
  3. Fever Without Focus Management 3 to 36 months
  4. Rochester Criteria for Febrile Infant 0 to 60 days
  5. Boston Criteria for Febrile Infant 28-89 days
  6. Yale Scale for Febrile Child 3 to 36 months
  7. Pediatric Sepsis
  8. Neonatal Sepsis
  9. Fever Without Focus Red Flags
  • Indications
  1. Assessment of febrile child (>38.2 C) aged 29-60 days
  2. Reassures against serious infection (Occult Bacteremia)
  • Criteria
  • Reassuring if all criteria are present
  1. Well appearing infant
  2. Reassuring examination
  3. Labs
    1. White blood count (WBC) <15,000/mm3
    2. Band to Neutrophil ratio <0.2
    3. Urinalysis <10 WBC/hpf
    4. Urine Gram Stain Negative
    5. CSF <8 WBC/mm3
    6. CSF Gram Stain Negative
    7. Chest XRay no infiltrate (if obtained)
    8. Stool without blood and few to no Fecal Leukocytes on smear (if indicated)
  • Interpretation
  1. Higher risk
    1. Admit and start empiric Antibiotics
  2. Lower risk (all reassuring criteria met)
    1. Supports discharge with Antibiotics and with close interval follow-up
  • Efficacy
  1. Test Sensitivity: 98%
  2. Test Specificity: 42%
  3. Positive Predictive Value: 14%
  4. Negative Predictive Value: 99.7%
  • References
  1. Bachur (2001) Pediatrics 108(2): 311-6 [PubMed]
  2. Baker (1993) N Engl J Med 329:1437-41 [PubMed]
  3. Baker (2008) Clin Ped Emerg Med 9:213-20 [PubMed]