Step-By-Step Protocol for Febrile Infants


Step-By-Step Protocol for Febrile Infants, Step By Step Fever Evaluation in Age Under 90 Days

  • Indications
  1. Risk Stratification of Febrile Infants under age 90 days
  • Precautions
  1. Study focused on infants >21 days, but may be safer to apply to >28 day old infants
  2. Assumes well appearing infant
    1. See Pediatric Assessment Triangle
  • Protocol
  1. Step 0: Ill or toxic appearing infant
    1. Evaluate and Manage as high risk (see Neonatal Sepsis)
  2. Step 1: Obtain Urinalysis
    1. Positive Urinalysis for Leukocytes: Treat as intermediate risk (complete Neonatal Sepsis workup)
  3. Step 2: Obtain Procalcitonin, CBC, CRP (if Urinalysis negative)
    1. Negative markers: Treat as low risk with close interval follow-up
    2. Positive markers: Treat as intermediate risk (complete Neonatal Sepsis workup)
      1. Procalcitonin >0.5 ng/ml OR
      2. CRP >20 OR
      3. Absolute Neutrophil Count >10,000