Risk Factors for Serious Bacterial Infection in Febrile Young Infants in a Community Referral Hospital.
10.3346/jkms.2009.24.5.844
- Author:
Seung Han SHIN
1
;
Chang Won CHOI
;
Jin A LEE
;
Ee Kyung KIM
;
Eun Hwa CHOI
;
Han Suk KIM
;
Beyong Il KIM
;
Jung Hwan CHOI
Author Information
1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. choicw@snu.ac.kr
- Publication Type:Original Article
- Keywords:
C-reactive Protein;
Enterovirus Infections;
Fever;
Neonatal Sepsis;
Serious Bacterial Infection
- MeSH:
Bacterial Infections/*diagnosis;
C-Reactive Protein/analysis;
Demography;
Enterovirus/genetics/isolation & purification;
Female;
Fever/diagnosis;
Hospitals, Community;
Humans;
Infant;
Infant, Newborn;
Male;
Meningitis, Bacterial/diagnosis;
Predictive Value of Tests;
Risk Factors;
Seasons;
Urinary Tract Infections/diagnosis
- From:Journal of Korean Medical Science
2009;24(5):844-848
- CountryRepublic of Korea
- Language:English
-
Abstract:
Differentiation of serious bacterial infection (SBI) from self-limiting viral illness in febrile infants younger than three months is a significant challenge for clinicians. We aimed to assess the risk factors for SBI in febrile infants. Data were obtained from 221 infants younger than three months who visited a single community referral hospital for fever and underwent a complete sepsis workup between August 2003 and July 2006. The causes of fever were febrile illness without a documented cause (FISDC, 65%), urinary tract infection (UTI, 12%), aseptic meningitis (12%), bacteremia (4%), bacterial meningitis (2%). Cerebrospinal fluid enterovirus polymerase chain reaction was positive in 28% of FISDC and 48% of aseptic meningitis cases. When UTI was excluded, the risk factors for SBI were 1) C-reactive protein (CRP) level of > or =1.87 mg/dL and 2) fevers of > or =38.9degrees C. The specificity and negative predictive values of risk factors 1) and 2) for the diagnosis of SBI were 94% and 95%, respectively. We concluded that enteroviral infection may be a major cause of febrile episodes in infants younger than three months. If UTI could be excluded, the presence of CRP levels > or =1.87 mg/dL and fevers of > or =38.9degrees C can be used as criteria to rule out SBI in these infants.
