Santiago Mintegi 1,2 , Borja Gomez 1,2 , Alba Carro 1,2 , Haydee Diaz 1,2 , Javier Benito 1,2 Show Affiliations »
Abstract
OBJECTIVE: To determine the prevalence of invasive bacterial infections (IBI, pathogenic bacteria in blood or cerebrospinal fluid) in infants less than 90 days old with fever without a source related to the presence or absence of fever on arrival to the emergency department (ED). DESIGN: Prospective registry-based cohort study. SETTING: Paediatric ED of a tertiary teaching hospital. PATIENTS: We included infants less than 90 days old with a history of fever evaluated in the ED from 2003 to 2016. MAIN OUTCOMES AND MEASURES: The prevalence of IBI in patients with a history of fever who were febrile and afebrile on arrival to the ED. RESULTS: We included 2470 infants: 678 afebrile and 1792 febrile when evaluated in the ED. Fifty-nine (2.4%) were diagnosed with an IBI (bacteraemia 46, meningitis 7 and sepsis 6): 16 in the group of afebrile infants with a history of fever (2.4%, 95% CI 1.4 to 3.8 vs 43 in the febrile group, 2.4%, 95% CI 1.8 to 3.2). Of the 16 afebrile infants with a history of fever diagnosed with an IBI, 14 were well appearing. The rate of non-IBI (pathogenic bacteria in urine or stools) was similar in both groups (15.5% and 16.7%). CONCLUSIONS: The prevalence of IBI in infants ≤90 days with a history of fever is similar regardless of the presence of fever on the arrival at the ED. The approach to infants with a history of fever who are afebrile in the ED should not differ from that recommended for infants who are febrile in the ED. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
OBJECTIVE: To determine the prevalence of invasive bacterial infections (IBI , pathogenic bacteria in blood or cerebrospinal fluid) in infants less than 90 days old with fever without a source related to the presence or absence of fever on arrival to the emergency department (ED). DESIGN: Prospective registry-based cohort study. SETTING: Paediatric ED of a tertiary teaching hospital. PATIENTS : We included infants less than 90 days old with a history of fever evaluated in the ED from 2003 to 2016. MAIN OUTCOMES AND MEASURES: The prevalence of IBI in patients with a history of fever who were febrile and afebrile on arrival to the ED. RESULTS: We included 2470 infants : 678 afebrile and 1792 febrile when evaluated in the ED. Fifty-nine (2.4%) were diagnosed with an IBI (bacteraemia 46, meningitis 7 and sepsis 6): 16 in the group of afebrile infants with a history of fever (2.4%, 95% CI 1.4 to 3.8 vs 43 in the febrile group, 2.4%, 95% CI 1.8 to 3.2). Of the 16 afebrile infants with a history of fever diagnosed with an IBI , 14 were well appearing. The rate of non-IBI (pathogenic bacteria in urine or stools) was similar in both groups (15.5% and 16.7%). CONCLUSIONS: The prevalence of IBI in infants ≤90 days with a history of fever is similar regardless of the presence of fever on the arrival at the ED. The approach to infants with a history of fever who are afebrile in the ED should not differ from that recommended for infants who are febrile in the ED. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Entities: Chemical
Disease
Species
Keywords:
fever; infant; invasive bacterial infection; serious bacterial infection
Mesh： See more »
Year: 2018
PMID： 29449214 DOI： 10.1136/archdischild-2017-313578
Source DB: PubMed Journal: Arch Dis Child ISSN： 0003-9888 Impact factor: 3.791