S-Space College of Medicine/School of Medicine (의과대학/대학원) Pediatrics (소아과학전공) Journal Papers (저널논문_소아과학전공)
Risk Factors for Serious Bacterial Infection in Febrile Young Infants in a Community Referral Hospital
- Shin, Seung Han; Choi, Chang Won; Lee, Jin-A; Kim, Ee-Kyung; Kim, Han-Suk; Choi, Jung-Hwan; Kim, Beyong Il; Choi, Eun Hwa
- Issue Date
- KOREAN ACAD MEDICAL SCIENCES
- JOURNAL OF KOREAN MEDICAL SCIENCE; Vol.24 5; 844-848
- C-reactive Protein; Enterovirus Infections; Fever; Serious Bacterial Infection; Neonatal Sepsis
- 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 >= 1.87 mg/dL and 2) fevers of >= 38.9 degrees 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 >= 1.87 mg/dL and fevers of >= 38.9 degrees C can be used as criteria to rule out SBI in these infants.