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Risk Factors for Serious Bacterial Infection in Febrile Young Infants in a Community Referral Hospital

Cited 11 time in Web of Science Cited 18 time in Scopus
Authors
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
2009-10
Publisher
KOREAN ACAD MEDICAL SCIENCES
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE; Vol.24 5; 844-848
Keywords
C-reactive ProteinEnterovirus InfectionsFeverSerious Bacterial InfectionNeonatal Sepsis
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 >= 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.
ISSN
1011-8934
Language
English
URI
http://hdl.handle.net/10371/76989
DOI
https://doi.org/10.3346/jkms.2009.24.5.844
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College of Medicine/School of Medicine (의과대학/대학원)Pediatrics (소아과학전공)Journal Papers (저널논문_소아과학전공)
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