Age <28 days |
Ill appearance |
Rectal temperature ≥38.5°C (101.3°F; infants 22 to 60 days old only)¶ |
Prematurity (gestational age <37 weeks) |
Received antibiotics within:
|
Comorbidities or chronic illness (any one of the following):
|
Maternal risk for early-onset sepsis (neonates <14 days only, any one of the following):
|
Focal infection◊ |
* Invasive bacterial illness (IBI) primarily refers to bacteremia and meningitis.
¶ For well-appearing neonates 22 to 28 days old and infants 29 to 60 days old in settings where procalcitonin measurements are not readily available, a temperature ≥38.6°C may also be used as an inflammatory marker that raises the risk of IBI along with absolute neutrophil count, or C-reactive protein (refer to UpToDate content on evaluation and management of the febrile neonate and the febrile infant 29 to 60 days of age).
Δ Examples include home ventilator, home oxygen, or total parenteral nutrition.
◊ Focal infections associated with an increased risk of IBI in febrile young infants include cellulitis, abscess, pneumonia, osteomyelitis, bacterial arthritis, and omphalitis.