Evaluation and management of well-appearing, otherwise healthy febrile infants ≤90 days of age with influenza

PCR: polymerase chain reaction; UTI: urinary tract infection; LE: leukocyte esterase; WBCs: white blood cells; HPF: high-power field.
* For recommended tests, refer to UpToDate content on outpatient evaluation of febrile young infants.
¶ Urine tests should be obtained by bladder catheterization or suprapubic aspiration. Some experts also recommend a complete blood count with differential and a blood culture, and, for patients with abnormal inflammatory markers, intravenous antibiotics and hospital admission.
Δ Empiric antibiotics should be adjusted based upon susceptibility of organisms in the region. Although risk of bacteremia is low in febrile infants who are 29 to 90 days of age with a UTI, some experts also recommend a complete blood count and a blood culture, and, for patients with an elevated WBC or absolute neutrophil count, intravenous antibiotics and hospital admission. Refer to UpToDate content on treatment of UTI in infants and children.
◊ Refer to UpToDate content on treatment of seasonal influenza in children. Infants who are hydrated, have adequate oral intake, and do not have significant respiratory distress may be discharged home with close follow-up within 24 to 48 hours.