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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد

Approach to febrile infants 29 to 60 days old at low risk for invasive bacterial illness

Approach to febrile infants 29 to 60 days old at low risk for invasive bacterial illness
This algorithm provides the diagnostic approach to IBI in low-risk, well-appearing, febrile infants 29 to 60 days old who do not have comorbidities and who have not received antibiotics within the prior three days. For preterm infants, this algorithm only applies to those 29 to 60 days old according to the patient's corrected post-conceptual age. The approach is based upon the PECARN low risk clinical prediction rule. This algorithm is intended for use with other UpToDate content; refer to UpToDate topics on the evaluation of febrile infants 29 to 60 days old.

ANC: absolute neutrophil count; CBC: complete blood count; CRP: C-reactive protein; CSF: cerebrospinal fluid; IM: blood inflammatory marker; IBI: invasive bacterial illness; LP: lumbar puncture; PCT: procalcitonin; PECARN: Pediatric Emergency Care Applied Research Network.

* Obtain urine sample by bladder catheterization or suprapubic aspiration. It is reasonable for clinicians to also send a urine culture with initial urine testing in settings with documented low rates of specimen contamination and with timely specimen processing. Urine specimens obtained using bag collection are not acceptable for culture.

¶ Abnormal urine testing includes any one of the following:

  • Leukocyte esterase or nitrite present on dipstick
  • >5 WBCs/high-power field (centrifuged urine)
  • >10 WBCs/mm3 (uncentrifuged urine)

Δ Oral antibiotics according to regional susceptibility of E. coli; it is reasonable to give a parenteral dose (intravenous or intramuscular) of ceftriaxone in the emergency department as a first dose. Refer to UpToDate content on management of urinary tract infections in infants >1 month old and children.

◊ If the social situation suggests that follow-up within 24 hours is problematic (eg, unreliable transportation, no phone, parent/primary caregiver inability to assess severity of illness, or other concerns regarding parental adherence), then admit the infant.

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