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- Title
Paediatric emergency departments should manage young febrile and afebrile infants the same if they have a fever before presenting.
- Authors
Orfanos, Ioannis; Sotoca Fernandez, Jorge; Elfving, Kristina; Alfvén, Tobias; Eklund, Erik A.
- Abstract
<bold>Aim: </bold>Our aim was to evaluate the risk of bacterial meningitis, bacteremia, and urinary tract infection (UTI) in infants ≤60 days who presented to paediatric emergency departments (PEDs) after having fever at home. We also investigated any differences between infants who were afebrile or febrile on presentation.<bold>Methods: </bold>This was a multicenter retrospective study of infants ≤60 days presented to four Swedish PEDs during 2014-2020 with reported fever at home. We used relative risks (RR) to compare the prevalence of UTI, bacteremia, and bacterial meningitis between the infants who were afebrile and the infants who were still febrile when they presented to the PED.<bold>Results: </bold>The cohort comprised 1926 infants, and 702 (36%) were afebrile on presentation. The prevalence of UTI in the afebrile and febrile infants was 6.1% [95% confidence interval (CI) 4.5-8.2] versus 14.2% (95% CI 12.3-16.2), corresponding to an RR of 0.43 (95% CI 0.31-0.59). In infants ≤28 days, the RR for meningitis was 1.05 (95% CI 0.18-6.23) for afebrile versus febrile infants. Five times more febrile infants underwent a lumbar puncture.<bold>Conclusion: </bold>Infants who were afebrile on presentation underwent fewer lumbar punctures, but they had similar rates of bacterial meningitis to febrile infants. Different management approaches are not justified.
- Subjects
BACTEREMIA; RESEARCH; HOSPITAL emergency services; FEVER; URINARY tract infections; RESEARCH methodology; RETROSPECTIVE studies; EVALUATION research; BACTERIAL meningitis; COMPARATIVE studies; BACTERIAL diseases
- Publication
Acta Paediatrica, 2022, Vol 111, Issue 10, p2004
- ISSN
0803-5253
- Publication type
journal article
- DOI
10.1111/apa.16483