How much work-up do you do in the well-appearing, term, feeding, 29-60 day old infant with low-grade fever (38-38.5) without source? What about the 61-89 day old?
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How much work-up do you do in the well-appearing, term, feeding, 29-60 day old infant with low-grade fever (38-38.5) without source? What about the 61-89 day old?
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July 13, 2016 at 1:27 pm
In both age groups I do full work-up minus LP, if meets all low-risk criteria (eg Rochester), obs off abx with close f/u. If going to give abx, would do LP first. Exception: RSV or Flu+ then only urine studies.
July 23, 2016 at 4:18 pm
I would do just urine and blood (with cultures), with close follow up and awaiting cultures if they are more than 60 days. If urine is positive, I just treat for UTI. If CBC shows high white count, I will re-think about what I am treating. I would do LP in higher risk patients (fussy, and ill appearing). I think hyperpyrexia would be a factor too, but I think 41 C, is what I remember.
I would do LP and Abx in the 29-60 day age group if ill appearing, perinatal complications, WBC > 15K, ANC >