Evaluation and Management of Febrile, Well-appearing Young Infants

Overview

Journal Infect Dis Clin North Am

Specialty Infectious Diseases

Date 2015 Jul 20

PMID 26188607

Citations 12

Authors

Eric A Biondi

Carrie L Byington

Affiliations

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Abstract

The evaluation and management of well-appearing febrile infants less than 3 months of age has presented a decades-long clinical conundrum for providers. This article reviews the epidemiology of bacterial and viral infections in these infants. It discusses evidence-based diagnostic and treatment strategies, including appropriate use of testing, admission to the hospital, use of antibiotics, and hospital discharge. It also highlights the substantial variation in care for febrile infants and provides strategies to standardize practice.

Citing Articles

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Fever without source in infants aged 22-60 days: how laboratory tests perform at identifying bacterial infections and predicting the need for a lumbar puncture?.

Vachon K, Gravel G, Leduc S, Larouche A, Mallet M, Simonyan D World J Emerg Med. 2025; 16(1):74-77.

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Boston Febrile Infant Algorithm 2.0: Improving Care of the Febrile Infant 1-2 Months of Age.

Dorney K, Neuman M, Harper M, Bachur R Pediatr Qual Saf. 2022; 7(6):e616.

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Illness severity indicators in newborns by COVID-19 status in the United States, March-December 2020.

Wallace B, Chang D, Woodworth K, DeSisto C, Simeone R, Ko J J Perinatol. 2021; 42(4):446-453.

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Time to Positive Blood and Cerebrospinal Fluid Cultures in Febrile Infants ≤60 Days of Age.

Alpern E, Kuppermann N, Blumberg S, Roosevelt G, Cruz A, Nigrovic L Hosp Pediatr. 2020; 10(9):719-727.

PMID: 32868377 PMC: 7446544. DOI: 10.1542/hpeds.2020-0045.