Clinical Study of Hospitalized Infants 28 to 90 Days of Age with Fever without Source

Rye, Min Hyuk; Noh, Yn Il; Lee, Seong Hun; Lee, Sun Young; Hur, Nam Jin; Lee, Dong Jin

Abstract

PURPOSE
The purpose of this study was to investigate clinical features of hospitalized infants 28~90 days of age with fever without source and to analyze those of young febrile infants using risk criteria for serious bacterial infection.
METHODS
The clinical features of 131 infants 28~90 days of age admitted to the Ulsan Dong-Kang General Hospital Pediatric Department because of fever(temperature â‰¥38â„ƒ rectally) without source, from January 2000 to December 2000, were investigated by retrospective chart review. The clinical features of 131 febrile infants were analyzed using Rochester criteria.
RESULTS
Among 131 cases, there were 60 cases(45.8%) of urinary tract infection, 33 cases (25.2%) of aseptic meningitis, 2 cases(1.5%) of bacteremia and 36 cases(27.5%) of no specific diagnosis. Among 131 cases, there were 57 cases(43.5%) in low risk group and 74 cases(56.5%) in not low risk one by Rochester criteria. A significant difference in the incidence of urinary tract infection, aseptic meningitis and no specific diagnosis was not found between both groups. Male to female ratio was 1.8 : 1. Sex ratio between both groups was not significantly different. Most febrile infant were noted in spring(35.1%) and the summer (36.7%). The peak incidence of aseptic meningitis was noted in May and June. The fever subsided mostly within 48~72 hours after administering antimicrobial agents(61.8~83.2%). A significant difference in duration of fever after administering antimicrobial agents was not found between both groups.
CONCLUSION
A selected group of low risk infants 28~90 days of age with fever without source can be managed as outpatients provided that a thorough initial evaluation is performed, that parents can reliably monitor their infant closely at home and that careful follow up can be assured. Because bag collected specimens were more likely to yield indeterminate urine culture result, a suprapubic or catheter obtained urine specimen for culture is a necessary part of the evaluation of all febrile infants 28âˆ¼90 days of age. The further prospective study on evaluation and management of young febrile infant should be performed in our hospital.