II. Indications

  1. Assessment of febrile child (>38.2 C) aged 29-60 days
  2. Reassures against serious infection (Occult Bacteremia)

III. Criteria: Reassuring if all criteria are present

  1. Well appearing infant
  2. Reassuring examination
  3. Labs
    1. White blood count (WBC) <15,000/mm3
    2. Band to Neutrophil ratio <0.2
    3. Urinalysis <10 WBC/hpf
    4. Urine Gram Stain Negative
    5. CSF <8 WBC/mm3
    6. CSF Gram Stain Negative
    7. Chest XRay no infiltrate (if obtained)
    8. Stool without blood and few to no Fecal Leukocytes on smear (if indicated)

IV. Interpretation

  1. Higher risk
    1. Admit and start empiric antibiotics
  2. Lower risk (all reassuring criteria met)
    1. Supports discharge with antibiotics and with close interval follow-up

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