Infectious Disease Book

Antibody

Febrile Illness

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Rochester Criteria for Febrile Infants

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  1. Indications
    1. Assessment of febrile child ages 60-90 days
    2. Reassures against serious infection (Occult Bacteremia)
  2. Criteria: Reassuring if all criteria are present
    1. Well appearing infant
    2. No skeletal, soft tissue, skin or ear infections
    3. Full term birth
    4. No prior illness
      1. No prior hospitalizations
      2. Not hospitalized longer than mother after delivery
      3. No prior antibiotics
      4. No Hyperbilirubinemia
      5. No chronic or underlying illness
    5. Complete Blood Count normal
      1. White Blood Cell count normal (5000 to 15,000/mm3)
      2. Band Neutrophils < 1,500/mm3
    6. Other Lab Findings
      1. If Diarrhea is present, Fecal Leukocytes <5 per hpf
      2. Urine White Blood Cells <10 per hpf
  3. Interpretation: Occult Bacteremia risk
    1. Well-appearing febrile infant risk: 7-9%
    2. All Rochester criteria present: <1%
  4. References
    1. Dagan (1985) J Pediatr 107:855
    2. Jaskiewicz (1994) Pediatrics 94:390

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