Evaluation/Treatment of Febrile Young Infants (0-56 days old)

Additional Diagnostic Tests

RRP

PE evidence of URI, bronchiolitis, conjunctivitis

Enterovirus
(June- October)

Blood, CSF, urine for PCR on admitted patients

HSV
Testing / Treatment

Start Acyclovir for infants ≤ 21 days OR for infants 22 to 40 days with ≥ 1 of the following:
  • Ill- appearance
  • Abnormal neurologic status, seizure
  • Vesicular rash
  • Hepatitis
Send the following tests:

Isolated CNS Disease
Blood, CSF PCR

SEM (Skin, Eye, Mouth)
Swabs from conjuctiva, buccal mucosa, rectum,
base of vesicle
Blood, CSF PCR

Disseminated Disease
Send all of the above
BMP, LFTs, PT/PTT, type and screen

Stool Studies

Bacterial Culture: Mucous or gross blood in the stool
Consider Norovirus, Adenovirus, Rotavirus

CXR

Concern for bacterial pneumonia
Suspected HSV infection with respiratory symptoms
Suspected Chlamydia or Pertussis

CSF Analysis

Tube 1 Culture and Gram stain
Tube 2 Glucose, protein
Tube 3 Cell count and differential
Tube 4 Viral Studies or to be saved for further studies