Inpatient Pathway for Evaluation - Febrile Young Infant (29-56 Days) Admitted
Febrile Young Infant (29-56 Days) Admitted
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29-56 days old with clinical
bronchiolitis and “low risk” by
Philadelphia criteria?
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Follow pending culture(s).
Strongly consider sending urine
culture if not sent
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Manage
bronchiolitis per
Bronchiolitis
Pathway
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Reassuring CSF profile
and blood and urine culture negative x 24 hours?
YES
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Consider discharge if infant well appearing
with adequate oral
intake
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NO
UTI?
YES
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Manage per
Urine Culture Positive
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NO
Bacteremia?
YES
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Manage per
Blood Culture Positive
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NO
HSV Positive?
YES
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Manage per
HSV Positive
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NO
Positive Viral Testing
from any site?
YES
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Manage per
Enterovirus PCR
positive
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NO
Acute diarrheal illness with
identifiable pathogen?
YES
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Viral vs.
Bacterial
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NO
Viremia with paraecho,
HHV6, parvo or adeno
YES
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Manage as per viral illness
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NO
Definitive bacterial process identified
(e.g, lymphadenitis, pneumonia, osteomyelitis, cellulitis)
YES
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Target management for
specific bacterial process
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NO
CSF studies not reassuring
(i.e., uninterpretable or unavailable)
Not
Reassuring
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Consider LP by IR
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Complete treatment for serious bacterial or viral
infection of concern that cannot be excluded
based on limitations of work-up.
Date Posted: January 2010.