Skip to main content

Febrile Infant Clinical Pathway – Emergency Department and Inpatient

Emergency Department and Inpatient Clinical Pathway for Evaluation/Treatment of Febrile Infants ≤ 56 Days Old with Community Onset Fever

Inclusion Criteria

  • 0–56 days of age
  • Recorded temp ≥ 38.0°C (100.4°F) in past 24 hrs
  • Well-appearing
Lab Study Definition of Abnormal
Procalcitonin > 0.5 ng/mL
Absolute Neutrophil Count > 4000 neutrophils/µL
Urinalysis with Reflex to Microscopy
  • Any leukocyte esterase (LE) on dipstick
  • or
  • > 5 WBCs per hpf
CSF
  • 0–28 days: ≥ 15 WBC/µL
  • 29–56 days: ≥ 9 WBC/µL
Antimicrobials
Recommendations, dosing, and rationale
 
 

ED Triage

ED nursing pathway standing order set: Febrile Young Infant
 
 

ED Team Assessment and Bedside Procedure

 
 
 
 
 
 
 
 
 
 

0–21 Days Old

  • Blood culture
  • UA, urine culture
  • HSV testing
  • Perform LP
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  • Abnormal UA
  • or
  • ≥ 1 abnormal IM
  • Perform LP
  • Normal UA
  • Normal IMs
  • No LP
  • Normal UA
  • ≥ 1 abnormal IM
  • Perform LP
  • Abnormal UA
  • Normal IMs
  • No LP
  • Normal UA
  • Normal IMs
  • No LP
 
 
 
 
 
 
 
 
 
 
 
 
No antimicrobials
  • Discharge home with follow-up
  • or
  • Admit without antimicrobials as indicated for etiologies other than serious bacterial infections
 
 
 
 
 
 
 
 
Admit from Emergency Department
 
 
 
 
 
 

 

Jump back to top