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Febrile Infant — LP Guidance — Clinical Pathway: Emergency and Inpatient

Febrile Infant Clinical Pathway — Emergency Department and Inpatient

LP Guidance

  • Multi-center studies show that, for this age group, the rate of bacterial meningitis is no higher among those with pyelonephritis than those without pyelonephritis.
  • In one study, 0/697 in 2nd month of life with abnormal UA had bacterial meningitis (including 0/90 with both elevated ANC and PCT).

Per 2021 AAP Guidelines:

  • Obtaining CSF if any IM is abnormal (with or without abnormal UA) is
    a “Weak recommendation.”
  • Data are unavailable comparing prevalence of bacterial meningitis in
    IM-positive versus IM-negative infants.
  • Individual IMs are seldom sensitive or specific for detecting bacteremia or bacterial meningitis. However, individual values that are exceedingly high or low or finding several abnormal IMs should be considered in decision-making.

 

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