Balanced Approach to Neonates and Young Infants with Fever

Abstract

Fever in early infancy may indicate the presence of an invasive bacterial infection [IBI]. Viral infection is the most common cause of fever in young infants, with Rhinovirus being the most common. Rectal temperature 38°C should be considered as fever. Bacterial infection may be the cause of fever in this age group even in the presence of a clear viral etiology. Evaluation and treatment of febrile infants during the first 3 months of life requires a balanced and cautious approach. After the introduction of vaccines in early infancy, there have been considerable changes in the bacterial pathogens and consecutive changes in the evaluation and empiric treatment of febrile young infants. While full septic screen seems necessary in the evaluation of many febrile young infants, partial septic screen without Lumbar puncture could be better in selected cases. It is the responsibility of the pediatrician to recognize the risk of invasive bacterial infection and to avoid unnecessary investigations at the same time. In this study, we suggest a simple approach that avoids the weak points of the available approach plans. Using clinical examples, we try to simplify this practical challenge.