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Pediatric “Sepsis”

  • Consider in any toxic appearing child/neonate
    • Especially with fever (or hypothermia)
  • Treatment
    • Early antibiotics
    • Fluid bolus

“Serious Bacterial Infections” (SBI)

  • Consider in any baby with fever
  • Three classic categories
    • Age <30 days
      • Introduction
        • Weak immune system
        • No immunizations
        • Very high risk for serious bacterial infections
      • Require a significant amount of testing
        • Urinalysis with Urine Culture
        • Blood Cultures
        • Lumbar Puncture with CSF Cultures
        • Chest X-Ray
      • Require admission and antibiotics
    • Age 30-60 days
      • ILL appearing
        • Treat same as fever in <30 day patient
      • WELL appearing
        • Testing and treatment differ by institution
        • Multiple criteria established to help in this age range
          • Rochester criteria
          • Philadelphia criteria
          • PECARN criteria
        • Choose one and use consistently
    • Age >60 days
      • (Assumes immunizations are up to date)
      • Workup is more targeted
        • Blood cultures, Urine cultures, Chest X-Rays still common

Additional Reading

  • Rochester Criteria Febrile Infants (MDCalc)
  • PECARN Rule for Low Risk Febrile Infants (MDCalc)