Current management of occult bacteremia in infants

Jornal de pediatria
Eduardo Mekitarian Filho, Werther Brunow de Carvalho

Abstract

To summarize the main clinical entities associated with fever without source (FWS) in infants, as well as the clinical management of children with occult bacteremia, emphasizing laboratory tests and empirical antibiotics. A non-systematic review was conducted in the following databases--PubMed, EMBASE, and SciELO, between 2006 and 2015. The prevalence of occult bacteremia has been decreasing dramatically in the past few years, due to conjugated vaccination against Streptococcus pneumoniae and Neisseria meningitidis. Additionally, fewer requests for complete blood count and blood cultures have been made for children older than 3 months presenting with FWS. Urinary tract infection is the most prevalent bacterial infection in children with FWS. Some known algorithms, such as Boston and Rochester, can guide the initial risk stratification for occult bacteremia in febrile infants younger than 3 months. There is no single algorithm to estimate the risk of occult bacteremia in febrile infants, but pediatricians should strongly consider outpatient management in fully vaccinated infants older than 3 months with FWS and good general status. Updated data about the incidence of occult bacteremia in this environment after conjugated vaccina...Continue Reading

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Citations

Nov 30, 2016·Pediatric Emergency Care·Eduardo Mekitarian Filho, Juliana Bronzato Luppi
Aug 25, 2019·Archives of Disease in Childhood·Jonathan KaufmanKim Dalziel
Nov 14, 2019·Revista da Associação Médica Brasileira·Leonardo Fernandes E SantanaOrlando Vieira Gomes
May 22, 2020·Frontiers in Pediatrics·Alexandre M PimentelCristiana M Nascimento-Carvalho
Jan 17, 2021·The Journal of Pediatrics·Jennifer DunnickParia M Wilson
Feb 20, 2021·Ciência & saúde coletiva·Pedro Jose PitoliMaria José Sanches Marin

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