04.2019
Author Prof. J. Spranger, University Department of Pediatrics Mainz

During a 13-year period a total of 2479 young infants (<3 months) were presented in a pediatric emergency unit with a history of fever [1]. To study the significance of fever itself, infants with clear clinical evidence of bacterial sepsis were eliminated from the retrospective study, as were infants with incomplete clinical data. This left a study group of 2470 infants who had fever at home but upon admission had no clinical signs suggesting a bacterial infection. The standardized management protocol included urine dipstick test, complete blood cell count, measurement of CRP, procalcitonin levels, blood and urine cultures. About a quarter of the patients were afebrile at admission. In this group of 678 well-appearing, afebrile infants sixteen (2.4%) had an invasive bacterial infection.  The incidence in infants with persisting fever was the same (43/1792 = 2.4%).