Management of fever in young infants

Management of the febrile young infant remains a source of consternation for parent and practitioner alike. Although the risk of serious bacterial illness in well-appearing febrile infants younger than 2 months old without a source of infection on physical examination is small, the absence of reliable clinical signs makes diagnosis difficult. For many years, a sepsis evaluation, routine hospitalization, and empiric antibiotic therapy was the rule. However, recent prospective studies have shown that a select group of febrile infants who meet low-risk criteria consisting of clinical and laboratory parameters, may be managed a as outpatients. This article reviews the epidemiology of febrile illness in infants younger than 2 months old. Recent prospective research is reviewed with an emphasis on differences in screening criteria and the subsequent effect on outcome. A management strategy based on these data is proposed. Copyright copy; 2000 by W.B. Saunders Company.