👶 Chapter 220 · Fever Without a Focus in the Neonate and Young Infant

Nelson Textbook of Pediatrics 22nd Edition | Evaluation of febrile infants 0-90 days. SBI (UTI, bacteremia, meningitis), HSV, low-risk criteria (Rochester, Philadelphia, Step-by-Step), procalcitonin, empiric antibiotics, outpatient management.

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📋 30 Clinical Scenarios — Fever Without Focus (Neonate/Young Infant)

📇 High‑Yield Review Cards (Febrile Infant)

🩺 Febrile Infant Clinical Scenarios

Select a scenario for evaluation guidance.

📋 Stepwise Approach: Febrile Infant 0-90 Days

    📐 AAP Algorithm (2021) – Well-appearing Febrile Infant 22-60 days:
    1. Obtain UA, blood culture, inflammatory markers (procalcitonin, CRP, ANC).
    2. If all low-risk criteria met:
      - Age 22-28 days: may perform LP, administer parenteral antibiotics, observe in hospital.
      - Age 29-60 days: LP not required if low-risk; may observe at home with close follow-up within 24-36 hours.
    3. If UA abnormal → treat UTI (oral or parenteral based on age/toxicity).
    4. If inflammatory markers abnormal → LP, parenteral antibiotics, hospitalize.

    ⚡ Reflex Prompts — Febrile Infant Decisions

    📖 Summary: Fever Without Focus in Neonate/Young Infant — Nelson Ch 220