In plain words
A febrile infant is a baby with a fever. In the first months of life, a fever is taken more seriously than in older children. Young babies can have serious infections without showing many other signs. The American Academy of Pediatrics uses a rectal temperature of 100.4 degrees Fahrenheit, or 38 degrees Celsius, as its threshold. A baby this young with a fever usually needs a prompt evaluation by a clinician, which may include blood and urine tests. Many babies with fever have a viral infection and do well. The team uses set rules to decide who needs more testing. Call your pediatrician or go to the emergency room right away if your baby has a fever, is hard to wake, or is feeding poorly.
The deeper version
The AAP clinical practice guideline on febrile infants up to 60 days (Pantell and colleagues, Pediatrics, 2021) uses a rectal temperature of 38.0 degrees Celsius or higher as the threshold and stratifies risk by age, well-appearing status, and laboratory results. The PECARN rule (Kuppermann and colleagues, JAMA Pediatrics, 2019) and the Step-by-Step approach are validated stratification tools for . Urinary tract infection and are the most common serious bacterial infections in this age group. and inflammatory markers are used in some pathways, with variable accuracy. Guidance differs for infants older than 28 days.
Where it comes up
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Sources
- Pantell RH et al. — Management and outcomes of care of fever in early infancy, American Academy of Pediatrics clinical practice guideline, Pediatrics, 2021
- Kuppermann N et al. — Identifying serious bacterial infections in infants aged 8 to 60 days (PECARN), JAMA Pediatrics, 2019