Pediatr Infect Vaccine.  2016 Aug;23(2):128-136. 10.14776/piv.2016.23.2.128.

Clinical Characteristics of Fever without Localizing Sign in Infants Younger than 100 Days of Age in a Single Center

• Lee HS
• Lee KH

• KMID: 2353393
• DOI: http://doi.org/10.14776/piv.2016.23.2.128

Abstract

PURPOSE
This study was done to define clinical characteristics of fever without localizing signs (FWLS) in infants younger than 100 days of age with a goal of providing baseline data to establish a new diagnostic paradigm in the future.
METHODS
We reviewed medical records of 183 patients who admitted to Daegu Catholic University Medical Center for FWLS younger than 100 days of age from January 2013 to September 2015 retrospectively. Demographic, clinical features and laboratory findings were analyzed. Patients were divided into serious bacterial infection (SBI) and non-SBI groups, and then were compared between two groups to find risk factors for SBI.
RESULTS
Among 183 patients, lumbar puncture was performed in 98.9% and CSF pleocytosis was present in 35.9%. Sterile CSF pleocytosis was found in 43% of urinary tract infection (UTI) patients. None had concomitant bacterial meningitis in patients with UTI. As final diagnosis, febrile syndrome without source (25.7%) was most common. Among SBI, UTI was most common (99%). Birth weight, ESR, and CRP were significantly higher in SBI group compared to non-SBI group. Male sex (OR 4.93, 95% CI 1.60-15.24) and pyuria (OR 18.88, 95% CI 6.76-52.76) were identified as risk factors for SBI. Presence of sibling (OR 0.30, 95% CI 0.11-0.83) was significantly lower in SBI group.
CONCLUSIONS
Our results showed UTI was the most common SBI in young infants with FWLS. Though aseptic meningitis can be coexisting with UTI, lumbar puncture may not be necessary in all patients having UTI.

Keyword

Fever; Infant; Bacterial infection; Urinary tract infection

MeSH Terms

Academic Medical Centers
Bacterial Infections
Birth Weight
Daegu
Diagnosis
Fever*
Humans
Infant*
Leukocytosis
Male
Medical Records
Meningitis, Aseptic
Meningitis, Bacterial
Pyuria
Retrospective Studies
Risk Factors
Siblings
Spinal Puncture
Urinary Tract Infections

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