A new article published in Indian Pediatrics discussed that fever is one of the most common presenting complaints among infants brought to pediatric emergency. Although most cases are of benign, self-limiting viral infections, approximately 10% of all may have serious bacterial infection.

The authors informed that clinical examination alone is an inadequate measure to detect serious bacterial infection in well appearing infants, and a standardized approach is always sought for. However, guidelines used in the United States or European countries may not be applicable in a tropical country like India. Deviation from these guidelines leads to challenges of unwarranted hospitalization and antibiotic usage, extra cost of care and risk of antimicrobial resistance.

This article further reported that various prediction rules can detect a low risk infant with negative predictive values ranging from 93.7-100%. Biomarkers such as C reactive protein and procalcitonin can be reliable; however, these tests are expensive and may not useful in the local population.

Source: Indian Pediatrics. 2021 Jan 15;58(1):15-19.