Evaluation and management of the febrile infant in the emergency department

Abstract

Treating the febrile infant strikes fear in all of us. The source of fever in a very young infant may be a serious bacterial infection. A thorough physical examination is just the beginning of a complete evaluation of a febrile infant. This article discusses appropriate testing, treatment, and disposition of these patients. Within the age group addressed in this article, diagnosis and treatment of febrile neonates (i.e. age < 1 month) are the least controversial. Febrile neonates warrant thorough evaluation, complete diagnostic testing, and aggressive inpatient treatment with i.v. antibiotics. Management of infants between 1-3 months of age may be guided by clinical evaluation and laboratory investigations. In infants above 3 months of age, the clinical assessment can direct regarding laboratory testing and treatment in most of the cases.