[The relationship between fever magnitude and serious bacterial infections in febrile infants less than two-months-old--a prospective study]

Abstract

Background: The evaluation and treatment of febrile infants below 2 months of age is inconsistent in hospitals in Israel. In some centers fever magnitude is considered to be one of the parameters that influence decision making as well as management.

Objective: To assess the correlation between fever magnitude and the risk of serious bacterial infections (SBI) in hospitalized infants under the age of 2 months.

Patients and methods: The study group consisted of all infants < or = 2 months hospitalized at the Schneider Children's Medical Center for evaluation of fever from September 2006 to December 2008. Data were collected prospectively regarding the magnitude of fever on admission, during hospitalization, and diagnosis of SBI.

Results: SBI was detected in 90 (10.8%) of the 833 infants that met the inclusion criteria (UTI in 68, bacteremia in 11, pneumonia in 10 and enteritis in one). The mean fever at presentation was 38.4 degrees in the group of infants with SBI compared to 38.3 degrees in the infants without SBI (p=NS). Mean maximal fever during hospitalization was 38.6 degrees in the two groups. No correlation was found between the degree of fever and the type of SBI.

Conclusion: There is no correlation between fever magnitude and the risk of SBI in hospitalized infants aged < or = 2 months. Therefore, we suggest that fever magnitude should not be a factor in the decision of evaluating febrile infants in this age group.