- Definition = temperature > 38.0°C or 100.4°F
- All febrile infants up to age 56 days undergo a sepsis workup:
- CBC, blood culture
- Urinalysis, urine culture
- Lumbar puncture with cell count, Gram stain, glucose, protein, culture, +/- HSV PCR
- Chest X-ray if respiratory distress
- Age 0-4 wks
- ADMISSION and IV antibiotics, regardless of physical exam, for 48h
- If LP negative: ampicillin, gentamicin, +/- acyclovir
- If LP positive: ampicillin, cefotaxime, +/- acyclovir
- Age 4-8 wks
- If well-appearing with normal exam and unremarkable labs, discharge home with antibiotics and CLOSE PMD FOLLOW-UP
- If ill-appearing, concern based on exam findings, or positive labs*, admit and treat with vancomycin and cefotaxime
*Positive labs are defined as:
CBC has WBC > 15,000 or
<> 0.2
LP shows CSF pleiocytosis
Urinalysis > 10 WBCs
Positive CXR findings
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*Positive labs are defined as:
CBC has WBC > 15,000 or <> 0.2
LP shows CSF pleiocytosis
Urinalysis > 10 WBCs
Positive CXR findings