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Table 1 Common viral illnesses presenting as fever in young infants and association with bacterial illness. Data from references [21,46,47,, 24, 25, 4548]

From: Facing the ongoing challenge of the febrile young infant

Virus Recommended diagnostic test Association with bacterial illness
Enterovirus (EV) CSF EV PCR; EV serum PCR if EV sepsis is suspected Low risk for concomitant bacterial meningitis and bacteremia. Decreased risk for UTI
Human parechovirus (HPeV) CSF HPeV PCR Insufficient data, but likely decreased risk of bacterial meningitis, bacteremia, and UTI
Respiratory syncytial virus (RSV) Nasopharyngeal RSV Ag detection or RSV RT‐PCR Low risk for concomitant bacterial meningitis or bacteremia. Decreased risk for UTI
Influenza A/B Nasopharyngeal Influenza A/B Ag detection or Influenza A/B RT‐PCR Low risk for concomitant bacterial infection
Human rhinovirus (hRV) Nasopharyngeal rhinovirus PCR Unknown. Due to prolonged viral shedding, unable to solely attribute febrile illness to rhinovirus
Adenovirus (ADV) Nasopharyngeal adenovirus RT‐PCR Unknown. Due to prolonged viral shedding, unable to solely attribute febrile illness to adenovirus
Human parainfluenza virus (HPIV) 1,2,3,4 Nasopharyngeal HPIV 1,2,3,4 RT‐PCR Insufficient data, but likely low risk of concomitant bacterial infection
Rotavirus (ROTA) Stool rotavirus Ag detection, stool rotavirus enzyme immunoassay or rotavirus PCR Insufficient data, but likely low risk of concomitant bacterial infection
Herpes simplex virus (HSV) Types 1 and 2 CSF HSV PCR, viral culture or PCR of vesicles
Surface cultures in neonates (mouth, nasopharynx, conjunctivae, perianal)
Serum HSV PCR (if available)
Insufficient data, but likely low risk of concomitant bacterial infection
Human herpes virus‐6 (HHV‐6) Plasma HHV‐6 RT‐PCR; HHV‐6 serologic antibody titers Insufficient data, but likely low risk of concomitant bacterial infection
  1. PCR polymerase chain reaction, RT‐PCR reverse‐transcriptase polymerase chain reaction, CSF cerebrospinal fluid, UTI urinary tract infection