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Table 2 Clinical and laboratory findings of common low‐risk criteria. Adapted from [12]

From: Facing the ongoing challenge of the febrile young infant

  Boston Milwaukee Philadelphia Rochester
Age range 28–89 days 28–56 days 29–60 days ≤60 days
History No immunizations or antimicrobials in prior 48 h Not defined Not defined Term infant; no prior antibiotics; no underlying disease; no hospitalization longer than mother
Physical exam Well appearing; no signs of focal infection Well appearing; no signs of focal infection Well appearing; no signs of focal infection Well appearing; no signs of focal infection
Laboratory parameters CSF < 10 WBC/mm3
WBC < 20,000 mm3
UA < 10 WBC/hpf
CXR without infiltrate (if obtained)
CSF < 10/mm3
WBC < 15,000/mm3
UA < 5–10 WBC/hpf; UA no bacteria, negative leukocyte esterase, negative nitrites
CXR without infiltrate
CSF < 8 WBC/mm3
WBC < 15,000/mm3
UA < 10 WBC/hpf
CXR without infiltrate (if obtained)
WBC > 5000 and < 15,000/mm3
ABC < 1500/mm3
UA ≤ 10 WBC/hpf
CXR without infiltrate (if obtained)
Stool: WBC ≤ 5/hpf smear (if indicated)
Management strategies for high risk Hospitalize, empiric antibiotics Not defined Hospitalize, empiric antibiotics Hospitalize, empiric antibiotics
Management strategy for low risk Home/outpatient ok
Empiric antibiotics, outpatient follow up required
Home/outpatient ok
i.m. ceftriaxone 50 mg/kg followed by outpatient follow up within 24 h
Must have reliable caretaker
Home/outpatient ok
No antibiotics, but outpatient follow up is required
Home/outpatient ok
No antibiotics, but outpatient follow up is required
  1. CXR chest X‐ray, UA urinalysis, CSF cerebrospinal fluid, WBC white blood cells, ABC absolute band count, hpf high power field, i.m. intramuscular