TY - JOUR
T1 - Neonatal fever in the term infant
T2 - Evaluation and management strategies
AU - Geskey, Joseph M.
AU - Beck, Michael J.
AU - Brummel, Gretchen L.
PY - 2008/5
Y1 - 2008/5
N2 - The presence of fever in the neonatal period demands urgent evaluation from healthcare providers since signs and symptoms of a serious bacterial infection in this age group can be nonspecific. Current practice guidelines recommend that febrile neonates should be presumed to have a serious bacterial infection and undergo a sepsis evaluation and hospitalization until the results of diagnostic testing are known. However, less than 50% of outpatient practitioners in a recent study followed these recommendations without apparent adverse outcomes even though the rate of serious bacterial infections in the neonatal period is higher than febrile infants 1-3 months of age. In this article we examine various clinical scenarios that healthcare providers confront when caring for febrile neonates, including whether febrile neonates with respiratory syncytial virus are at increased risk for developing a serious bacterial infection and whether diagnostic testing and empiric antiviral therapy for herpes simplex virus should be part of the standard evaluation of febrile neonates. Although the discovery of inflammatory mediators that are elevated during the early stages of infection has the potential to improve diagnostic capabilities in this age group, there is enough evidence to support international guidelines recommending hospitalization and sepsis evaluations in febrile neonates.
AB - The presence of fever in the neonatal period demands urgent evaluation from healthcare providers since signs and symptoms of a serious bacterial infection in this age group can be nonspecific. Current practice guidelines recommend that febrile neonates should be presumed to have a serious bacterial infection and undergo a sepsis evaluation and hospitalization until the results of diagnostic testing are known. However, less than 50% of outpatient practitioners in a recent study followed these recommendations without apparent adverse outcomes even though the rate of serious bacterial infections in the neonatal period is higher than febrile infants 1-3 months of age. In this article we examine various clinical scenarios that healthcare providers confront when caring for febrile neonates, including whether febrile neonates with respiratory syncytial virus are at increased risk for developing a serious bacterial infection and whether diagnostic testing and empiric antiviral therapy for herpes simplex virus should be part of the standard evaluation of febrile neonates. Although the discovery of inflammatory mediators that are elevated during the early stages of infection has the potential to improve diagnostic capabilities in this age group, there is enough evidence to support international guidelines recommending hospitalization and sepsis evaluations in febrile neonates.
UR - http://www.scopus.com/inward/record.url?scp=47749151555&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=47749151555&partnerID=8YFLogxK
U2 - 10.2174/157339608784462052
DO - 10.2174/157339608784462052
M3 - Review article
AN - SCOPUS:47749151555
SN - 1573-3963
VL - 4
SP - 84
EP - 95
JO - Current Pediatric Reviews
JF - Current Pediatric Reviews
IS - 2
ER -