Fever in Young Infants

This time of year, there seems to be more children in the ED, many with fevers. When an infant younger than two months presents with a fever providers must be aware that these tiny patients are high-risk. A missed bacterial infection in infants, particularly those younger than 60 days, can involve permanent disability and even death.

EPIC CEO Graham Billingham, MD, FACEP, and Vice President Jeanie Taylor, RN, BSN, MS, discuss the clinical protocol for these patients in the adjacent video. Infants younger than 29 days with a fever need to receive a complete diagnostic workup, timely antibiotic therapy and hospital admission.

Infants between 29 and 60 days can sometimes be discharged if they are non-toxic appearing and the provider is confident that the parents will closely observe the child and return to the ED if indicated. With any child that is discharged, follow-up is key.

New UTI Treatment Guidelines


While on the topic of young children, the American Academy of Pediatrics (AAP) has outlined an approach to the diagnosis and treatment of UTI in children 2 – 24 months. The guidelines are outlined in a recent EPIC Alert which advices several risk management tips including:

• All urine samples must be cultured
• Temperatures should be rectal
• Complete a thorough skin exam on an undressed child
• Follow-up within 24 hours when the source of the fever is not known

EPIC Etcetera

• EPIC has completed implementation of iCatalyst, an integrated policy and claims management system. Information on the new system can be found on the EPIC website.

• Happiest of holidays from the EPIC family. In observance of the holidays, the EPIC office will be closed from December 22, 2011 to January 2, 2012.