Prevalence and Management of Invasive Bacterial Infections in Febrile Infants Ages 2 to 6 Months

Green, Rebecca S; Sartori, L.; Lee, Brian E.; Linn, Alexandra R.; Samuels, Marissa R.; Florin, Todd A.; Aronson, Paul L.; Chamberlain, James M.; Michelson, Kenneth A.; Nigrovic, Lise E.

doi:10.1016/j.annemergmed.2022.06.014

Cited by 3 publications

(1 citation statement)

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“… 1 It remains a diagnostic challenge as the underlying aetiologies can vary, from self-limiting viral infections to serious bacterial infections (SBIs) with long-term sequelae and mortality. 2 It is particularly challenging in children ≤36 months of age as they often present without focal symptoms and may even appear well. 3 Despite extensive history and physical examination, clinicians are often unable to identify a specific source in this population.…”

Section: Introductionmentioning

confidence: 99%

Protocol for the diagnostic performance of C reactive protein, procalcitonin and interleukin-6 for serious bacterial infections among children ≤36 months old presenting with fever without source: a systematic review and meta-analysis

Sutiman,

Yao,

Goh

et al. 2024

bmjpo

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IntroductionThe management of fever without source in children ≤36 months old remains a diagnostic challenge as the underlying aetiologies can vary from self-limiting viral infections to serious bacterial infections (SBIs). Biomarkers such as C reactive protein (CRP), procalcitonin (PCT) and interleukin-6 (IL-6) have varying thresholds in the prediction of SBIs due to differences in SBI definitions, SBI prevalence, patient characteristics and timing of presentation. This protocol describes a systematic review and meta-analysis that aims to determine the thresholds at which CRP, PCT and IL-6 can perform optimally in distinguishing the presence of SBIs in children ≤36 months old, as well as to determine their performances in early detection of bacterial infections within 48 hours of fever onset.Methods and analysisWe will systematically search electronic databases including MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane CENTRAL, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and Science Citation Index from 1 July 2023 to 31 July 2023. We will include studies that report the diagnostic accuracy of CRP, PCT and IL-6 in detecting SBIs in children aged ≤36 months presenting with fever without apparent source. Randomised controlled trials (RCTs) and non-randomised studies including non-RCTs and controlled before-and-after studies will be included. A meta-analysis will be performed and diagnostic performances of these biomarkers will be reported.Ethics and disseminationThe results of this study will provide guidance on clinical decision-making in young children presenting with fever without source. Ethics approval will not be required for this study. The authors aim to publish the findings in a peer-reviewed journal as well as present at international conferences.PROSPERO registration numberCRD42023439093.

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Section: Introductionmentioning

confidence: 99%