Sepsis evaluations in hospitalized infants with bronchiolitis

Abstract

Temperature was not a predictor of sepsis evaluation. Infants with respiratory distress and normal chest roentgenogram were more likely to receive sepsis evaluations; those with recognized typical bronchiolitis and those > 28 days of age were less likely. Risk of serious bacterial infection is low; the costs of a sepsis evaluation outweigh the benefits in infants with obvious bronchiolitis.

Utility of sepsis evaluation in infants 90 days of age or younger with fever and clinical bronchiolitis

“…Exceptions have been noted in the literature and will certainly occur at a low rate. For example Antonow et al 11 reported on 282 infants Ͻ60 days of age who were hospitalized for bronchiolitis. Five (1.5%) of the infants had a serious bacterial infection with 3 urinary tract infections, 1 pneumococcal bacteremia and 1 meningitis diagnosed by CSF pleocytosis with sterile blood and cerebrospinal cultures.…”

Sepsis Workup in Febrile Infants 0–90 Days of Age With Respiratory Syncytial Virus Infection

“…4 Concomitant and secondary bacterial infections in patients with viral diseases are known to occur. [5][6][7][8][9][10][11][12][13][14][15][16][17] These bacterial infections tend to be focal, mainly pneumonia or acute otitis media. 11,12,14 Much of the existing data pertain to children 3 months or older.…”

“…11,12,14 Much of the existing data pertain to children 3 months or older. [5][6][7][8] Currently, there is no consensus on the necessity of such a workup in the very young infant when there is certainty of viral, specifically RSV, infection. This is a retrospective cohort study ascertaining the incidence, determinants, and outcome of sepsis workup in febrile infants aged 0-90 days infected with RSV.…”

A systematic review of predictive modeling for bronchiolitis

“…As reported in Antonow et al [112], among infants hospitalized with bronchiolitis, those who underwent sepsis evaluation had a hospitalization cost of $4,507 and a hospital length of stay of 3.4 days on average. In contrast, the others had a lower hospitalization cost of $2,998 and a shorter hospital length of stay of 2.8 days on average.…”

“…Antonow et al [112], 49.6% of infants who are younger than 60 days and hospitalized with bronchiolitis receive sepsis evaluation. However, most of these evaluations are unnecessary.…”