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Predictive factors for severe infection among febrile infants younger than three months of age

Korean Journal of Pediatrics 2009;52(8):898-903.
Published online August 15, 2009.
Predictive factors for severe infection among febrile infants younger than three months of age
Eun Young Cho1, Hwa Song1, Ae Suk Kim1, Sun Ju Lee1, Dong Seok Lee1, Doo Kwun Kim1, Sung Min Choi1, Kwan Lee2, Byoung Chan Park2
1Department of Pediatrics, Collage of Medicine, Dongguk University, Gyeong-ju, Korea
2Department of Preventive Medicine, Collage of Medicine, Dongguk University, Gyeong-ju, Korea
발열을 주소로 내원한 3개월 미만의 영아에서 중증 감염의 예측 인자
조은영1, 송화1, 김애숙1, 이선주1, 이동석1, 김두권1, 최성민1, 이관2, 박병찬2
1동국대학교 의과대학 소아과학교실
2동국대학교 의과대학 예방의학교실
Abstract
Purpose
This study investigated the predictive factors for identifying infection-prone febrile infants younger than three months.
Methods
We conducted a retrospective study of 167 infants younger than three months with an axillary temperature >38℃ who were hospitalized between 2006 and 2008. If they met any of the following criteria, positive blood culture, CSF WBC ≥ 11/mm3 or positive CSF culture, urinalysis WBC ≥6/HPF and positive urine culture, WBC ≥6/HPF on microscopic stool examination or positive stool culture, they were considered at high risk for severe infection. Infants with focal infection, respiratory infection or antibiotic administration prior to admission to the hospital were excluded. We evaluated the symptoms, physical examination findings, laboratory data, and the clinical course between the high risk and low risk groups for severe infection.
Results
The high-risk group included 77(46.1%) infants, and the most common diagnosis was urinary tract infection (51.9%). Factors, such as male sex, ESR and CRP were statistically different between the two groups. But, a multilinear regression analysis for severe infection showed that male and ESR factors are significant.
Conclusion
We did not find the distinguishing symptoms and laboratory findings for identifying severe infection-prone febrile infants younger than three months. However, the high-risk group was male and ESR-dominated, and these can possibly be used as predictive factors for severe infection.
Key Words: Fever without source, Infants, Infection


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