Management of Young, Febrile Infants

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Abstract
The difficulty in diagnosing bacterial sepsis in newborns by clinical examination has long been recognized and emphasized.1Fever in neonates is of great concern and, operationally in most nurseries, is regarded as indicative of infection, warranting evaluation (a "sepsis workup") and treatment.1,2 However, until the last decade, the literature contained little consideration of the appropriate management of a febrile infant who is old enough to be discharged from the hospital but still very young, in the first weeks of life. The prevailing policy in most university centers seemed to be routine hospitalization of febrile "neonates" and antibiotic treatment after culturing CSF, blood, and urine.3This bias, extrapolated from nursery experience, was reinforced by McCarthy and Dolan4; they reviewed the records of 22 infants, 3 months of age or younger, with a temperature of 40 °C (104 °F) or higher and reported the "serious implications" of such

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