Febrile Infant
Clinical Pathways promote evidence based, safe, and high-value care for patients by providing clinical recommendations and standard processes. They are developed by multidisciplinary committees of subject matter experts, informed by methodical review of available evidence and consensus among committee members.
Clinical Pathways:
- Febrile infant 8 to 21 days Algorithm
- Febrile infant 22 to 28 days Algorithm
- Febrile infant 29 to 60 days Algorithm
Additional tools associated with this clinical pathway:
Inclusion and exclusion criteria
Inclusion:
- Well-appearing.
- Full-term (≥ 37 weeks estimated gestational age).
- 8 to 60-days of age.
- Temperature ≥ 38 °C at home in the past 24 hours or determined in a clinical setting.
- Without an identifiable source of infection.
Exclusion:
- ≤ 7 days.
- Preterm infants ≤ 37 weeks.
- Younger than 2 weeks of age whose perinatal courses were complicated by maternal fever, infection, and/or antimicrobial use.
- Focal bacterial infection (e.g., cellulitis, omphalitis, septic arthritis, osteomyelitis). These infections should be managed according to accepted standards.
- Infants with clinical bronchiolitis, with or without positive test results for respiratory syncytial virus (RSV).
- Documented or suspected immune compromise.
- Neonatal course was complicated by surgery or infection.
- Congenital or chromosomal abnormalities.
- Medically fragile infants requiring some form of technology or ongoing therapeutic intervention to sustain life.
- Infants who have received immunizations within the last 48 hours.
Committee members involved in the development:
- Christopher Veit, MD, MHPE, FAAP | Hospital Medicine | Committee Chair
- Stephanie Karnik, MD | Emergency Medicine | Committee Chair
- Josh Herigon, MD, MPH, MBI | Infectious Diseases | Committee member
- Maria Blanco, MD | Urgent Care | Committee member
- Alaina Burns, Pharm.D., BCPPS | Pharmacy | Committee member
- Jordan Marquess, MD | Pediatric Resident | Committee member EBP Committee Members
- Katie Berg, MD, FAAP | Evidence Based Practice & Hospital Medicine | Committee member
- Jarrod Dusin, MS, RD, LD, CPHQ | Evidence Based Practice | Committee member
Febrile Infant Without An Evident Source of Infection Synopsis (provides standards employed for this clinical pathway)
Publication dates:
- Version 1 finalized date: 04/2017
- Version 2 revised date: 02/02/2022
- Next expected revision date: 02/2025
If you have any questions regarding this content, or identify a broken link, please email evidencebasedpractice@cmh.edu.
These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.