Serious Bacterial Illness (SBI): 1) UTI and pyelonephritis Most common cause of SBI Accounts for 3-8% of uncharacterized fevers Female > male, uncircumcised > circumcised Consider BCx, CSF evaluation as 5-10% bacteremic at presentation Urinalysis: LE 75% specificity, Nitrites 97% specificity 2) Pneumonia and sinusitis Sinusitis uncommon <3yo (sinuses unformed) PNA diagnosed with CXR, obtain if findings of respiratory distress (grunting, tachypnea, hypoxemia) or rales on exam 3) Meningitis Diagnose with LP Meningitis suggested if: - ANC > 1,000 - Protein > 80 - Seizure (particularly complex febrile seizure) #Diagnosis #Peds #EM #Classification #Fever #SBI #SeriousBacterialIllness #Ddxof
