ACEP Clinical Policy — Febrile Infant Evaluation in the ED (2016, Updated)

The ACEP Clinical Policy on evaluation of febrile infants (age 29 days to 3 months) in the emergency department provides evidence-based guidance for risk stratification of serious bacterial infection (SBI) — bacteremia, meningitis, urinary tract infection, pneumonia, enteritis. Febrile infants in this age group have immature humoral and cellular immunity, unreliable clinical examination, and potentially masked presentations of life-threatening infections. Multiple validated clinical decision rules (Rochester Criteria, Philadelphia Criteria, Boston Criteria, and the newer Step-by-Step rule and PECARN Febrile Infant rule) are available to guide lumbar puncture, blood culture, and hospitalization decisions.