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Clinical and Laboratory "Low Risk" Criteria for Children Younger Than 3 Months with Fever and No Focus of Infection

Clinical criteria

  • Born at term (gestational age >/= 37 weeks) with uncomplicated nursery stay
  • Previously healthy infants
  • No toxic manifestations
  • No focal bacterial infection (except otitis media)

Laboratory criteria

  • White blood cell count 5-15 x 109/l, < 1.5 x 109 band cells/l, or band/neutrophil ratio < 2
  • Normal urine analysis results (negative Gram stain of unspun urine, negative leucocyte esterase and nitrite, fewer than five white blood cells per high power field)
  • When diarrhoea is present, no haem and fewer than five white blood cells per high power field
  • Fewer than 8 x 106 white blood cells/l in cerebrospinal fluid, if lumbar puncture is performed, and negative Gram stain findings in cerebrospinal fluid
  • No infiltrate on chest radiograph

Related Criteria

Definition and Causes of Apparent Life-Threatening Events (ALTE)

Rochester Criteria for Identifying Febrile Infants at Low Risk for Serious Bacterial Infection

Causes of Bacteraemia and Meningitis in Young Children

Diagnostic Criteria for Cystic Fibrosis (CF)

Modified Bellīs Staging Criteria for Necrotizing Enterocolitis (NEC)



1.      Brook I. Unexplained fever in young children: how to manage severe bacterial infection. BMJ. 2003 Nov 8;327(7423):1094-7. [Medline]

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Created: July 21, 2005
Last Modified: 10/23/2010

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