Markers for invasive bacterial infections in previously healthy children

Furthermore, most of these patients are younger than 2–3 years-old, being the clinical expression of different infections more unspecific. [...]physicians may not be confident enough in the physical exam and seek for blood tests like white blood cell count (WBC) or the absolute neutrophil count (ANC) to guide initial clinical decision-making in certain febrile children. For the purpose of this subanalysis, we included those children classified as previously healthy patients and excluded those non-previously healthy: immunosuppression (oncological illness, chronic renal failure, transplant patient, sickle cell disease); presence of a mechanical device (indwelling catheter, ventriculoperitoneal shunt, auditory prostheses); and chronic diseases/severe malformative syndromes.2.1 Definitions Invasive bacterial infection (IBI): isolation in blood or cerebrospinal fluid (CSF) of a bacterial pathogen, using bacterial culture or real time polymerase chain reaction (PCR) technique to detect S. pneumoniae and N. meningitidis. The Clinical Research Ethics Committee of the Hospital approved the study (Code E11/52).3 Results During the study period, we registered 665.997 episodes in the pediatric ED, of which 367 (0.05%) were finally diagnosed with an IBI. [...]children are often able to maintain normal haemodynamic parameters in the early stages of sepsis. [...]it is comprehensible to use blood tests in some situations to rule in or rule out an IBI.