{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:11:50Z","timestamp":1792635110432,"version":"4.5.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>High fevers, especially in young children, often alarm clinicians and prompt extensive evaluation based on perceptions of increased risk of serious bacterial infection (SBI), and even brain damage or seizure disorders.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>The aim of this study was to determine the prevalence of SBI in infants aged 3\u201336 months with fever \u226540.5\u00b0C in a population of infants offered universal pneumococcal conjugate vaccine 13 and <jats:italic toggle=\"yes\">Haemophilus influenzae<\/jats:italic> B immunization.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This study is a retrospective review of all infants aged 3\u201336 months with temperature \u226540.5\u00b0C presenting to a tertiary care pediatric emergency department over a 30-month period in an era of universal pneumococcal conjugate 13 and <jats:italic toggle=\"yes\">H. influenzae<\/jats:italic> B immunization.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>SBI was recorded in 54 (21.8%) of 247 study infants, most commonly pneumonia 30 patients (12.1%) and urinary tract infection 16 patients (6.5%). Two patients had positive blood cultures, yielding a bacteremia rate of 0.8%. Patients with SBI had a significantly higher WBC count (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001) and C-reactive protein levels (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001), and were significantly more likely to be hospitalized (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Discussion<\/jats:title>\n            <jats:p>Although SBI was common (21.8%) in our cohort of hyperpyrexic infants universally offered vaccination with pneumococcal conjugate 13 and <jats:italic toggle=\"yes\">H. influenzae<\/jats:italic> B vaccines, bacteremia was a rare finding (0.8%).<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000003217","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T19:00:55Z","timestamp":1716404455000},"page":"e143-e146","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Incidence of Bacteremia and Serious Bacterial Infections in Hyperpyrexic Infants Offered Universal Pneumococcal Conjugate Vaccine 13 and Haemophilus influenzae B Immunization"],"prefix":"10.1097","volume":"40","author":[{"given":"Moria","family":"Be'er","sequence":"first","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayelet","family":"Rimon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Or","family":"Segev","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adi","family":"Huber","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Scolnik","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Glatstein","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s12519-008-0045-3","article-title":"Fever: to treat or not to treat?","volume":"4","year":"2008","journal-title":"World J Pediatr"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"63","DOI":"10.4103\/IJCIIS.IJCIIS_3_18","article-title":"An evidence-based approach to evaluation and management of the febrile child in Indian emergency department","volume":"8","year":"2018","journal-title":"Int J Crit Illn Inj Sci"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1111\/j.1553-2712.2009.00444.x","article-title":"Serious bacterial infections in febrile infants in the post-pneumococcal conjugate vaccine era","volume":"16","year":"2009","journal-title":"Acad Emerg Med"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1542\/peds.108.6.1275","article-title":"C-reactive protein in febrile children 1 to 36 months of age with clinically undetectable serious bacterial infection","volume":"108","year":"2001","journal-title":"Pediatrics"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1097\/PEC.0000000000000454","article-title":"Does extreme leukocytosis predict serious bacterial infections in infants in the post-pneumococcal vaccine era? 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