{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T04:40:26Z","timestamp":1780720826996,"version":"3.54.1"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,7,16]],"date-time":"2022-07-16T00:00:00Z","timestamp":1657929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Our aim was to evaluate the risk of bacterial meningitis, bacteremia, and urinary tract infection (UTI) in infants \u226460\u2009days who presented to paediatric emergency departments (PEDs) after having fever at home. We also investigated any differences between infants who were afebrile or febrile on presentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a multicenter retrospective study of infants \u226460\u2009days presented to four Swedish PEDs during 2014\u20132020 with reported fever at home. We used relative risks (RR) to compare the prevalence of UTI, bacteremia, and bacterial meningitis between the infants who were afebrile and the infants who were still febrile when they presented to the PED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cohort comprised 1926 infants, and 702 (36%) were afebrile on presentation. The prevalence of UTI in the afebrile and febrile infants was 6.1% [95% confidence interval (CI) 4.5\u20138.2] versus 14.2% (95% CI 12.3\u201316.2), corresponding to an RR of 0.43 (95% CI 0.31\u20130.59). In infants \u226428\u2009days, the RR for meningitis was 1.05 (95% CI 0.18\u20136.23) for afebrile versus febrile infants. Five times more febrile infants underwent a lumbar puncture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Infants who were afebrile on presentation underwent fewer lumbar punctures, but they had similar rates of bacterial meningitis to febrile infants. Different management approaches are not justified.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.16483","type":"journal-article","created":{"date-parts":[[2022,7,9]],"date-time":"2022-07-09T06:43:20Z","timestamp":1657349000000},"page":"2004-2009","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Paediatric emergency departments should manage young febrile and afebrile infants the same if they have a fever before presenting"],"prefix":"10.1111","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0466-4499","authenticated-orcid":false,"given":"Ioannis","family":"Orfanos","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences Lund University  Lund Sweden"},{"name":"Department of Pediatrics Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6096-0546","authenticated-orcid":false,"given":"Jorge","family":"Sotoca Fernandez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4477-8765","authenticated-orcid":false,"given":"Kristina","family":"Elfving","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sahlgrenska Academy University of Gothenburg  Gothenburg Sweden"},{"name":"School of Public Health and Community Medicine, Sahlgrenska Academy University of Gothenburg  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2328-3512","authenticated-orcid":false,"given":"Tobias","family":"Alfv\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Global Public Health Karolinska Institutet  Stockholm Sweden"},{"name":"Sachs' Children and Youth Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1902-4865","authenticated-orcid":false,"given":"Erik A.","family":"Eklund","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund University  Lund Sweden"},{"name":"Department of Pediatrics Sk\u00e5ne University Hospital  Lund 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