{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:57:26Z","timestamp":1790913446005,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":348,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Serious viral infections (SVIs) are a frequent and worrisome cause of fever in infants aged &lt;90\u2009days. The present study aimed to clarify the distinction between SVIs, viremia, and respiratory infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was a secondary analysis of data derived from a pre\u2010COVID\u201019 registry of infants aged &lt;90\u2009days presenting with a fever to the emergency department at a tertiary pediatric hospital in Japan. Data on the patient characteristics, vital signs, clinical symptoms, physical examinations, and laboratory examinations were collected. Patients meeting the systemic inflammatory response syndrome (SIRS) criteria or having a serious infection were stratified into a viremia group or respiratory infection group for univariate analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among young infants aged &lt;90\u2009days presenting with febrile episodes (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009321), 48 had a SVI. Of these, 28 and 20 were categorized into the viremia and respiratory infection groups, respectively. The mean age and body weight of the former group were significantly lower than those of the latter group (29.6\u2009days vs. 54.6\u2009days; 4007.1\u2009g vs. 4976.8\u2009g). The respiratory rate was higher in the viremia group (41.4\/min vs. 35.3\/min), whereas upper respiratory tract symptoms were more common in the respiratory infection group (3.6% vs. 60.0%). Laboratory examinations found a significant difference in the white blood cell count (7700\/\u03bcL vs. 10,200\/\u03bcL).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The present study found that viremia was associated with younger age and a higher respiratory rate than respiratory infections. Multicentric studies are needed to verify these preliminary findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70288","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T12:38:48Z","timestamp":1765802328000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Identifying the cause of serious viral infections in febrile young infants visiting the pediatric emergency department"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2842-9733","authenticated-orcid":false,"given":"Yuta","family":"Sasaoka","sequence":"first","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine Tokyo Metropolitan Children's Medical Center  Tokyo Japan"},{"name":"Department of Pediatrics Hakodate Municipal Hospital  Hakodate Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaaki","family":"Mori","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine Tokyo Metropolitan Children's Medical Center  Tokyo Japan"},{"name":"Department of Emergency Medicine KK Women's and Children's Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9677-6000","authenticated-orcid":false,"given":"Yusuke","family":"Hagiwara","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1296-1768","authenticated-orcid":false,"given":"Osamu","family":"Nomura","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine Tokyo Metropolitan Children's Medical Center  Tokyo Japan"},{"name":"Medical Education Development Center Gifu University  Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.14692"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild\u20102019\u2010317382"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00010-16"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2008.02.031"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.6.1662"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017\u20102384"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021\u2010052228"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/children8111003"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PCC.0000149131.72248.E6"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(09)62000\u20106"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.13831"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000901"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020\u20100782"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015\u20104381"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2018.5501"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1309483"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(10)70209\u2010X"}],"container-title":["Pediatrics 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