Management of the non-toxic-appearing acutely febrile child: A 21st century approach

Although controversy remains as how to best manage acutely febrile infants and children, there are several areas of near consensus. Infants aged ≤60 days continue to have the highest rates of SBI and pose a challenge to practitioners attempting to determine how extensive an evaluation to perform in a non-toxic-appearing child. UTIs are the most common SBIs in all age groups. It is our opinion that assessment for UTI should be part of any evaluation for all but the lowest-risk patients (ie, circumcised boys). New technologies to can more rapidly diagnose common viral and bacterial infections and recommendations to simplify the management of these febrile infants and children are needed.