In spite of recent improvements in the prevention of invasive infections, bacteremia in infants and toddlers continues to be a major problem. This study’s primary objective was to characterize the demographics, microbiological etiology, and outcomes of bacteremic, otherwise healthy-appearing children aged 3 to 36 months who were sent home from the  pediatric emergency department PED after a single evaluation. Conducting a retrospective cohort study from 1 June 2015 to 30 June 2021 in the PED of a tertiary children’s hospital, all healthy-appearing infants between the ages of 3 and 36 months old who were examined for fever in the PED and sent home after a blood culture was taken were included in the study. From the index visit and subsequent contacts in the patient’s electronic medical records, researchers retrieved demographic, clinical, and laboratory data. In total, 17,114 of the children examined for fever during the study period met the inclusion criteria. Of those patients, 72 (or 0.42%) received positive culture results for pathogens. There were 36 males, or 50%, and 36 people, or 50%, were younger than 1 year old. In terms of frequency, S. pneumonia (26%; n = 19), K. Kingae (25%; n = 18), and Salmonella spp. (13.9; n = 10) were the most frequently isolated organisms. Approximately 85% of patients were called or sent reminders to return to the ED, 14% of patients returned on their own, and 2 were contacted via phone. The average interval between doctor’s visits was 28.7 hours (IQR 19.1–41.1). During the course of the hospitalization, 1 patient was transferred to intensive care. No one was hurt or killed. These results show that serious clinical worsening during the first 24 hours of infection is uncommon, and that the rate of undiagnosed genuine bacteremia was low in the study.

Source: journals.lww.com/pidj/Abstract/2022/10000/Incidence,_Characteristics,_and_Outcomes_of.6.aspx