Managing Fever Without Source in Well-appearing Young Infants: A Pragmatic Approach

Neonates and young infants are at increased risk of invasive bacterial infection (IBI), defined as bloodstream infection (BSI) and/or bacterial meningitis (BM). Fever (rectal body temperature ≥38°C) may be the only presenting clinical symptom [fever without source (FWS)], and many of those infants are clinically well-appearing.1 Despite substantial variation in clinical management of infants below 2 months of age with FWS—resulting in excessive invasive diagnostics, hospital admission, and empir