Crain and Shelov identified certain findings associated with bacteremia in febrile infants. The study was done at Albert Einstein College of Medicine and was published in 1982.
Patient selection:
• infant with rectal temperature >= 38°C (>= 100.4°F)
Parameter
Finding
Points
clinical impression of sepsis
no
0
yes
1
white blood cell count
< 15,000 per µL
0
>= 15,000 per µL
1
erythrocyte sedimentation rate (ESR)
< 30 mm/h
0
>= 30 mm/h
1
number of risk factors present =
= SUM(points for 3 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 3
• The presence of all 3 risk factors in a febrile infant identified 100% of all infants with bacteremia and excluded 82% of infants without bacteremia (the number of patients without bacteremia in the identified group is 2-3 times larger than the number with bacteremia).
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