The Step-By-Step approach is a sequence of clinical or laboratory findings that can help to triage a febrile infant.

Patient selection: febrile infant <= 90 days old, previously healthy, without clear source of fever


Criteria for high-risk - one or more of the following:

(1) ill-appearing with abnormal Pediatric Assessment Triangle

(2) age <= 21 days old

(3) leukocyturia

(4) serum procalcitonin >= 0.5 ng/mL

(6) serum CRP > 20 mg/L

(7) absolute neutrophil count > 10,000 per microliter


If none of these findings are present then the infant is classified as low risk for an invasive bacterial infection.

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