Evaluation of the febrile child 3 to 36 months old in the era of pneumococcal conjugate vaccine: focus on occult bacteremia

The management of febrile infants 3 to 36 months old has been an ongoing topic of controversy, particularly with respect to occult bacteremia. Published strategies and algorithms have been developed to aid the clinician in the evaluation and management of these children. With the licensure and implementation of universal hepatovalent conjugate pneumococcal (PCV7) vaccination in infants, it is worthwhile to reexamine the data on which these recommendations were based. In this article, we will discuss the management of occult bacteremia in young febrile children in the era of PCV7 immunization and propose a management strategy for young febrile children.