The occult bacteremia controversy

A young child with a high fever and no source for infection is a common situation confronting pediatricians and pediatric emergency medicine physicians alike. Although most febrile children with no apparent source of infection are suffering from viral illnesses, a percentage will he harboring occult bacterial infection. Whereas most cases of occult bacteremia resolve spontaneously, a small number of cases progress to serious bacterial illness, This article reviews the approach to children 3 to 36 months of age with fever mid no apparent source and reflects on practice guidelines developed to guide clinicians managing this situation, The rationale for a variety of management approaches is reviewed and data from ongoing studies which might influence care in the future are presented.