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PEDIATRICS Vol. 110 No. 1 July 2002, pp. e12-e12

ELECTRONIC ARTICLE

Absolute Band Counts in Febrile Infants: Know Your Laboratory

Brett Luxmore, DO*, Keith R. Powell, MD*,{ddagger}, Sebastián R. Díaz, PhD§ and Robert W. Novak, MD||

* Children’s Hospital Medical Center of Akron, Akron, Ohio
{ddagger} Department of Pediatrics, Northeastern Ohio Universities College of Medicine, Ohio
§ Research Center for Educational Technology, Kent State University, Kent, Ohio
|| Department of Pathology and Laboratory Medicine, Children’s Hospital Medical Center of Akron, Akron, Ohio

It was the impression of 1 of the authors that band counts in febrile infants ≤60 days of age were much higher as reported from the clinical laboratory at Children’s Hospital Medical Center of Akron, Ohio, than they had been at Strong Memorial Hospital in Rochester, New York. Absolute band counts (ABC) from 119 febrile infants ≤60 days of age seen in the emergency department of Children’s Hospital Medical Center of Akron for whom blood culture results were known were obtained retrospectively and compared with results from a prospective study conducted in Rochester. In Akron, 45% of the infants had elevated band counts and 16% had no other risk factor for serious bacterial infection compared with 5.9% and 1.4%, respectively, in Rochester. The ABC can vary widely from laboratory to laboratory. The clinician must use caution when using the ABC as a criterion for identifying infants at low risk for serious bacterial infection.

Key Words: febrile infants • absolute band counts • low risk criteria • serious bacterial infection • bacteremia

Abbreviations: SBI, serious bacterial infection • ABC, absolute band count • ED, emergency department • CHMCA, Children’ Hospital Medical Center of Akron • WBC, white blood cell • NPV, negative predictive value • CI, confidence interval

Received for publication Dec 21, 2001; Accepted Mar 18, 2002.


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