PEDIATRICS Vol. 66 No. 2 August 1980, pp. 171-175
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Bacteremia in Private Pediatric Practice

Michael A. Baron MD1 and Howard D. Fink MD1

1 Departments of Pediatrics, Yale-New Haven Hospital and Yale University School of Medicine, New Haven, Connecticut, and Milford Hospital, Milford, Connecticut

The capillary white blood cell count and differential, a test easily done in office practice, was used in unexplained febrile illness of infants and toddlers to help distinguish those babies most likely to have bacteremia who would benefit from blood culture and early bacteriologic diagnosis. Four criteria were used as indicators suggestive of bacterial infection: white blood cell count ge15,000/cu mm, total segmented neutrophils ge10,000/cu mm, total band cells ge500/cu mm, and total polymorphonuclear leukocytes (segmented neutrophils plus band cells) ge10,500/cu mm. These measurements were found helpful in separating a small group of bacteremic babies at high risk of complications from a large group of babies who recovered without antibiotic treatment and without complications. There were 146 febrile illnesses recorded in babies 3 to 24 months of age; bacteremia was proven in eight of these. Three or four blood cell count criteria were fulfilled in seven of the eight bacteremic babies and in only ten (7.2%) of the remaining 138 febrile illnesses (P < .001 by khgr2 test).

Submitted on September 17, 1979
Accepted on November 26, 1979




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