89 Neonatal fever

This episode of EM Basic features Zac Hodges and Dr. Kathryn McLeod discussing the management of well-appearing febrile infants less than 60 days old. Dr. McLeod provides background on the importance of careful history and physical exams, emphasizing the need to differentiate between viral illnesses and potentially serious bacterial infections. They review critical aspects of the infant's and mother's medical history, vital signs, and physical exam findings, including the Pediatric Assessment Triangle. The discussion covers temperature thresholds for fever, types of bacterial and viral infections, and risk stratification using criteria like the Boston, Milwaukee, Philadelphia, and Rochester criteria, as well as newer tools like the step-by-step approach and the PCARN rule. They also discuss the use of white blood cell counts, inflammatory markers, empiric antibiotics, and respiratory viral testing, concluding with a review of a clinical case and key management recommendations.