To identify the clinical utility of obtaining blood, urine and cerebrospinal fluid for bacterial culture among febrile infants<90 days of age with clinical bronchiolitis.
Retrospective chart review from 1995 to 2000.
Urban emergency department of a tertiary children's hospital.
All infants<90 days of age presenting with fever and clinical bronchiolitis.
MAIN OUTCOME MEASURES:
Result of the cultures of blood, urine and cerebrospinal fluid.
Of 3051 (11%) febrile infants, 329 met criteria for clinical bronchiolitis. Blood for culture was obtained from 309 (94%), urine for culture was obtained from 273 (83%) and cerebrospinal fluid for culture was obtained from 200 (61%). One hundred eighty-seven (57%)infants had all 3 specimens sent for culture. No cases of bacteremia [0%; 95% confidence interval (CI), 0, 1.1%]or meningitis (0%; 95% CI 0, 1.8%) occurred among these infants. However, 6 infants (2%; 95% CI 0.8, 5.7%), all male, had a culture of urine consistent with infection (4 Escherichia coli, 1 Staphylococcus aureus, 1 viridans streptococci).
The risk of bacteremia or meningitis among infants<90 days with fever and bronchiolitis is low in this age group. The risk of urinary tract infection in this age group is also low, but not negligible, at 2%.
Department of Medicine, Children's Hospital Boston, MA 02115, USA.