Bleeker et al reported several models for the diagnosis of serious bacterial infection in a febrile child without obvious source. A model for laboratory studies was revised after further studies. The authors are from Sophia Children's Hospital, University of Rotterdam, University Medical Centre Utrecht and Juliana Children's Hospital in The Hague.
Patient selection: child from 1 to 36 months, temperature >= 38.0°C, no apparent source after clinical evaluation
Outcome: diagnosis of serious bacterial infection
Parameters:
(1) white blood cell count in 10^9/L
(2) serum CRP in mg/L
(3) number of white blood cells per microliter urine
Parameter
Finding
Points
WBC
< 10 * 10^9
0
10 to 19
2
20 to 29
4
30 to 39
6
>= 40
8
serum CRP
MIN(16,INT((CRP/10,0))
WBC per µL urine
< 70
0
>= 70
9
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 33
Clinical Score
Lab Score <= 8
Lab Score > 8
<= 10
4%
31%
> 10
15%
54%
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