Fever (< 3 months)

• History
• Associated symptoms - pulmonary, GI, feeding, irritability, activity
• Sick contacts - siblings, babysitters, day care
• Previous illness or antibiotic use
• Birth history - maternal factors (fever, GBS status/prophylaxis, STD hx, PROM) and infant's nursery course
• Labs
• CBC
• ESR/CRP
• UA/UCx
• Stool studies if symptommatic
• BCx - optional if > 28 days and no recent Abx use
  
• LP - optional if > 28 days and well-appearing and low-grade fever
• CXR - optional depending on H&P
• Treatment
• Group B Strep (GBS), E. coli and other gram negative rods, Listeria, S. pneumoniae, H. influenzae, and N. meningitidis
• Ampicillin + gentamicin or ampicillin + cefotaxime
• Vanco if concern for MRSA soft-tissue infection
• Acyclovir if vesicles
• Ceftriaxone - if giving a shot and then sending home

Partial Sepsis workup [Infants ≥ 61 days old]

• CBC and differential
• Blood culture
• +/- CXR
• +/- Urinalysis and urine culture
• +/- Stool culture

Full Sepsis workup [Infants < 61 days old]

• CBC and differential
• Blood culture
• Lumbar puncture
  
• Urinalysis and urine culture
• =/- CXR
• +/- Stool culture

Fever (3 - 36 months)

• History
• Immunization history
• Associated symptoms - pulmonary, GI, feeding, irritability, activity
• Sick contacts - siblings, babysitters, day care
• Previous illness or antibiotic use
• Birth history - maternal factors (fever, GBS status/prophylaxis, STD hx, PROM) and infant's nursery course
• Labs
• CBC
• ESR/CRP
• UA/UCx
• Stool studies - depending on H&P
• BCx -  depending on H&P
• LP - depending on H&P
• CXR - depending on H&P
• Treatment
• Hib, S. pneumoniae, E. coli, S. aureus, N. meningitidis, Group A strep, Salmonella