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The Pediatric Forum |

Bacteremia and Urinary Tract Infections in Young Febrile Children With Bronchiolitis

Harminder S. Dhaliwal, MD
Arch Pediatr Adolesc Med. 1998;152(8):818-819. doi:.
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I read with interest the article by Kuppermann et al published in the December 1997 ARCHIVES (1997;151:1207-1214). The conclusion was "Previously healthy febrile children aged 24 months or younger with bronchiolitis are unlikely to have bacteremia or UTI [urinary tract infecions]. Therefore, routine cultures of the blood and urine in these patients are unnecessary."1(p1207) This recommendation seems to be too sweeping in nature. If you have a 10- to 12-week-old infant who has a fever, mild respiratory distress, and wheezing, it may be wise to do a blood culture for possible pneumonia because very often the radiological findings of pneumonia may lag behind the clinical presentation.2 An almost 2-year-old child with a low-grade fever and wheezing does not require a blood or urine culture. A screening urine analysis may be a better option.3 The decision of doing a blood and urine culture in a febrile patient should be considered using the age of the patient and the presence or absence of a clearly defined source of infection.4,5

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