Febrile infant 61-90 days — MCCQE Part 1 MCQ

Correct answer: D — Use CPS risk-stratified approach with urine testing and inflammatory markers, deciding admission/treatment by risk

Use CPS risk-stratified approach with urine testing and inflammatory markers, deciding admission/treatment by risk is best because well-appearing infants up to 90 days still need structured risk assessment. Provide only reassurance without clear follow-up or safety-netting is suboptimal because children can deteriorate quickly and follow-up must be explicit; Use adult dosing or adult pathways without paediatric adjustment is suboptimal because children require age- and weight-appropriate care; Delay assessment until the next routine visit is suboptimal because developmental, infectious and neonatal red flags require timely assessment; Give antibiotics, steroids or investigations routinely despite no indication is suboptimal because over-treatment can cause harm when supportive or targeted care is indicated. Age bands matter in Canadian febrile-infant guidance.

Reference: Canadian Paediatric Society febrile infant statement