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Febrile infant 21 days — ABEM Board MCQ

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ModeratePediatric emergenciesFebrile infant 21 daysABEM Board

A 21-day-old term infant arrives with fever and decreased feeding. Triage acuity is ESI 2; T 100.8 F rectal, HR 168/min, RR 42/min. He appears irritable but perfused, with no focal source on exam. Immunizations are not yet due. Which of the following is the most appropriate next step in management?

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Correct answer: B — Perform full sepsis evaluation and give empiric IV antibiotics

Febrile neonates younger than 28 days generally require blood, urine, and CSF evaluation with empiric parenteral antibiotics.

Reference: AAP febrile infant clinical practice guideline; ACEP Fever in Infants policy