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Febrile infant 29 to 60 days — USMLE Step 3 MCQ

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HardPediatrics (well-child, chronic management)Febrile infant 29 to 60 daysUSMLE Step 3

A 38-day-old term infant is brought to clinic for fever to 38.4°C. He is feeding well and appears alert. He has no focal findings on examination. The family lives 15 minutes from the hospital and has reliable transportation. Urinalysis shows pyuria; inflammatory markers are low and CSF is not obtained. Which of the following is the most appropriate at this time?

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Correct answer: A — Obtain urine culture and treat with antibiotics with close follow-up

In well-appearing febrile infants 29 to 60 days old, evaluation includes urine testing and culture; a positive urinalysis requires antimicrobial treatment and reliable follow-up when low-risk features are present.

Reference: AAP febrile infant clinical practice guideline