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Well-appearing febrile infant aged 45 days — MCCQE Part 1 MCQ

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HardChild with FeverWell-appearing febrile infant aged 45 daysMCCQE Part 1

A 45-day-old term infant presents with rectal temperature 38.3°C and mild rhinorrhoea. He is feeding well, has normal perfusion and no focal bacterial source. Parents report routine immunisations were not given recently. What is the most appropriate investigation?

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Correct answer: D — Urinalysis and urine culture with age-stratified inflammatory marker assessment

CPS guidance supports risk-stratified evaluation of well-appearing febrile infants, with urine testing important because UTI is a common serious bacterial infection. Discharge without assessment is unsafe in this age group. Lumbar puncture decisions depend on age, inflammatory markers and clinical risk rather than being automatic in every well 45-day-old.

Reference: CPS Position Statement—Well-appearing febrile infants ≤90 days