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Serious bacterial infection in young infant — MCCQE Part 1 MCQ

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HardChild with FeverSerious bacterial infection in young infantMCCQE Part 1

A 6-week-old infant is brought to the emergency department with rectal temperature 38.4°C and poor feeding. He appears irritable, capillary refill is 4 seconds, and there is no clear source on examination. What is the most appropriate next step in management?

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Correct answer: D — Perform full sepsis evaluation and start empiric intravenous antibiotics

Fever in a young infant with poor feeding and delayed perfusion requires urgent sepsis evaluation, cultures, and empiric intravenous antibiotics. Discharge or oral antibiotics without cultures risks missing invasive bacterial infection. Viral testing does not exclude bacterial sepsis in an unwell young infant. Canadian paediatric practice prioritises age, appearance, and perfusion in febrile infants.

Reference: CPS febrile young infant guidance