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Febrile young infant with poor perfusion — RCPSC EM MCQ

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HardPaediatric emergenciesFebrile young infant with poor perfusionRCPSC EM

A 6-week-old infant presents CTAS 2 with fever 38.6°C and poor feeding. HR is 182, capillary refill is 4 seconds, and the infant is irritable. Urine has not been passed for 8 hours. There is no localising focus. What is the most appropriate next step?

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Correct answer: C — Obtain cultures promptly, start IV broad-spectrum antibiotics, and admit for neonatal sepsis evaluation

Young febrile infants, particularly with poor perfusion or feeding, require sepsis evaluation, early empiric antibiotics and admission; procedures should not delay antimicrobials in unstable infants.

Reference: Canadian Paediatric Society guidance