Assessing the Febrile Child for Serious Infection: A Step Closer to Meaningful Rapid Results

* Abbreviations: CRP — : C-reactive protein PCT — : procalcitonin WBC — : white blood cell All pediatricians have experienced the difficult decision about whether a young infant has a life-threatening infection that requires hospitalization or has a self-limited viral disease that can safely be managed at home. As our appreciation of the negative aspects of antibiotic overuse (both to society and individuals) has matured, these situations have become more rather than less frequent. The almost dizzying development of sophisticated diagnostic modalities over the past 10 to 20 years has, in at least some situations, outpaced our ability to know how to use the test results. No single test has proven adept at accurately distinguishing the child with a life-threatening infection from the child who will get better on his or her own. Into this terrain, Srugo et al1 increase the number of tools in our toolbox and potentially move us substantially closer to that Holy Grail of accurately determining which child truly is at risk for having a serious bacterial infection. To fully scrutinize the results of this large, international study, we must first discuss how we assess the utility of … Address correspondence to David W. Kimberlin, MD, Department of Pediatrics, University of Alabama at Birmingham, 1600 7th Ave South CHB 303, Birmingham, AL 35233. E-mail: dkimberlin{at}peds.uab.edu