children s health issues
Occult Bacteremia
Diagnosis of Occult Bacteremia
Blood culture Urine culture and urinalysis Sometimes other blood and stool tests and a spinal tap Because doctors cannot tell with certainty which children who have a fever have occult bacteremia, doctors need to identify any bacteria by doing a blood culture. Because the bacteria are too few or too small to see, doctors send samples of blood to the laboratory so the bacteria can be examined and grown ( Culture of Microorganisms ) for identification. regardless of whether they have received vaccinations, have samples of blood, urine, and spinal fluid taken for testing. The spinal fluid is removed during a Spinal Tap (lumbar puncture), which involves withdrawing a sample of spinal fluid with a small needle. All samples are sent to a laboratory for testing to look for signs of bacterial infection. In most cases, the infant or child is admitted to the hospital and given antibiotics. Children who have trouble breathing will likely have a chest x-ray as well. Other blood tests and stool tests may also be done depending on the age of the child. Rapid detection tests for certain viruses may also be done in some children. For these tests, a swab is used to take a sample from the nose or throat. The results usually are available within a few hours. When infants are under 3 months of age and have a fever, doctors cannot always tell just by looking at them whether they could have bacteremia. In these infants, doctors usually do laboratory tests (complete blood count, urinalysis, and blood cultures). If the results of the blood and urine tests seem normal, some doctors have the parents or caretakers monitor the infant at home and then return to the doctor's office within 24 hours so the infant can be re-examined and the blood cultures checked. They do not prescribe antibiotics during this time. Other doctors prefer to admit these infants to the hospital and do further tests of the blood, urine, and spinal fluid. Most doctors consider infants less than 30 days old to be at high risk of bacteremia. Infants in this age group are typically admitted to the hospital and tests of the blood, urine, and spinal fluid are done. Infants and children in this age group who have a fever but who have complete routine vaccinations and who appear well are at very low risk of bacteremia. Because of this low risk, doctors may decide to monitor the children without doing blood tests. However, a urinalysis and a urine culture are typically done to look for a Urine tests as a cause of the fever. The parents or caretakers are asked to monitor the children's symptoms and follow up with the doctor (by visit or telephone) in 24 to 48 hours. Children who worsen or whose fever does not go away have blood tests and possibly chest x-rays or a spinal tap. 