The frequency of occult bacteremia and serious bacterial infection among children aged 3 months- 3 years with fever

Aim: The aim of the study was to determine the frequency and causes of occult bacteremia and serious bacterial infection, and the frequency of complications of theses among Turkish children aged 3 months to 3 years in the Cukurova region. Materials and Methods: The patients 3 months-3 years of age admitted to pediatric emergency department between November 2006-November 2007 with the complaint of tympanic fever 38,0°C, of whom origin of fever could not been found included in the study. Blood samples of the patients who met the study conditions were obtained for complete blood counts, peripheral blood smears, C-RP levels and blood cultures. Results: Among 318 cases included in the study, 10 (3.1%) were diagnosed as serious bacterial infection: 4 (1.3%) had occult bacteremia, 2 (0.6%) had pneumonia, 2 (0.6%) had urinary tracy infection, 1 (0.3%) had menengitis and 1 (0.3%) had bacterial enteritis. The bacteria S.aureus, S. Pneumoniae and group B streptococci were isolated occult bacteremia cases. In cases with bacteremia only, mean absolute neutrophil count was 11.646 ± 1.405/ mm3, mean C-RP level was 82,1 ± 31,7 mg/L, mean PMNL percentage was 75 ± 5,8, and mean band form percentage was 8,7 ± 3,0, all were elevated and statistically significant. Toxic granulation and fever lasting 3-7 days were statistically significant for occult bacteremia and risk for serious bacterial infection, where sex, age and degree of fever were not. Only 4 of the 10 patients with serious bacterial infection had fever 39 oC and leucocyte count 15.000/mm3. Conclusions: Occult bacteremia and serious bacterial infection have to be considered as causes of fever in chidren 3 months-3 years of age with fever of unknown origin. The cases with leucocyte count15.000/mm3, mean absolute neutrophil count10.000/mm3, and segmented percentage70% have high risk for serious bacterial infection.