Roberts K B, Borzy M S
Johns Hopkins Med J. 1977 Jul;141(1):9-13.
Sixty-one febrile infants in the first eight weeks of life were evaluated for serious, treatable illness. Infants with bacteremia could not be distinguished from non-bacteremic infants by height of fever, white blood cell count, absolute number of juvenile or mature polymorphonuclear leukocytes, or the presence of a focus of infection (meningitis excluded). The examiners' overall assessment ("clinical judgment") correctly identified eight of the nine infants with bacteremia as not being "well"; one 2-week-old with group B streptococcal bacteremia was "missed" clinically, This points up the limitation of clinical judgment in assessing febrile infants in the age group studied and supports an aggressive approach in the management of very young febrile infants.
对61名出生后前8周的发热婴儿进行了严重可治疗疾病的评估。发热高度、白细胞计数、幼稚或成熟多形核白细胞的绝对数量或感染灶(不包括脑膜炎)的存在,均无法区分菌血症婴儿和非菌血症婴儿。检查人员的总体评估(“临床判断”)正确地将9名菌血症婴儿中的8名判定为“情况不佳”;一名2周大的B组链球菌菌血症婴儿在临床上被“漏诊”。这指出了在所研究年龄组的发热婴儿评估中临床判断的局限性,并支持对非常年幼的发热婴儿采取积极的管理方法。