Pediatric Fever Without a Source: Quick Assessment

Fever without a source (FWS) in pediatric patients poses a diagnostic challenge that requires a careful balance between identifying serious infections and avoiding unnecessary testing or hospitalization. This session reviews the age-specific approach to evaluating FWS in infants and young children, emphasizing differences in immune response, clinical risk factors, and presentation. Participants will learn how to stratify risk using validated tools such as the Rochester, Boston, and Philadelphia criteria, especially in febrile infants under 90 days. Diagnostic testing, including blood cultures, urinalysis, lumbar puncture, and biomarkers like procalcitonin and CRP, will be discussed in guiding clinical decisions. The session also explores evolving outpatient management strategies for low-risk infants and the role of shared decision-making with caregivers. Rapid viral testing, vaccination status, and recent exposure history are also considered to narrow differential diagnoses. Timely and structured assessment of FWS helps avoid missed serious bacterial infections while promoting efficient, family-centered care.

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