SHM Converge Scientific Abstract ePoster Gallery-Evaluating the Safety of Avoiding Lumbar Punctures in Febrile Infants

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This retrospective study evaluated whether lumbar punctures (LPs) can be safely avoided in low-risk febrile infants aged 7–28 days using a clinical pathway introduced in 2018. The goal was to reduce unnecessary invasive procedures while still detecting bacterial meningitis, a serious but uncommon condition.<br /><br />Researchers reviewed ED visits from 2018–2022 for full-term infants with fever who were managed on the pathway. Infants who were ill-appearing, had focal infection, or seizures were excluded. Low-risk status was based on clinical history, CBC, procalcitonin, urinalysis, and culture results. Low-risk infants did not require LPs or antibiotics under the protocol.<br /><br />A total of 385 infants met inclusion criteria. Of these, 166 (43%) were classified as low-risk and 219 (57%) as high-risk. The mean age of low-risk infants was 19.5 days. Among the 166 low-risk infants, 140 (84%) did not undergo LPs as recommended. Importantly, there were no missed cases of bacterial meningitis in these infants. The 26 low-risk infants who still received LPs did so for reasons such as prior LP at another hospital, clinician judgment, positive cultures after admission, increased fussiness, or seizures after admission. None had bacterial meningitis, though one had viral meningitis.<br /><br />The study concluded that LPs can be safely avoided in low-risk febrile infants 7–28 days without missed bacterial meningitis cases.

Asset Subtitle

Ammar Kamil

Meta Tag

Author List Ammar Kamil, Hannah Riggins, Jamie Librizzi, Maheshwor Kafle

Category Research

Concept Risk Stratification

Concept Febrile Infant

Concept Lumbar Puncture

Concept Infant Age 728 Days

Concept Invasive Bacterial Infection

Distinguished Non-Finalist

Presenter Organization Phoenix Children's Hospital

Presenting Author Ammar Kamil

Track Pediatric

Keywords

lumbar puncture

febrile infants

bacterial meningitis

low-risk pathway

retrospective study

clinical protocol

neonatal fever

emergency department

procalcitonin

invasive procedures

Risk Stratification

Febrile Infant

Lumbar Puncture

Infant Age 728 Days

Invasive Bacterial Infection