This version was machine-translated from German and has not been medically reviewed. The authoritative version is the German version.

Step-by-Step Febrile Infant

Sequential risk assessment of febrile infants ≤ 90 days: appearance, age, urine, procalcitonin, CRP/neutrophils

Details

Ill appearance (not “well appearing”)

Age

Leukocyturia

Procalcitonin (ng/ml)

CRP (mg/l)

Absolute neutrophil count (/µl)

Calculation aid for healthcare professionals: the calculator reproduces what the sources cited assign to the inputs. Clinical assessment and every treatment decision remain with the treating physician. Inputs and results are not stored.

Found an error or have an idea?

Tell us if something does not work or could be better.

Give feedback

Sources

A clinical prediction rule to identify febrile infants 60 days and younger at low risk for serious bacterial infections (JAMA Pediatr 173:342–351) Kuppermann N, Dayan PS, Levine DA, et al.; Febrile Infant Working Group of the Pediatric Emergency Care Applied Research Network (PECARN), 2019. Original paper (freely accessible)
Validation of the 'Step-by-Step' approach in the management of young febrile infants (Pediatrics 138:e20154381) Gomez B, Mintegi S, Bressan S, Da Dalt L, Gervaix A, Lacroix L; European Group for Validation of the Step-by-Step Approach, 2016. Validation study
Accuracy of a sequential approach to identify young febrile infants at low risk for invasive bacterial infection (Emerg Med J 31:e19–e24) Mintegi S, Bressan S, Gomez B, et al., 2014. Original paper (derivation)
Febrile infants at low risk for serious bacterial infection – an appraisal of the Rochester criteria and implications for management (Pediatrics 94:390–396) Jaskiewicz JA, McCarthy CA, Richardson AC, et al.; Febrile Infant Collaborative Study Group, 1994. Original paper
Clinical practice guideline: evaluation and management of well-appearing febrile infants 8 to 60 days old (Pediatrics 148:e2021052228) Pantell RH, Roberts KB, Adams WG, et al.; Subcommittee on Febrile Infants, American Academy of Pediatrics, 2021. Guideline (freely accessible)

Scientific basis last reviewed: September 2026.

Related calculators

Note

Calculation aid for healthcare professionals. Percentiles and z-scores describe the position of a measured value in the reference population; clinical assessment remains with the treating physician.