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Clinical Pediatrics
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What's this?

Infections and Apparent Life-Threatening Events

Robin L. Altman, MD

Department of Pediatrics, Section of General Pediatrics, robin_altman{at}nymc.edu

Karl I. Li, MD

Section of Pediatric Infectious Diseases, New York Medical College and Westchester Medical Center, Valhalla, New York

Donald A. Brand, PhD

Office of Health Outcomes Research, Winthrop University Hospital, Mineola, New York

The need for routine sepsis evaluation in patients who have experienced an apparent life-threatening event but lack signs of infection remains controversial. To assess their risk of a serious occult bacterial infection, records were reviewed of 95 infants in whom infections were discovered during their inpatient evaluation after an apparent life-threatening event. Noted for each patient was the presence of any suggestive findings that would have prompted a physician to consider the given type of infection in the differential diagnosis. Thirty patients had bacterial infections; all but 5 had suggestive findings. The exceptions included 1 patient with pneumonia and 4 with urinary tract infections. None of the remaining 25 patients had occult bacterial infections. In patients with an apparent life-threatening event who appear well and lack signs suggestive of a serious bacterial infection, it may be possible to forego routine sepsis evaluation beyond a chest radiograph and urine culture without risking a serious missed diagnosis.

Key Words: apparent life-threatening event • ALTE • occult infection • serious bacterial infection

This version was published on May 1, 2008

Clinical Pediatrics, Vol. 47, No. 4, 372-378 (2008)
DOI: 10.1177/0009922807310934
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