Journal Club: PECARN febrile infant updates

We're back with journal club to review a study evaluating the PECARN guidelines on febrile infants under 28 days of age and serious bacterial infections like meningitis.

This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Julia Magana (pediatric emergency medicine). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

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Key Points:

• Urinalysis, absolute neutrophil count, and procalcitonin are useful predictors of serious bacterial infection
• In this study, using urine studies, absolute neutrophil count, and procalcitonin were able to risk stratify patients into risk for meningitis and no cases of meningitis were missed

Sources:

• Burstein B, Waterfield T, Umana E, Xie J, Kuppermann N. Prediction of Bacteremia and
• Bacterial Meningitis Among Febrile Infants Aged 28 Days or Younger. JAMA. Published
• online December 8, 2025. doi:10.1001/jama.2025.21454
• Kuppermann N, Dayan PS, Levine DA, et al. A Clinical Prediction Rule to Identify
• Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. JAMA
• Pediatr. 2019;173(4):342-351. doi:10.1001/jamapediatrics.2018.5501