cliot (version 1.0.0)

rochester_criteria_febrile_infant: Rochester Criteria for Febrile Infants

Description

Calculates the Rochester Criteria to identify febrile infants (typically < 60 days old) at low risk for serious bacterial infection (SBI). Meeting all criteria suggests a low risk, potentially allowing for outpatient management without lumbar puncture (though clinical practice varies).

Usage

rochester_criteria_febrile_infant(well_appearing, no_skeletal_soft_tissue_infection,
                                  term_infant, no_unexplained_hyperbilirubinemia,
                                  no_previous_antimicrobials, no_prior_hospitalization,
                                  no_chronic_illness, wbc_count, band_count_percent,
                                  urinalysis_wbc_hpf, stool_wbc_hpf = NULL,
                                  diarrhea_present = 0)

Value

A list containing:

Risk_Classification

"Low Risk" or "High Risk".

Inputs

Breakdown of whether History, Exam, and Lab criteria were met.

Arguments

well_appearing

Numeric (0 or 1). Infant generally well-appearing? (1 = Yes).

no_skeletal_soft_tissue_infection

Numeric (0 or 1). No evidence of ear, soft tissue, or skeletal infection? (1 = Yes).

term_infant

Numeric (0 or 1). Born at term (>= 37 weeks)? (1 = Yes).

no_unexplained_hyperbilirubinemia

Numeric (0 or 1). No unexplained hyperbilirubinemia? (1 = Yes).

no_previous_antimicrobials

Numeric (0 or 1). No previous antimicrobial therapy (perinatal or postnatal)? (1 = Yes).

no_prior_hospitalization

Numeric (0 or 1). No prior hospitalizations (excluding birth)? (1 = Yes).

no_chronic_illness

Numeric (0 or 1). No chronic or underlying illness? (1 = Yes).

wbc_count

Numeric. Peripheral WBC count (cells/mm^3). (Low risk: 5,000 - 15,000).

band_count_percent

Numeric. Band neutrophils percentage. (Low risk: Absolute band count < 1,500/mm^3).

urinalysis_wbc_hpf

Numeric. Urinalysis WBC per high-power field. (Low risk: < 10).

stool_wbc_hpf

Numeric (Optional). Stool WBC per high-power field. Required if diarrhea is present. (Low risk: < 5).

diarrhea_present

Numeric (0 or 1). Is diarrhea present? (1 = Yes).

References

Jaskiewicz JA, McCarthy CA, Richardson AC, et al. Febrile infants at low risk for serious bacterial infection--an appraisal of the Rochester criteria and implications for management. Febrile Infant Collaborative Study Group. Pediatrics. 1994;94(3):390-396.

Examples

# Example 1: Low Risk
# Well appearing, Term, No history issues, WBC 10k, Bands 5%, UA 2 WBC
rochester_criteria_febrile_infant(1, 1, 1, 1, 1, 1, 1, 10000, 5, 2, NULL, 0)

# Example 2: High Risk
# Preterm (0), otherwise normal
rochester_criteria_febrile_infant(1, 1, 0, 1, 1, 1, 1, 10000, 5, 2, NULL, 0)