cliot (version 1.0.0)

step_by_step_febrile_infant: Step-by-Step Approach for Febrile Infants

Description

Calculates the risk stratification for Invasive Bacterial Infection (IBI) in febrile infants (typically <= 90 days old) using the "Step-by-Step" approach. This sequential algorithm allows for the identification of low-risk infants who may be managed without lumbar puncture or antibiotics.

Usage

step_by_step_febrile_infant(age_days, ill_appearing, urinalysis_positive,
                            procalcitonin, crp_mg_l, absolute_neutrophil_count)

Value

A list containing:

Risk_Classification

The determined risk category (High Risk, Intermediate Risk, or Low Risk).

Recommendation

Clinical guidance based on the risk level.

Arguments

age_days

Numeric. Age of the infant in days.

ill_appearing

Numeric (0 or 1). Is the infant ill-appearing? (1 = Yes). If Yes, the patient is automatically High Risk.

urinalysis_positive

Numeric (0 or 1). Is there leukocyturia (positive urinalysis)? (1 = Yes). If Yes, the patient is High Risk.

procalcitonin

Numeric. Serum Procalcitonin level in ng/mL. (>= 0.5 ng/mL indicates High Risk).

crp_mg_l

Numeric. C-Reactive Protein level in mg/L. (> 20 mg/L indicates Intermediate Risk if previous steps are negative).

absolute_neutrophil_count

Numeric. Absolute Neutrophil Count (ANC) in cells/mm^3. (> 10,000 indicates Intermediate Risk if previous steps are negative).

References

Mintegi S, Bressan S, Gomez B, et al. Accuracy of a sequential approach to identify young febrile infants at low risk for invasive bacterial infection. Emerg Med J. 2014;31(e1):e19-24. doi:10.1136/emermed-2013-202449 Gomez B, Mintegi S, Bressan S, et al. Validation of the "Step-by-Step" Approach in the Management of Young Febrile Infants. Pediatrics. 2016;138(2). doi:10.1542/peds.2015-4381

Examples

# Example 1: Low Risk
# 45 days old, Well-appearing, Neg UA, PCT 0.1, CRP 5, ANC 4000
step_by_step_febrile_infant(45, 0, 0, 0.1, 5, 4000)

# Example 2: High Risk (Procalcitonin)
# 60 days old, Well-appearing, Neg UA, PCT 0.8, CRP 10, ANC 5000
step_by_step_febrile_infant(60, 0, 0, 0.8, 10, 5000)

# Example 3: Intermediate Risk (CRP)
# 50 days old, Well, Neg UA, PCT 0.2, CRP 30, ANC 5000
step_by_step_febrile_infant(50, 0, 0, 0.2, 30, 5000)