Suspected Bacteremia (Child)

Causes

Bacteremia usually starts with an infection in 1 organ that spreads to the blood. Almost any type of infection can cause bacteremia. This includes:

• Skin infection.

• Abdominal or intestinal infection, such as gastroenteritis.

• Infection after surgery.

• Lung infection (pneumonia).

• Ear infection.

• Infection in the urine.

Symptoms

At first, symptoms may seem like any typical infection or illness, but then they get worse. Symptoms of bacteremia can include:

• Fever and chills.

• Loss of appetite or trouble feeding.

• Nausea or vomiting.

• Trouble breathing or fast breathing.

• Fast heart rate.

• Skin rashes or blotches.

• Lethargy.

• Confusion or loss of consciousness.

• Seizures.

Diagnosing bacteremia needs a blood test (culture). The results of the blood culture may take 24 to 48 hours to be available and may not always be positive. Because of the time needed to get the test result, your child’s doctor may start treatment based on other information. The doctor will likely ask about your child’s health history and do a physical exam. Other lab and imaging tests may also be done. Most children will need to stay in the hospital. Hospital care may include IV (intravenous) antibiotics, IV fluids, and breathing support.

Home care

Once your child returns home, follow these guidelines.

General care

• Always contact the doctor if you have any questions or concerns about your child's well-being. Some things to look out for include new fever, other symptoms getting worse, or possible reactions to medicines for the infection or any other new medicines.

• Follow the doctor's directions for caring for your child.

• Notice any changes in your child’s normal activity and sleep patterns.

• If your child is not eating well, talk to your doctor.

Special note to parents

Wash your hands well with soap and clean, running water before and after caring for your child to prevent spreading infection.

Medicines

• If your doctor prescribed antibiotics, give them as directed. Do not stop giving them just because your child feels better. Your child needs to take the full course of antibiotics.

• Always follow your doctor's directions when giving your child any medicines. Use children’s acetaminophen for fever, fussiness, or discomfort, unless another medicine was prescribed. Make sure you give your child the correct dose of these medicines. In babies over 6 months of age, you may use children’s ibuprofen or acetaminophen. Talk with the doctor before using these medicines if your child has chronic liver or kidney disease or has ever had a stomach ulcer or gastrointestinal bleeding. Do not give aspirin to children or teens unless your child’s doctor says it is safe. Aspirin can put your child at risk for Reye syndrome, a rare but serious condition.

Follow-up care

Follow up with your child’s doctor, or as advised:

• You will be notified if the antibiotic needs to be changed based on the blood culture results.

• If X-rays, a CT, or an ultrasound were done, a specialist will review them. You will be notified of any findings that may affect your child’s care.

Call 911

Call 911 if:

• Your child has trouble breathing.

• Your child can't swallow.

• Your child has extreme confusion.

• Your child is extremely drowsy or has trouble waking up.

• Your child faints or loses consciousness.

• Your child has a rapid heart rate.

• Your child has a seizure.

• Your child has a stiff neck.

When to contact your child's doctor

Call your child’s doctor right away if:

• Your child has a fever (see Fever and children, below).

• Your child’s fever does not go down within 24 hours of antibiotic use or gets worse.

• Your child is vomiting.

• Your child has a bloated stomach.

• Your baby is fussy or cries and cannot be soothed.

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the doctor what type to use instead. When you talk with any doctor about your child’s fever, tell them which type you used.

Below is when to call the doctor if your child has a fever. Your child’s doctor may give you different numbers. Follow their instructions.

When to call a doctor about your child’s fever

For a baby under 3 months old:

• First, ask your child’s doctor how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the doctor

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the doctor

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the doctor