• Jason B Fischer, Julie Sturza, Zio Kim, LopezM JamesMJDivision of Pediatric Gastroenterology, Department of Pediatrics., and Alexander J Rogers.
• From the Division of Emergency Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA.
• Pediatr Emerg Care. 2021 Oct 1; 37 (10): e585e588e585-e588.

ObjectivesThis study aimed to describe demographic, clinical, and laboratory values in febrile pediatric intestinal failure patients with indwelling central venous catheters presenting to the emergency department to determine if there are low-risk features predictive of negative blood cultures that could help identify a subset that do not need hospitalization and/or broad-spectrum antibiotics.MethodsWe conducted a retrospective cohort study of febrile patients younger than 18 years with diagnosis of intestinal failure requiring a central venous catheter for home parenteral nutrition to identify factors associated with normal blood cultures to identify a low-risk subset.ResultsOf 119 encounters, 46% had a bloodstream infection. Children with a bloodstream infection were older than those without. A normal lactate and heart rate were associated with negative blood cultures.ConclusionPediatric intestinal failure patients with a central venous catheter for home parenteral nutrition presenting to the emergency department with fever and found to have a normal lactate and heart rates had lower rates of bloodstream infection. Although we were unable to create a highly sensitive clinical decision-making rule to identify a low-risk cohort because of the low number of patients meeting both criteria, the promising candidate variables identified merit for future multicenter studies.Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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