Skip to main content

Febrile Infant

Clinical Pathways promote evidence based, safe, and high-value care for patients by providing clinical recommendations and standard processes.  They are developed by multidisciplinary committees of subject matter experts, informed by methodical review of available evidence and consensus among committee members.

Clinical Pathways: 

Additional tools associated with this clinical pathway: 

Inclusion and exclusion criteria 

Inclusion:  

  • Term: Estimated gestational age (EGA) > 37 weeks.
  • Otherwise healthy patients who also do not meet any exclusion criteria below
  • Temperature ≥ 38°C: Patients have documented rectal temperature of ≥ 38°C or 100.4°F at home in the past 24 hours or in a clinical setting

Exclusion:  

  • Patients who have remained hospitalized since birth
  • Preterm (< 37 weeks gestation)
  • Less than 2 weeks of age whose perinatal courses were complicated by maternal fever, infection, and/or antimicrobial use
  • Known or suspected immune compromise
  • Neonatal course was complicated by surgery or infection
  • Congenital or chromosomal abnormalities
  • Medically fragile, requiring some form of technology or ongoing therapeutic intervention to sustain life
  • Focal bacterial infection (e.g., cellulitis, omphalitis, septic arthritis, osteomyelitis). These infections should be managed according to accepted standards
  • Clinical bronchiolitis, with or without positive test results for respiratory syncytial virus (RSV)
  • Received immunizations within the last 48 hours

Committee members involved in the revision: 

  • Christopher Veit, MD, MHPE, FAAP | Hospital Medicine | Committee Chair
  • Maria Blanco, MD | Urgent Care | Committee Member
  • Alaina Burns, Pharm.D., BCPPS | Pharmacy | Committee Member
  • John Daniel, MD, MS | Neonatology | Committee Member
  • Josh Herigon, MD, MPH, MBI | Infectious Diseases | Committee Member
  • Alexandra Oschman, PharmD, BCPPS | Pharmacy | Committee Member
  • Erin Scott, DO | Emergency Medicine | Committee Member
  • Douglas Swanson, MD | Infectious Diseases | Committee Member
  • Julie Weiner, DO | Neonatology | Committee Member

EBP Committee Members:

  • Katie Berg, MD, FAAP | Evidence Based Practice
  • Jarrod Dusin, PhD, RD, CPHQ | Evidence Based Practice 
  • Megan Gripka, MPH, MLS (ASCP) SM | Evidence Based Practice

Publication dates: 

  • Finalized revised date: 06/2025, 08/2026
  • Next expected revision date: 06/2028 

If you have any questions regarding this content, or identify a broken link, please email evidencebasedpractice@cmh.edu. 

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.

Evidence Based Practice Menu