rochester_criteria_febrile_infant: Rochester Criteria for Febrile Infants

In cliot: Clinical Indices and Outcomes Tools

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)

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).

Value

A list containing:

Risk_Classification	"Low Risk" or "High Risk".
Inputs	Breakdown of whether History, Exam, and Lab criteria were met.

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)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.