Interpretation
| Result | Meaning |
|---|---|
| All three negative | Low risk for SBI (UTI, bacteremia, meningitis); LP may be deferred in well-appearing infants |
| Any positive | Not low risk; further evaluation and empiric treatment per protocol |
Formula
Low risk if ALL: urinalysis negative (no LE, no nitrite, ≤ 5 WBC/hpf) AND ANC ≤ 4,090/µL AND procalcitonin ≤ 1.71 ng/mL
Clinical pearls
- Applies only to well-appearing, previously healthy infants with temperature ≥ 38.0 °C; ill-appearing infants need full evaluation regardless.
- Infants ≤ 28 days have higher rates of invasive infection; the AAP 2021 guideline recommends full evaluation including LP in neonates.
- The AAP 2021 guideline uses lower inflammatory-marker cut-offs (PCT > 0.5 ng/mL, ANC > 4,000–5,200/µL); both are shown.
Examples
pecarn febrile infant 45 days ua negative anc 3.2 pct 0.2febrile 5 week old, negative urine, ANC 5100, procalcitonin 0.340 day old with fever, ua positive, anc 2.8, pct 0.1 pecarn
FAQ
What are the PECARN febrile infant criteria?
A febrile infant ≤60 days is low risk if the urinalysis is negative, the absolute neutrophil count is 4,090/µL or less, and procalcitonin is 1.71 ng/mL or less.
Does a low-risk PECARN infant need a lumbar puncture?
In the derivation study no bacterial meningitis was missed; well-appearing low-risk infants 29–60 days can usually be managed without LP, per AAP 2021 guidance.