Occult bacteremia in young febrile children

The evaluation of young febrile children, who appear to be nontoxic, has be en a subject of considerable debate. This article reviews the following iss ues regarding occult bacteremia caused by S. pneumoniae, nontyphoidal Salmo nella species, and N. meningitidis. How commonly does occult bacteremia due to these organisms occur? What is the natural history of these infections? Which, if any, clinical features or screening laboratory tests help to det ect occult bacteremia? Do empiric antibiotics prevent serious sequelae of o ccult bacteremia? What are the costs and benefits of empiric antibiotic tre atment of young febrile children at risk for occult bacteremia?