The importance of septic work-up in the febrile neonate.

71 febrile neonates admitted to the Paediatric and Neonatal Department in 1988 and 1989 were studied. Septic work ups were done for 84% of patients & 80% had lumbar puncture. These infants were subdivided into 5 groups in order to identify the significance of the various stages of septic work up. It was found that 48% of patients with significant infections were only diagnosed after some stage of septic work up. 14% had meningitis and diagnosed only after CSF examination. Only in 13% of patients the diagnosis could be made confidently without a septic work up confirming that the diagnosis of infection in the neonate is difficult and often missed without a septic work up. Clinical impression by paediatricians reduced the number of patients requiring unnecessary investigations and receiving empiric therapy. We recommend maintaining our present cautious policy of admitting neonates with pyrexia.