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October 8, 1982

Treatment of Young, Febrile Patients in Long Island, NY

JAMA. 1982;248(14):1712. doi:10.1001/jama.1982.03330140026025

To the Editor.—  Previous studies have shown that certain risk factors for bacteremia are applicable to young, febrile patients who make their first visit to an inner-city "walk-in" clinic and are discharged, with or without antimicrobial therapy. Such patients have no focus of infection, an upper respiratory tract infection, pharyngitis, otitis media, or pneumonia, and are not ill enough to be hospitalized. The three risk factors for outpatient bacteremia in this setting are an age between 6 months and 24 months, WBC count of 15,000/cu mm or greater, and a temperature of 38.9 °C or higher.1Although one study2 suggests a similar incidence of bacteremia in such patients in private pediatric practice, how the preceding data relate to a private practice setting remains unclear.3A mail survey was conducted to determine how practicing pediatricians on the voluntary staff of the Nassau County Medical Center treat their "patients