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Clinical Implications of Positive Blood Cultures in Children 李秉穎 台大醫院小兒部 健康保險局、台北醫學大學護理學院August, 2004 愛的小叮嚀: 得感冒時，先別急著去看醫師，放下手邊煩人的事情，好好休息幾天，多喝水、多吃新鮮蔬果，不要吝嗇睡眠時間，可以參考上面的妙方減輕感冒症狀的不適，感冒自然就會好喔!! 上呼吸道感染後，應該何時去看病？ 當您經過上述方法處理，如果仍未見效，遇有下列情況，應立即就醫：如果有這些症狀要趕快去看醫生喔～ 口溫超過39.4℃、呼吸短促或哮喘、 頭、胸、胃、耳朵或頸部淋巴腺有疼痛情形、 喉嚨越來越痛…….. Occult Bacteremia in Children 3 Mo–3 Yr of Age Occult bacteremia (bacteremia without an apparent focus of infection) due to S. pneumoniae, N. meningitidis, and Salmonella occurs in approximately 1.5% of relatively well-appearing children between 3–36 mo of age with fever (rectal temperature ≥38.0°C). For nontoxic-appearing infants with a rectal temperature of 39OC or greater, two options were suggested: (1) obtain a blood culture and give empirical antimicrobial therapy (ceftriaxone, a single dose of 50?mg/kg, not to exceed 1?g) or (2) if the WBC count is 15,000/μL or greater, obtain a blood culture and give empirical antimicrobial therapy. Septic emboliCandida species Ecthyma gangrenosaPseudomonas aeruginosa Blood cultureBehrman: Nelson Textbook of Pediatrics, 17th ed., 2004 Proper skin disinfection before blood collection is essential. Povidone-iodine may be used, but this agent must be allowed to dry completely for maximum activity. Alcohol is rapidly bactericidal and is a suitable alternative agent. For patients with suspected bacteremia and fungemia, two or three separate blood cultures are preferred. Whenever possible, a minimum of 2?mL of blood should be obtained for culture before administration of antibiotics. 10–20% of pediatric patients may have low-grade bloodstream infections. How reliable is a negative blood culture result?Australia, 2007 Adequate blood culture volume 1 month: ≥ 0.5 mL 1 month – 36 months: ≥ 1.0 mL ≥ 36 months: ≥ 4.0 mL Positive blood culture: adequate 5.2% (34/655) vs. inadequate 2.1% (14/648) Neonatal sepsisBlood culture The minimum blood volume is not known, but generally, 0.75 to 1.0 mL is recommended. Multiple