Introduction: Occult bacteremia is the condition in which bacteremia is identified without clinical evidence of sepsis and no clear foci of infection.

Aims:
1) To study the prevalence of occult bacteremia among children 3-36 months of age with fever without focus, presenting in the Paediatric Emergency Services of CMC Hospital, Vellore.
2) To study the pattern of causative organisms.

Methods:

Prospective study

Period: December 1, 2004 - August 31, 2005

Population: Infants 3-36 months of age

Inclusion criteria:

• Fever>/= 39oC at presentation
  Duration of illness <7 days
  Not received antibiotics in the 4 days prior to this visit
• No identifiable focus of infection

Age, sex, Hib vaccine status, temperature at presentation, symptoms, examination findings and investigations recorded and analysed.

Results:

• 77 children were studied
  Mean age - 19.2 months ; 62.3% males
  52 had Hib vaccination
• Mean presenting temperature - 39.3^oC

Diagnosis:

Diagnosis	Number	Percentage
Viral fever Pneumonia Acute gastroenteritis Acute tonsillopharyngitis UTI Dengue fever Occult bacteremia Enteric fever Sepsis Aseptic meningitis Heat related illness	51 11 4 2 2 2 1 1 1 1 1	66.2 14.3 5.2 2.6 2.6 2.6 1.3 1.3 1.3 1.3 1.3
Total	77	100

72 children received empirical antibiotics.

Conclusion: One child's blood culture grew Haemophilus influenza type b. Prevalence of occult bacteremia was 1.3%. Administration of empirical antibiotics may be justified since 20.8% of the diagnoses were of bacterial origin.