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Title: ALTE and FULL SEPTIC WORK UP

Category: Pediatrics

Keywords: ALTE, Menningitis, Sepsis (PubMed Search)

Posted: 5/24/2008 by Don Van Wie, DO (Updated: 7/21/2026)

ALTE and Infections - when to do full septic workups?

Given some recent cases of newborns with ALTEs at UMMS and Wash Co I thought I'd offer the following Pearls:

Overall the number of children with bacterial meningitis or bacteremia / sepsis as a cause of the ALTE is very low, much less than 1%

However there is no data regarding the risk of meningitis in a well-appearing, afebrile infant with an ALTE

That being said THE RISK OF MISSING A SERIOUS LIFE THREATENING INFECTION is much greater than the risk of doing a complete septic workup, administering antibiotics, and admitting an infant with an ALTE.

References

McGovern MC, Smith MB. Causes of apparent life threatening events in infants: a systematic review. Arch Dis Child. 2004;89(11):1043-8.