Background: Many infants with fever or irritability are hospitalized for concerns of undetectable serious bacterial infection. This hospitalization may change the family's perception of their child's health and subsequent health seeking behavior.

Purpose: The purpose of this observational study is to determine if otherwise healthy infants admitted to the hospital during the first three months of life with a negative evaluation for serious bacterial infection have more subsequent physician visits than do age-matched controls.

Methods: Cases and controls were healthy, term infants identified by reviewing a clinical data repository that contains information concerning all inpatients and outpatients seen in the University of Virginia (UVA) Health System. Cases include all children 15 to 120 days of age admitted to UVA during a one year period who fulfilled the following: 1) hospitalization ≤3 days in length; 2) ≥1 outpatient visit to the UVA Health System prior to hospitalization and 3) underwent lumbar puncture during the hospitalization. Controls include all infants born at UVA during the same time period and fulfilled the following: 1) ≥ 1 outpatient visit to the UVA Health System and 2) no hospitalizations during the first year of life. Differences between groups were compared by unpaired t-test.

Results: 83 infants were identified as cases with the average age of 40.3 ± 16.4 days at the time of admission (range 15 - 87 days) and 831 infants were identified as controls. During the first 300 days of life, cases had significantly more outpatient visits than did controls(8.78 ± 6.98 vs. 6.18 ± 3.81, p<0.001). The number of “well-child” visits was comparable (3.33 ± 1.32 vs. 3.70± 1.42, p > 0.2). Cases had significantly more “sick” visits than did controls (6.76 ± 5.98 vs. 3.54 ± 2.79, p<0.001) and the majority of “sick” visits among cases were after hospitalization (5.38 ± 5.51 vs. 3.54 ± 2.79, p<0.001).

Conclusion: Infants who are hospitalized for evaluation of serious bacterial infection during the first three months of life have more subsequent physician visits during the first year of life than age-matched controls.