Paeds Vivas · infectious-diseases
Bacteraemia and occult bloodstream infection — branching viva
A branching viva following the question of bacteraemia and occult bloodstream infection across the age range, from the modern reframing of occult bacteraemia, through the febrile young infant pathway, the toxic child in septic shock, and the interpretation of a positive culture, with evidence and regional boundaries tested throughout.
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Target exams
RACP General PaediatricsRACP DCERCPCH Progress+MRCPCH ClinicalABP General PediatricsACGME PediatricsRCPSC Pediatrics
Prompt
The examiner releases the topic in stages, beginning with a well-appearing vaccinated toddler with fever without source, moving to a febrile young infant, then to a toxic older child, and finally to a positive blood culture at 24 hours. The candidate must state the physiology and epidemiology before the action, apply age-stratified pathways, justify empiric therapy timing, and build a safe disposition at each stage.
Viva format
The examiner takes the candidate through four escalating branches, each anchored to a patient. At each stage the candidate must state the reasoning before the action, name the active guideline or rule, and respect regional boundaries. The examiner probes the why and the corners. [10]
References7ShowHide
- [1]Gomez B Bacteremia in previously healthy children in emergency departments: clinical and microbiological characteristics and outcome European journal of clinical microbiology & infectious diseases, 2015.PMID 25252630
- [2]Kuppermann N A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections JAMA pediatrics, 2019.PMID 30776077
- [3]Pantell RH Evaluation and Management of Well-Appearing Febrile Infants 8 to 60 Days Old Pediatrics, 2021.PMID 34281996
- [6]Kanegaye JT Lumbar puncture in pediatric bacterial meningitis: defining the time interval for recovery of cerebrospinal fluid pathogens after parenteral antibiotic pretreatment Pediatrics, 2001.PMID 11694698
- [9]Ben-Shimol S Dynamics of invasive pneumococcal disease in infants younger than 2 years old following PCV7/13 implementation using two infant and a booster dose schedule: evidence for indirect protection of young infants, Israel, 2004 to 2019 Euro surveillance, 2023.PMID 37347413
- [10]Gaur AH Optimizing blood culture practices in pediatric immunocompromised patients: evaluation of media types and blood culture volume The Pediatric infectious disease journal, 2003.PMID 12799512
- [12]Weiss SL Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026 Pediatric critical care medicine, 2026.PMID 41869844