AbstractsResults Of the 1123 infants (Invasive Bacterial Infection -IBI-, 48; 4.2%), 488 (43.4%) were classified as low risk criteria for IBI according to the "step by step" approach (vs 693-61.7%-with the Labscore and 458-40.7%-with the Rochester criteria). The prevalence of IBI in the low-risk criteria patients was 0.2% (95% CI 0-0.6%) using the "step by step" approach (vs 0.7%-95% CI 0.1-1.3% with the Labscore and 1.1%-95% CI 0.1-2%-with Rochester). Using the "step by step" approach, 1 patient with IBI was not correctly classified (2.0%, CI95% 0-6.12) vs 5 using the Labscore or Rochester (10.4%, CI95% 1.76-19.04%). Conclusions A sequential approach to young febrile infants including procalcitonin identifies better patients more suitable for outpatient management. Inhaled foreign bodies are very serious problem in the pediatric pulmonology since they increase the rate of morbidity and mortality. Aim of this study was analysis of endoscopic changes caused by vegetable foreign bodies (VFB) in correlation with their long -standing in the bronchial tree. ENDOSCOPIC ASPECTS OF INHALED VEGETABLE FOREIGN BODIES IN CHILDREN Material and MethodsIn ten years period (2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011) inhaled foreign bodies were removed in 219 children (age 6 mths-14 yrs), 60.27%-male and 39.73%-female. Most of the children (57.50%) belong to the youngest group of age (1-2 yrs). The inhaled foreign bodies were from organic origin in 208 (94.97%). Of these, 203 (92.69%) were with vegetable origin. The most commonly found grains were peanuts (57.14%). Inhaled foreign bodies were single object in 123 (56.16%) while in 96 (43.80%) they were multiple. Results Endoscopically we found:Insignificant inflammation (some hours presence of VFB) in 48 (23.64%)Significant inflammation -vulnerable mucous membrane (VFB with presence more than 3 days) in 78 (38.42%) Severe inflammation -manifest inflammation (VFB more than 7 days presence) in 77 (37.93%). In this group of children we detected:-granulomatous formations 57 (82.60%)-decubital changes 28 (40.57%)-mucopurulent secretion 41 (59.42%). Conclusion Severity of the endoscopic changes was closely correlated with the quality of the foreign body (vegetable ones), the period of lodgement and the age of the patients. Timely broncoscopic extirpation of VFB decreases the percentage of complications and represents the most successful and only logically carried out therapeutically procedure.

Among well-appearing young infants with FWS, PCT performs better than CRP in identifying patients with IBIs and seems to be the best marker for ruling out IBIs. Among patients with normal urine dipstick results and fever of recent onset, PCT remains the most accurate blood test.

Overall bacteremia rate is currently <0.5% in well-appearing children aged 3-36 months with FWS attending the PED in areas with PCV-7 widespread vaccination and is sufficiently low to preclude laboratory testing in favour of close follow-up. Further research is needed to evaluate a more conservative approach in infants 2-3 months of age.

IMPORTANCESevere gastrointestinal (GI) manifestations have been sporadically reported in children with COVID-19; however, their frequency and clinical outcome are unknown. OBJECTIVE To describe the clinical, radiological, and histopathologic characteristics of children with COVID-19 presenting with severe GI manifestations to identify factors associated with a severe outcome.

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