Table 3 Central categories which influence physicians’ decision-making process on whether to perform a lumbar puncture or not in febrile infants ≤ 60 day and relevant quotes

Actively looking for a focus of infection

(on-call physician, focus group 5)

“If you find an obvious explanation; the infant has a cold, mom has a cold, someone else close by obviously has a cold. Then you may put yourself at ease if the child is well-appearing.”

Questioning the fever

(on-duty physician, focus group 6)

“If you at some point are in a situation where the baby had fever at home, presents with no fever and [you think]: “What was that? Was it a thermometer that did not work? Was the baby warm because of how it was dressed?” You want to find an explanation as to why it might have been different at home and a normal temperature here.”

Considering the general condition

(on-duty physician, focus group 3)

“I perceived that child as extremely healthy and content, and without any signs of meningitis. At that point, it would be a pity to start up the whole process (LP)”