important conditions to be considered in a child with a fever
Last edited 11/2019 and last reviewed 12/2021
| Diagnosis to be considered | Symptoms and signs in conjunction with fever in a child under 5 years of age |
| Meningococcal disease |
Non-blanching rash, particularly with 1 or more of the following:
|
| Bacterial meningitis |
Neck stiffness Bulging fontanelle Decreased level of consciousness Convulsive status epilepticus |
| Herpes simplex encephalitis |
Focal neurological signs Focal seizures Decreased level of consciousness |
| Pneumonia |
Tachypnoea (respiratory rate >60 breaths/minute, age 0-5 months; >50 breaths/minute, age 6-12 months; >40 breaths/minute, age >12 months) Crackles in the chest Nasal flaring Chest indrawing Cyanosis Oxygen saturation <=95% |
| Urinary tract infection |
Vomiting Poor feeding Lethargy Irritability Abdominal pain or tenderness Urinary frequency or dysuria |
| Septic arthritis |
Swelling of a limb or joint Not using an extremity Non-weight bearing |
| Kawasaki Disease |
Fever for 5 days or longer and may have some of the following:
|
Do not use duration of fever to predict the likelihood of serious illness. However, children with a fever lasting 5 days or longer should be assessed for Kawasaki disease
Reference:
- NICE (November 2019). Feverish illness in children Assessment and initial management in children younger than 5 years