Paediatric Fever

Fever is an incredibly effective mechanism to fight off pathogens.

Clearly, whilst many illnesses that cause a fever don’t require anything more than the body’s natural response, there are some patients in which a fever might represent a serious illness. Differentiating those serious illnesses from self-limiting presentations can be tricky at times, but can also be anxiety provoking for clinicians and parents, or carers of that child.

In children the limited communication can make the diagnostic challenge of the origin of the fever a real challenge, along with the added difficult of gaining some tests. Differentiating those with a benign disease from those with a life threatening presentation can be a daunting challenge.

The numbers of presentations to healthcare providers are staggering. Paediatric fever has been reported to represent as high as 15-25% of all presentations in primary care and emergency departments, so massive numbers. Thankfully the prevalence of serious infections in children is low and is estimated at <1% in primary care settings in industrialised countries, although it has been suggested that for ED attendances the prevalence of serious illness could be as high as 25%.

So we thought with this common but tricky presentation that it was about time we tackled the topic. We’ll be running through;

    • A definition

    • Patholphysiology

    • Relevance of the severity of the fever

    • Febrile seizures

    • Clinical assessment

    • NICE guidelines

    • Duration of fever

    • Management

    • Antipyretics

Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom!

Simon, Rob & James

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Normal Body Temperature: A Systematic Review. Geneva. Open Forum Infect Dis. 2019

Defining Fever. Mackowiak. Open Forum Infect Dis. 2019

Fever in Children: Pearls and Pitfalls. Barbi. Children (Basel). 2017

Physiology, Temperature Regulation. Osilla. Stats Pearls. 2023

The pathophysiological basis and consequences of fever. Walter. Crit Care. 2016

Fever under 60 days of age – Don’t Forget the Bubbles (

Hot Garbage: Mythbusting fever in children – Don’t Forget the Bubbles (

Is this child dehydrated? Steiner. JAMA. 2004

Fever in under 5s: assessment and initial management; NICE 2019

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