Fever: management (red or amber features)
Children with red/amber features
need admission. Those with red fea-tures have life-threatening illness and need
hypoxic children or those in shock.
there is no apparent source of infection, despite fever, then the
investigations should include the following:
Blood—culture, FBC, CRP, electrolytes;
Urine—test for UTI;
lumbar puncture—consider if the clinical
assessment dictates and there are no
CXR—consider if high white blood cell
Maximum dose third-generation
cephalosporins (cefotaxime or ceftriax-one) should be given to children with
of shock or coma
of meningococcal disease
Consider giving high dose IV
aciclovir if suspect herpes simplex encepha-litis or disseminated neonatal
Consider giving IV corticosteroid
if confirmed bacterial meningitis (but not in infants younger than 3mths
cephalosporin if any of the following are sus-pected
Haemophilus influenzae type b
Consider choice of antibiotics or
route of administration carefully in the following instances:
Child <3mths: add antibiotic against listeria
Child with decreased level of
consciousness: give parenteral antibiotics.
Significant rates of antibiotic
Fever should be treated if the
child is unwell with it:
use tepid sponging.
over- or underdress the child.
use paracetamol or ibuprofen if the child is distressed with fever.