Paediatrics: The child with fever

The child with fever

In children aged 4wks to 5yrs body temperature should be measured using any one of:

·  Electronic thermometer in the axilla.

·  Chemical dot thermometer in the axilla.

·  Infrared tympanic thermometer.

Fever in babies 6mths is rare. Fever >=38.5°C requires further investigation.

Differential diagnosis

The majority of children with fever have a self-limiting viral infection that resolves without any problem. However, in the very young it is particular-ly important to consider the possibility of an underlying serious infection. When there is no apparent cause of infection, the differential diagnosis of fever includes the following.

·  Bacteraemia.

·  Respiratory tract infection.

·  Meningitis and encephalitis.

·  UTI.

·  Viral infection.

·  Osteomyelitis.

·  Bacterial gastroenteritis.

·  Endocarditis.

·  Rheumatic fever.

·  Malaria.

·  Tuberculosis.

·  Post-vaccination fever.

Highlights the signs and symptoms of disease that requires spe-cific medical treatment