Fever in children
Sam Behjati and John FitzSimons look at how to assess and manage this condition
The most common ailment of childhood is feverish illness. In England and Wales, for example, general practitioners are consulted by their paediatric patients for feverish illnesses on average 3.7 times a year.12 Fortunately, most feverish illnesses are caused by self limiting, harmless viral infections. Set against this benign backdrop are sinister bacterial infections, such as meningitis, which, if left untreated, may have fatal consequences.
The challenge of managing children with feverish illnesses is to identify those children at risk of serious illness while avoiding unnecessary treatment and investigation of children with benign viral illnesses. Junior staff in general practice, emergency departments, and paediatric departments are on the front line.
Viral infections—Most feverish illnesses are caused by respiratory and gastrointestinal viruses. Both can cause malaise and often erythematous rashes, which are usually blanching. Although mostly benign and self limiting, viruses may occasionally cause serious, life threatening illnesses—for example, respiratory failure in