​​​Fever is a normal physiological response to illness, which facilitates and accelerates recovery. The condition is common in children, and often benign and self-limiting. However, as childhood fever may be associated with increased morbidity in children, it frequently causes concern among parents and healthcare providers, and is consequently one of the most common reasons for which children are brought to seek medical attention. 

In most cases, fever is a presenting symptom of a self-limiting viral infection. However, it may also be associated with serious bacterial infections, such as meningitis and pneumonia, and other non-infective illnesses such as Kawasaki’s disease and malignancy.​

Thus it is important for healthcare professionals to determine the underlying illness causing the fever, and to identify children with life-threatening features and those at risk of serious illness so that timely intervention and proper referral can be made.​

​​​The most common causes of fever seen in children who seek treatment at the Children's Emergency department at KK Women's and Children's Hospital include viral fevers, upper respiratory tract infections and gastroenteritis.​

Related: Fever

​Guidelines for Clinical Assessment and Management of fevers in children​

1. Identify and treat immediate life-threatening features
Be alert to features such as compromised airway, breathing or circulation, and decreased level of consciousness.​ ​

2. Conduct thorough history-taking and systematic examination
​After stabilising the child with fever, a thorough history-taking and systematic examination should be carried out to determine the underlying cause of the fever and assess the child for risk of serious illness.​

It is crucial to measure and record the child’s vital signs such as temperature, heart rate, respiratory rate and capillary refill time. Signs of dehydration such as prolonged capillary refill time, abnormal skin turgor, abnormal respiratory pattern, weak pulse and cool extremities should also be assessed. ​ 

​​3. Identify and treat features suggestive of specific diseases (Table 1)​

4. Assess the risk of serious illness in children with fever (Table 2)​

Click here to read more and refer to Table 1 and 2.