Fever, Sepsis & Serious Infection
Assess the febrile child using age, physiology and the evolving clinical picture.
Quick revision ↓ Medical Dictionary
01Risk assessment
Assess behaviour, breathing, circulation, hydration and age rather than temperature alone. Young infants have a lower threshold for urgent assessment. A child who appears severely ill needs immediate help regardless of the measured temperature, and parental concern can add important information about change from baseline.
02Look for the source
Examine for respiratory, urinary, meningeal, skin, bone and joint infection as appropriate. A clear symptom can help localise disease but does not exclude a second problem. Persistent fever or new focal findings warrants reassessment rather than simply repeating the original diagnosis.
03Sepsis response
Suspected sepsis requires an age-appropriate risk assessment, timely investigations, antimicrobial treatment and physiological support according to the current pathway. Obtain relevant cultures without delaying urgent treatment. Reassess perfusion and respiratory state after interventions and escalate when the child fails to improve.
04Fever treatment
Use antipyretics for distress according to age, weight and safe prescribing guidance, not simply to normalise a number. Improvement after an antipyretic does not distinguish a harmless illness from serious infection. Avoid duplicate ingredients and explain accurate administration to carers.
05Safety net
Discuss specific warning signs such as worsening responsiveness, breathing difficulty, poor intake, reduced urine or a concerning rash. A non-blanching rash with illness needs urgent assessment, but its absence does not rule out meningococcal disease. Arrange review if fever persists or the child deteriorates.
High-Yield Revision
- Temperature alone does not determine severity.
- Antipyretic response does not exclude serious infection.
- Reassess after every important intervention.
Common Pitfalls
- Waiting for a rash before considering meningococcal disease.
- Treating the thermometer instead of the distressed child.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.