Assessment of fever in children

Last reviewed: 23 Apr 2022
Last updated: 11 Jan 2022

Summary

Differentials

Common

  • Urinary tract infection
  • Pneumonia
  • Coronavirus disease 2019 (COVID-19)
  • Sinusitis
  • Meningitis
  • Bacteraemia (occult)
  • Sepsis
  • Septic arthritis
  • Osteomyelitis
  • Cat-scratch disease
  • Viral syndromes
  • Infectious mononucleosis
  • Cytomegalovirus infection
  • Malaria infection
  • Lyme disease
  • Tuberculosis
  • Kawasaki disease
  • Juvenile idiopathic arthritis (JIA)
  • Systemic lupus erythematosus
  • Rheumatic fever
  • Crohn's disease
  • Ulcerative colitis
  • Leukaemia
  • Non-Hodgkin's lymphoma
  • Drug-related fever
  • Vaccine reaction
Full details

Uncommon

  • Typhoid (enteric fever)
  • Endocarditis
  • Hepatic abscess
  • Cerebral abscess
  • Streptococcal toxic shock syndrome
  • Staphylococcal toxic shock syndrome
  • Tularaemia
  • Brucellosis
  • Leptospirosis
  • Encephalitis
  • Myocarditis
  • Herpes simplex virus (HSV) infection
  • Human immunodeficiency virus (HIV) infection
  • Toxoplasmosis
  • Rocky Mountain spotted fever
  • Sarcoidosis
  • Hodgkin's lymphoma
  • Thyroid storm
  • Serotonin syndrome
  • Serum sickness/serum sickness-like reaction
  • Factitious fever
  • Munchausen syndrome by proxy
  • Heat-related illness
  • Paediatric autonomic disorders
  • Dengue fever
Full details

Contributors

Authors

Paul Ishimine, MD
Paul Ishimine

Director

Pediatric Emergency Medicine

Department of Emergency Medicine

UC San Diego Health System

Fellowship Director

Pediatric Emergency Medicine

Rady Children's Hospital, San Diego

Clinical Professor of Emergency Medicine and Pediatrics

University of California

San Diego School of Medicine

San Diego

CA

Disclosures

PI declares that he has no competing interests.

Peer reviewers

Linton Yee, MD

Associate Professor

Departments of Pediatrics and Surgery

Director of Pediatric Emergency Medicine Education

Duke University School of Medicine

Durham

NC

Disclosures

LY declares that he has no competing interests.

Philip Spandorfer, MD, MSCE

Pediatric Emergency Medicine

Children's Healthcare of Atlanta at Scottish Rite

Atlanta

GA

Disclosures

PS declares that he has no competing interests.

Esse Menson, null

Consultant in Paediatric Infectious Diseases

Evelina Children's Hospital

London

UK

Disclosures

EM declares that she has no competing interests.

  • Assessment of fever in children images
  • Guidelines

    • Fever in under 5s: assessment and initial management
    • Evaluation and management of well-appearing febrile infants 8 to 60 days old
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    Urinary tract infections in children

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