Assessing under 5s with a fever

How common is this presentation?

Fever is the second most common reason for hospital attendance in children, after breathing difficulties.^{1 2} Most children who present with a fever will have a mild self limiting viral illness, which will require no medical intervention. About 5% of children who present with fever will have a bacterial infection, with urinary tract infection and pneumonia being the most common.^{3 4} Only 1% of children with suspected infection will have bacteraemia or meningitis.⁵ Children under 1 year old are at higher risk of serious bacterial infection,^{5 6} with those under 3 months of age being at the highest risk. A normal heart rate in children under 1 year old is between 110 and 160 beats/min; normal respiratory rate should be 30-40 breaths/min.⁷

It is important to be able to identify children with more serious causes of fever. This can be difficult because many young children present with non-specific symptoms, and often there is no obvious source of infection. To help assessment the National Institute for Health and Care Excellence (NICE) guideline on …