Wysoka temperatura (gorączka) u dzieci
Diagnostyka i diagnoza

Gorączka u dzieci definiowana jest jako temperatura rektalna ≥38°C u niemowląt poniżej 3. miesiąca życia oraz ≥38,5°C u starszych dzieci, z różnicami zależnymi od metody pomiaru (oralna ≥37,8°C, pachowa ≥37,2°C). Pomiar rektalny jest złotym standardem u niemowląt i małych dzieci, natomiast pomiary uszne i czołowe są mniej dokładne i mają ograniczenia wiekowe. Kluczowa jest ocena kliniczna dziecka, uwzględniająca stan ogólny, nawodnienie, objawy neurologiczne, oddechowe oraz reakcję na leki przeciwgorączkowe. Wskazania do pilnej konsultacji obejmują m.in. gorączkę ≥38°C u niemowląt <3 miesiąca, ≥39°C u dzieci 3-36 miesięcy, temperaturę >40°C w każdym wieku, utrzymującą się gorączkę >3-5 dni, objawy neurologiczne, trudności w oddychaniu, wysypkę plamistą lub wybroczynową oraz objawy odwodnienia.

Wysoka temperatura (gorączka) u dzieci – Diagnostyka

Gorączka jest jednym z najczęstszych objawów, z którymi rodzice zgłaszają się do lekarza pediatry. Jest to naturalny mechanizm obronny organizmu w walce z infekcją, jednak wymaga właściwej oceny i diagnozy, szczególnie u najmłodszych pacjentów. Temperatura ciała uznawana jest za gorączkę, gdy wynosi 38°C (100,4°F) lub więcej przy pomiarze rektalnym.123

Definiowanie gorączki u dzieci w zależności od wieku

Definicja gorączki różni się w zależności od wieku dziecka oraz metody pomiaru temperatury:

  • U noworodków i niemowląt poniżej 3. miesiąca życia – temperatura rektalna 38°C (100,4°F) lub wyższa12
  • U dzieci powyżej 3. miesiąca życia – temperatura rektalna 38,5°C (101,3°F) lub wyższa2
  • Przy pomiarze w ustach (pomiar oralny) – temperatura 100°F (37,8°C) lub wyższa34
  • Przy pomiarze pod pachą (pomiar pachowy) – temperatura 99°F (37,2°C) lub wyższa5

Metody pomiaru temperatury

Właściwy pomiar temperatury jest kluczowy dla diagnostyki gorączki u dzieci. Różne metody pomiaru cechują się odmienną dokładnością i mają zastosowanie w różnych grupach wiekowych:627

  • Pomiar rektalny – jest najdokładniejszą metodą, szczególnie zalecaną u niemowląt i małych dzieci. Polega na umieszczeniu termometru cyfrowego w odbycie dziecka. Jest metodą referencyjną dla dzieci do 5. roku życia.
  • Pomiar uszny (tympaniczny) – wykonywany przy pomocy termometru na podczerwień, nie jest zalecany u dzieci poniżej 6 miesiąca życia ze względu na mniejszą dokładność.
  • Pomiar czołowy/skroniowy – przeprowadzany termometrem na podczerwień po powierzchni czoła dziecka.
  • Pomiar pachowy – mniej dokładny, ale bezpieczny i najmniej inwazyjny.
  • Pomiar oralny – zalecany dla dzieci powyżej 5. roku życia, które potrafią utrzymać termometr pod językiem.

Najważniejsze jest użycie termometru cyfrowego, gdyż zapewnia on najdokładniejszy pomiar.89 Tradycyjne termometry rtęciowe nie są już zalecane ze względów bezpieczeństwa.

Ocena kliniczna dziecka z gorączką

Przy diagnostyce gorączki u dzieci, szczególne znaczenie ma ocena kliniczna stanu dziecka, która nierzadko mówi więcej o ciężkości choroby niż sama wartość temperatury.1011

Objawy ogólne istotne w diagnostyce

Podczas oceny dziecka z gorączką lekarz zwraca uwagę na następujące aspekty:1112

  • Ogólny wygląd i zachowanie dziecka – czy dziecko jest aktywne, reaguje na otoczenie, czy jest ospałe i apatyczne
  • Zdolność do picia płynów i nawodnienie organizmu
  • Oddychanie – przyspieszony oddech lub trudności w oddychaniu
  • Obecność wysypki lub zmian skórnych
  • Kolor skóry – czy występuje bladość, sinica, zaczerwienienie
  • Objawy neurologiczne – sztywność karku, nadwrażliwość na światło, bóle głowy
  • Reakcja na leki przeciwgorączkowe – czy gorączka reaguje na podanie leków

Dziecko, które mimo gorączki pozostaje aktywne, pije odpowiednią ilość płynów i reaguje prawidłowo na otoczenie, zazwyczaj nie wymaga intensywnego postępowania diagnostycznego.1113

Sytuacje wymagające natychmiastowej pomocy medycznej

Istnieją stany, w których dziecko z gorączką wymaga natychmiastowej konsultacji lekarskiej lub pomocy na oddziale ratunkowym:11415

  • Niemowlę poniżej 3. miesiąca życia z temperaturą 38°C (100,4°F) lub wyższą
  • Dzieci w wieku 3-36 miesięcy z temperaturą 39°C (102,2°F) lub wyższą
  • Temperatura powyżej 40°C (104°F) u dziecka w każdym wieku
  • Gorączka utrzymująca się dłużej niż 3-5 dni
  • Gorączka niewrażliwa na leki przeciwgorączkowe
  • Drgawki gorączkowe lub inne objawy neurologiczne
  • Trudności w oddychaniu, sinica warg lub języka
  • Wysypka, zwłaszcza plamista lub wybroczyny (drobne czerwono-fioletowe plamki)
  • Silne bóle głowy, sztywność karku
  • Nadmierna senność, trudności z wybudzeniem
  • Silne wymioty lub biegunka prowadzące do odwodnienia
  • Płacz niemożliwy do uspokojenia

Diagnostyka laboratoryjna i obrazowa

W zależności od stanu klinicznego dziecka, wieku oraz objawów towarzyszących, lekarz może zlecić różne badania diagnostyczne mające na celu ustalenie przyczyny gorączki.1617

Badania laboratoryjne

Najczęściej wykonywane badania laboratoryjne w diagnostyce gorączki u dzieci to:161819

  • Morfologia krwi z rozmazem – pozwala na ocenę liczby krwinek białych i ich rozkładu, co może wskazywać na infekcję bakteryjną lub wirusową
  • Markery stanu zapalnego – oznaczenie poziomu białka C-reaktywnego (CRP) i prokalcytoniny (PCT), które są bardziej czułymi wskaźnikami w różnicowaniu infekcji bakteryjnych od wirusowych
  • Badanie ogólne moczu i posiew moczu – szczególnie ważne u dzieci z gorączką bez oczywistego źródła, gdyż zakażenie układu moczowego jest najczęstszą poważną infekcją bakteryjną u małych dzieci
  • Posiew krwi – zalecany u noworodków i niemowląt poniżej 1. miesiąca życia z gorączką, ze względu na wyższe ryzyko bakteriemii w tej grupie wiekowej
  • Badanie płynu mózgowo-rdzeniowegopunkcja lędźwiowa jest wykonywana w przypadku podejrzenia zapalenia opon mózgowo-rdzeniowych, szczególnie u noworodków i niemowląt
  • Testy w kierunku grypy lub COVID-19 – w okresach zwiększonej zachorowalności na te choroby

Badania obrazowe

W diagnostyce gorączki u dzieci mogą być wykonywane różne badania obrazowe:1916

  • Zdjęcie rentgenowskie klatki piersiowej – przy podejrzeniu zapalenia płuc, szczególnie gdy występują objawy oddechowe
  • Ultrasonografia – przy podejrzeniu ropni, zapaleń stawów lub innych kolekcji płynowych
  • Tomografia komputerowa lub rezonans magnetyczny – w przypadkach gorączki o nieznanej przyczynie, szczególnie gdy inne badania nie dają jednoznacznej odpowiedzi

Algorytmy diagnostyczne w zależności od wieku

Podejście diagnostyczne do gorączki u dzieci różni się w zależności od wieku, a lekarze korzystają z ustalonych algorytmów postępowania:202119

Noworodki (do 28 dni życia)

W tej grupie wiekowej gorączka jest zawsze stanem pilnym, wymagającym pełnej diagnostyki w warunkach szpitalnych:

  • Pełna ocena kliniczna
  • Morfologia krwi z rozmazem
  • Markery stanu zapalnego (CRP, PCT)
  • Posiew krwi
  • Badanie ogólne i posiew moczu
  • Punkcja lędźwiowa z badaniem płynu mózgowo-rdzeniowego
  • Często empiryczna antybiotykoterapia do czasu uzyskania wyników badań
Niemowlęta (1-3 miesięcy)

Dzieci w tej grupie wiekowej również wymagają dokładnej oceny, choć podejście może być nieco mniej agresywne u dobrze wyglądających niemowląt:2221

  • Ocena kliniczna z użyciem skali oceny ryzyka
  • Morfologia krwi z rozmazem
  • Markery stanu zapalnego
  • Badanie ogólne i posiew moczu
  • Punkcja lędźwiowa – w przypadku dzieci źle wyglądających lub z nieprawidłowymi wynikami badań laboratoryjnych
  • Posiew krwi – w wybranych przypadkach
Dzieci (3-36 miesięcy)

W tej grupie wiekowej decyzje diagnostyczne są bardziej zindywidualizowane i zależą od stanu klinicznego dziecka:1816

  • U dzieci dobrze wyglądających z gorączką bez oczywistego źródła – badanie ogólne i posiew moczu (zwłaszcza u dziewczynek)
  • U dzieci z objawami sugerującymi zakażenie układu oddechowego – rentgen klatki piersiowej
  • U dzieci z innymi objawami (np. bóle brzucha, wymioty) – badania ukierunkowane na podejrzewane źródło infekcji
  • U dzieci źle wyglądających – pełniejszy panel badań łącznie z posiewem krwi i punkcją lędźwiową

Gorączka o nieznanym pochodzeniu

Gorączka o nieznanym pochodzeniu (FUO – Fever of Unknown Origin) to szczególny przypadek diagnostyczny definiowany jako gorączka utrzymująca się przez ponad 2 tygodnie, w przypadku której wstępne badania i ocena kliniczna nie pozwalają ustalić przyczyny.2023

Przyczyny gorączki o nieznanym pochodzeniu

Najczęstsze przyczyny FUO u dzieci to:2421

Rozszerzona diagnostyka w przypadku FUO

W przypadku gorączki o nieznanym pochodzeniu diagnostyka jest zazwyczaj rozszerzona i może obejmować:2125

  • Badania serologiczne w kierunku różnych patogenów (EBV, CMV, bartonella, toxoplasma)
  • Testy immunologiczne (ANA, czynnik reumatoidalny)
  • Rozszerzone badania obrazowe (USG jamy brzusznej, ECHO serca, tomografia komputerowa)
  • Testy w kierunku gruźlicy (próba tuberkulinowa, QuantiFERON-TB)
  • Biopsje, jeśli istnieje podejrzenie nowotworu lub specyficznego procesu zapalnego
  • Konsultacje specjalistyczne (immunolog, reumatolog, onkolog)

Diagnoza FUO wymaga systematycznego podejścia i często zaangażowania wielodyscyplinarnego zespołu specjalistów.26

Diagnostyka różnicowa gorączki u dzieci

Gorączka u dzieci może być objawem szerokiego spektrum chorób, od łagodnych infekcji wirusowych po poważne choroby zagrażające życiu.2728

Najczęstsze przyczyny gorączki u dzieci

W diagnostyce różnicowej gorączki u dzieci należy uwzględnić:293031

  • Infekcje wirusowe – przeziębienie, grypa, ospa wietrzna, COVID-19, opryszczka, różyczka
  • Infekcje bakteryjne – zakażenie układu moczowego, zapalenie ucha środkowego, zapalenie gardła, zapalenie płuc, zapalenie opon mózgowo-rdzeniowych
  • Reakcje poszczepienne – gorączka może wystąpić po niektórych szczepieniach
  • Choroby autoimmunologiczne – młodzieńcze idiopatyczne zapalenie stawów, choroba Kawasaki
  • Nowotwory – białaczki, chłoniaki
  • Reakcje alergiczne – na leki lub inne alergeny

Specyficzne jednostki chorobowe w diagnostyce różnicowej

Niektóre jednostki chorobowe wymagają szczególnej uwagi przy diagnostyce gorączki u dzieci:2432

  • Zapalenie opon mózgowo-rdzeniowych – poważna infekcja wymagająca natychmiastowego leczenia, objawiająca się gorączką, sztywnością karku, bólem głowy i zaburzeniami świadomości
  • Posocznica – zakażenie krwi, które może szybko postępować i prowadzić do wstrząsu septycznego
  • Drgawki gorączkowe – występują u 3-5% dzieci w wieku 6 miesięcy do 5 lat, zazwyczaj nie powodują trwałych uszkodzeń, ale wymagają diagnostyki przy pierwszym epizodzie
  • Choroby z wysypkąpłonica, odra, choroba Kawasaki (może prowadzić do uszkodzenia serca)
  • Gorączka reumatyczna – powikłanie po infekcji paciorkowcowej, które może uszkodzić zastawki serca

Postępowanie z dzieckiem z gorączką

Właściwe postępowanie z dzieckiem z gorączką zależy od jego wieku, stanu klinicznego oraz wyników badań diagnostycznych.2233

Leczenie objawowe

W większości przypadków leczenie gorączki u dzieci koncentruje się na łagodzeniu objawów:348

  • Leki przeciwgorączkowe – paracetamol lub ibuprofen mogą być stosowane, gdy dziecko odczuwa dyskomfort. Aspiryna nie powinna być stosowana u dzieci ze względu na ryzyko zespołu Reye’a.
  • Nawodnienie – istotne jest zapewnienie odpowiedniej ilości płynów, gdyż gorączka zwiększa ryzyko odwodnienia.
  • Odpoczynek – ważne jest, aby dziecko z gorączką miało zapewniony odpowiedni odpoczynek.
  • Unikanie przegrzania – nie należy nadmiernie okrywać dziecka z gorączką, gdyż może to utrudniać oddawanie ciepła.

Hospitalizacja

Decyzja o hospitalizacji dziecka z gorączką zależy od kilku czynników:2233

  • Wiek dziecka – noworodki i niemowlęta poniżej 2-3 miesiąca życia z gorączką wymagają zazwyczaj hospitalizacji
  • Stan kliniczny – dzieci z zaburzeniami świadomości, zaburzeniami oddychania lub innymi poważnymi objawami
  • Wyniki badań laboratoryjnych wskazujące na ciężką infekcję bakteryjną
  • Brak możliwości adekwatnej obserwacji i kontroli w warunkach domowych

W warunkach szpitalnych możliwe jest prowadzenie intensywniejszej diagnostyki oraz odpowiednie monitorowanie stanu dziecka. Niemowlęta, zwłaszcza poniżej 2 miesiąca życia, mogą wymagać dożylnego podawania antybiotyków i całodobowego monitorowania.33

Leczenie przyczynowe

Leczenie ukierunkowane na przyczynę gorączki zależy od rozpoznania:2422

  • Infekcje bakteryjne – wymagają zazwyczaj antybiotykoterapii, dobór antybiotyku zależy od lokalizacji infekcji i wyników posiewów
  • Infekcje wirusowe – zazwyczaj wymagają jedynie leczenia objawowego, choć niektóre mogą być leczone lekami przeciwwirusowymi (np. grypa, opryszczka)
  • Choroby autoimmunologiczne – mogą wymagać leczenia przeciwzapalnego lub immunosupresyjnego
  • Nowotwory – wymagają specjalistycznego leczenia onkologicznego

Wskazówki dla personelu medycznego

W diagnostyce gorączki u dzieci należy pamiętać o kilku kluczowych aspektach:3513

  • Wysokość gorączki nie zawsze koreluje z ciężkością choroby – ważniejszy jest ogólny stan dziecka i towarzyszące objawy
  • Wiek dziecka ma kluczowe znaczenie w interpretacji gorączki – im młodsze dziecko, tym większe ryzyko poważnej infekcji
  • Dokładny wywiad i badanie fizykalne często pozwalają ustalić przyczynę gorączki bez konieczności wykonywania rozbudowanej diagnostyki
  • Infekcje układu moczowego są najczęstszą przyczyną poważnych infekcji bakteryjnych u dzieci z gorączką bez oczywistego źródła
  • Nowoczesne biomarkery (PCT, CRP) mają przewagę nad tradycyjnymi parametrami zapalenia w różnicowaniu infekcji bakteryjnych i wirusowych
  • Istnieją algorytmy postępowania diagnostycznego dopasowane do wieku dziecka, które pomagają w podejmowaniu decyzji klinicznych

Diagnostyka gorączki u dzieci wymaga systematycznego podejścia, uwzględniającego nie tylko wyniki badań, ale również ogólny stan dziecka oraz umiejętność oceny ryzyka poważnej infekcji.2313

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  1. 09.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Fever in Children | Boston Children’s Hospital
    https://www.childrenshospital.org/conditions/fever
    Your child has a fever if her temperature is 100.4 degrees Fahrenheit or higher. […] The symptoms of a fever may resemble other medical conditions. According to the American Academy of Pediatrics, if your child is younger than 2 months of age and has a rectal temperature of 100.4 degrees Fahrenheit or higher, you should call your pediatrician. If you are unsure, always consult your child’s physician for a diagnosis. […] If your child’s temperature reaches 105 degrees Fahrenheit, this is considered a medical emergency and your child needs immediate medical attention, according to the American Academy of Pediatrics. […] Call your child’s physician immediately if your child is younger than 3 months old and any of the following conditions are present: Your child’s rectal temperature is greater than 100.4 degrees Fahrenheit. […] Call your child’s physician within 24 hours if your child, 3 months or older, has any of the following conditions present: The fever is 102 degrees Fahrenheit or higher (especially if your child is younger than 2 years old).
  • #1 Fever in Children | Texas Children’s
    https://www.texaschildrens.org/content/conditions/fever-children
    The definition of fever in a child depends on the child’s age and general health. For infants younger than 3 months of age and for all children with an abnormal immune system, a fever is defined as a temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) and higher. The temperature should be measured rectally for very young infants, but other methods (orally, under the arm) of measuring fever may be required for children with problems of the immune system. […] For older infants and children and those without a problem of the immune system, most doctors define fever as a temperature of 101.2 degrees Fahrenheit (38.4 degrees Celsius) and higher when taken by any method (orally, rectally, under the arm, etc.). […] According to the American Academy of Pediatrics, if your child is younger than 3 months of age and has a temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, you should call your child’s health care provider immediately. If you are unsure, always check with your child’s health care provider for a diagnosis.
  • #2 Overview: Fever in children – InformedHealth.org – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK279455/
    „My child has a high temperature” not an unlikely event in the lives of parents with young children. Children are considered to have a fever if they have a body temperature of 38.5C (101.3F) or more, and babies under three months old are already considered to have a fever at a body temperature of 38.0C (100.4F) or more. […] Only about 1 out of 100 children with fever have a serious medical problem that needs to be treated by a doctor. In most cases bacterial infections such as pneumonia are then to blame. […] The best way to get reliable readings is by inserting a digital thermometer into the child’s bottom (rectal temperature). […] Only about 1 out of 100 children with fever have a serious medical problem. […] It is considered to be a fever at temperatures of 38.5 (101.3F) or more in children, and at temperatures of 38.0C (100.4F) or more in babies under three months old. […] The length of time needed to take the temperature depends on where it is measured and what kind of thermometer is used you will find further information in the instructions that come with the thermometer.
  • #3 Fever – Symptoms & causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/fever/symptoms-causes/syc-20352759
    A fever is a temporary rise in body temperature. It’s one part of an overall response from the body’s immune system. A fever is usually caused by an infection. […] A temperature taken using a mouth thermometer (oral temperature) that’s 100 F (37.8 C) or higher is generally considered to be a fever. […] A fever is a particular cause for concern in infants and toddlers. Call your baby’s health care provider if your child is: […] Call your child’s health care provider if your child: […] Ask your child’s health care provider for guidance in special circumstances, such as a child with immune system problems or with a preexisting illness. […] Call your health care provider if your temperature is 103 F (39.4 C) or higher. Seek immediate medical attention if any of these signs or symptoms accompanies a fever:
  • #4 Fever in Children – Stanford Medicine Children’s Health
    https://www.stanfordchildrens.org/en/topic/default?id=fever-in-children-90-P02512
    A fever is defined by most healthcare providers as a temperature of 100.4F (38C) and higher when taken rectally. […] The symptoms of a fever may look like other health conditions. According to the American Academy of Pediatrics, if your child is younger than 3 months of age and has a temperature of 100.4F (38C) or higher, you should call your child’s healthcare provider right away. If you are unsure, always check with your child’s healthcare provider for a diagnosis. […] In children, a fever that is making them uncomfortable should be treated. Treating your child’s fever will not help the body get rid of the infection any faster. It simply will relieve discomfort linked to the fever. […] Unless advised otherwise by your child’s healthcare provider, call the provider right away if: Your child is 3 months old or younger and has a fever of 100.4F (38C) or higher. Get medical care right away. Fever in a young baby can be a sign of a dangerous infection.
  • #5 Fever Care For Children | Children’s Hospital Colorado
    https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/symptoms/fever/
    Fever is a body temperature above normal. Your child has a true fever if: Rectal (Bottom), Ear or Forehead temperature: 100.4 F (38.0 C) or higher. Oral (Mouth) temperature: 100 F (37.8 C) or higher. Under the arm (Armpit) temperature: 99 F (37.2 C) or higher. Almost all fevers are caused by a new infection. Fever may be the only symptom for the first 24 hours. Fever that occurs during the first 3 months of life can be serious. All of these babies need to be seen as soon as possible. The fever may be due to sepsis (a bloodstream infection). Bacterial infections in this age group can get worse quickly. They need rapid treatment. A bacterial infection of the membrane that covers the spinal cord and brain. The main symptoms are a stiff neck, headache and confusion. Fever on its own shouldn’t cause much crying. Frequent crying in a child with fever is caused by pain until proven otherwise. Fever with no other symptoms and your child acts mildly ill. Having a fever means your child has a new infection. It’s most likely caused by a virus. You may not know the cause of the fever until other symptoms develop. This may take 24 hours. Most fevers are good for sick children. They help the body fight infection. Fever meds are mainly needed for fevers higher than 102 F (39 C). Fever goes higher than 104 F (40 C). Any fever occurs if less than 12 weeks old. Fever without other symptoms lasts more than 48 hours. Fever with other symptoms lasts more than 3 days (72 hours).
  • #6 Patient education: Fever in children (Beyond the Basics) – UpToDate
    https://www.uptodate.com/contents/fever-in-children-beyond-the-basics/print
    Fever is a normal response to a variety of conditions, the most common of which is infection. Fever occurs when the body’s temperature is elevated as a result of the body’s thermostat being reset to a higher-than-usual temperature. […] This topic review will discuss the definition of a fever, how to accurately measure a child’s temperature, how and when to treat fever, and signs and symptoms that require further evaluation. […] In general, a fever means a temperature above 100.4°F (38°C). […] Axillary, ear, and forehead temperature measurements are easier to obtain than rectal or oral temperatures, but they are less accurate and may need to be confirmed rectally or orally in certain children. […] A health care provider should be consulted in the following situations: Infants who are less than three months of age who have a rectal temperature of 100.4°F (38°C) or greater, regardless of how the infant appears (eg, even well-appearing young infants should be evaluated).
  • #7 What You Need to Know About Fevers in Kids | Children’s Healthcare of Atlanta
    https://www.choa.org/parent-resources/everyday-illnesses/what-to-know-about-fevers-in-kids
    A fever is defined as a temperature higher than 100.4F (38C). […] Infants younger than 3 months of age whose temperature reaches 100.4F (38C) or higher should be evaluated by a doctor because fevers in infants can indicate a serious illness. […] In kids between 3 months and 3 years of age, a fever of 102.2F (39C) or higher requires a call to your pediatrician. […] If you think your child has a fever, take his temperature. […] The most reliable way is to use a digital thermometer. […] Taking a temperature rectally is the best way to get an accurate measurement, especially in infants. […] A high fever may not be a good indicator of how sick your child is. […] Call your pediatrician right away if your child has a fever with: Rash, Sore throat or earache, Lasting diarrhea or repeated vomiting, Signs of dehydration (urinating less than usual or no tears when crying), Refusal to consume fluids.
  • #8 Fever in children
    https://www.rch.org.au/kidsinfo/fact_sheets/fever_in_children/
    For all other children, take them to see a GP if their temperature is above 38C and they have any of the following symptoms: a stiff neck or light is hurting their eyes, vomiting and refusing to drink much, a rash, more sleepy than usual, problems with breathing, pain that doesn’t get better with pain relief medication. […] Also take your child to a GP if they have had any fever for more than two days and there’s no obvious cause, seem to be getting more unwell, have had a febrile seizure. […] A fever is when a child’s temperature is 38C or higher. […] Fevers are common in children. […] A fever itself rarely causes harm and can help fight an infection. […] If your child seems otherwise well and comfortable, there is no need to treat a fever. […] If your baby is under three months and has a fever above 38C, then you should take them to a doctor or emergency department as soon as possible.
  • #9 High temperature or fever in children | Raising Children Network
    https://raisingchildren.net.au/babies/health-daily-care/health-concerns/fever
    Fever in children is when their body temperature is higher than 38C. A normal temperature range for children is 36.5C-38C. […] Fever is not an illness in itself its usually the bodys immune system responding to an infection, disease or inflammation. […] In general, a high temperature in children is a sign their body is fighting an infection. […] If you think your child has a fever, taking your childs temperature with a thermometer will tell you whether your childs temperature is higher than normal. […] If your child of any age has a weak immune system and a fever, seek immediate medical attention. […] If your child aged 0-3 months has a fever, seek immediate medical attention. […] If your child aged over 3 months has a fever, take them to a GP if they have had the fever for 2 or more days.
  • #10 Fever in Infants and Children – Children’s Health Issues – Merck Manual Consumer Version
    https://www.merckmanuals.com/home/children-s-health-issues/symptoms-in-infants-and-children/fever-in-infants-and-children
    Normal body temperature varies from person to person and throughout the day (it is typically highest in the afternoon). Normal body temperature is higher in preschool-aged children and highest at approximately 18 to 24 months of age. However, despite these variations, most doctors define fever as a temperature of 100.4 F (approximately 38 C) or higher when measured with a rectal thermometer. […] Although parents often worry about how high the temperature is, the height of the fever does not necessarily indicate how serious the cause is. […] Fever can be useful in helping the body fight infection. […] Thus, although a fever is uncomfortable, it does not always require treatment in otherwise healthy children. […] However, in children with a lung, heart, or brain disorder, fever may cause problems because it increases demands on the body (for example, by increasing the heart rate).
  • #11 Fever Symptoms & Treatment (for Parents) (for Parents) | Nemours KidsHealth
    https://kidshealth.org/en/parents/fever.html
    All kids get a fever from time to time. Usually, a fever isnt dangerous or bad for kids. It can even be a good thing because it can help the immune system fight infection. […] In general, a fever means the bodys temperature is 100.4F (38C) or higher. […] Fevers in kids are usually caused by an infection. A fever helps the body by stimulating the immune system to fight the infection. […] A fever probably is not serious if your child is 3 months or older and: is still interested in playing, is drinking well, is alert and smiling, has a normal skin color, looks well when their temperature comes down. […] Fever symptoms to watch for in kids: feeling warm, acting differently (they might be fussy or cranky, or quieter than usual), breathing a little faster or have a faster heart rate than normal, having a headache, having chills or sweating, having red or flushed skin.
  • #12 Fever in children
    https://www.rch.org.au/kidsinfo/fact_sheets/fever_in_children/
    Fever (a high temperature) is common in children. Fever is a normal response to many illnesses, the most common being an infection in the body. Fever itself is usually not harmful in fact, it helps the body’s immune system fight off infection. […] While fevers can be concerning for parents, doctors will usually be more concerned about what is causing the fever, and not what the child’s temperature is. It is more important for you to monitor any symptoms of the underlying illness, rather than the fever itself. […] Your child has a fever when their temperature reads above 38C on a thermometer. […] If your baby is under three months and has a fever above 38C, then you should take them to a doctor or emergency department as soon as possible. […] If your child is immunocompromised (has a weakened immune system) for any reason and has a fever above 38C, you should seek immediate care from your doctor or hospital emergency department.
  • #13 Fever in children
    https://www.rch.org.au/kidsinfo/fact_sheets/fever_in_children/
    Take your child to the doctor if they seem to be getting worse or have a prolonged fever. […] Doctors do not focus on fever in a child. They are more concerned about how your child looks and feels if your child is not drinking, is lethargic and not themselves, or they have had a persistent fever for two or more days, that is when a doctor may try to work out what is causing the fever, and may require a blood test or urine sample. […] Children who are teething may have a fever of up to 38C. However, a temperature greater than 38C should never just be attributed to teething. It is more likely that an infection is present. […] If the fever has lasted for more than two days without getting better, see a doctor. […] Aspirin should never be given to a child to help manage their fever. It can lead to a dangerous condition called Reye syndrome. It should only be given when specifically recommended by a doctor. Paracetamol or ibuprofen can be used instead.
  • #14 When Is a Fever Too High for a Child, Toddler, or Newborn?
    https://www.healthline.com/health/childrens-health/when-is-a-fever-too-high-for-a-child
    Your little one feels warm to the touch. After taking their temperature, you realize its 103F a fever! […] A fever starts with any temperature that reaches 100.4F or above. […] A temperature between 100.4F and 102.2F is considered a low-grade fever; a temperature above 102.2F is considered a high fever. […] In young babies, even slight temperatures may be a reason for concern. Thats why you should always contact your doctor or head to urgent care if your little one has any fever thats 100.4F or above. […] In older babies and toddlers, call your doctor if your childs fever is 102.2F or above. […] For kids over age 3, a fever over 102 F that lasts for 2 or more days may be a reason for concern. […] Your baby is younger than 3 months old with a fever over 100.4F. […] Your baby (ages 3 to 6 months) has a temperature of 102F and is acting unlike themselves (lethargic, uncomfortable, etc.).
  • #15 Fever Symptoms & Treatment (for Parents) (for Parents) | Nemours KidsHealth
    https://kidshealth.org/en/parents/fever.html
    Get emergency care if your child shows any of these signs: crying that won’t stop, extreme irritability or fussiness, sluggishness and trouble waking up, a rash or purple spots that look like bruises on the skin (that were not there before your child got sick). […] But you know your child best. If you’re ever in doubt about what to do or what a fever might mean, or if your child seems ill in a way that concerns you even with no fever, always call your doctor for advice.
  • #16 Fever in Infants and Children – Children’s Health Issues – Merck Manual Consumer Version
    https://www.merckmanuals.com/home/children-s-health-issues/symptoms-in-infants-and-children/fever-in-infants-and-children
    Children under 3 years old who develop a fever (particularly if their temperature is 102.2 F [39 C] or higher) sometimes have bacteria in their bloodstream (bacteremia). […] Routine vaccines against the bacteria that usually cause occult bacteremia are now widely used in the United States and Europe. […] Testing is especially necessary in infants because the source of their fever is difficult to determine and because their immature immune system puts them at high risk of serious infection. […] Children in this age group who have a fever but look well and can be watched closely may not need tests, especially if doctors find a source of the fever. […] If children have no symptoms suggesting a specific disorder but look ill, have risk factors for a serious bacterial infection, or have a temperature of 102.2 F [39 C] or higher), blood and urine tests are usually done.
  • #17 Management of Fever in Infants and Young Children | AAFP
    https://www.aafp.org/pubs/afp/issues/2020/0615/p721.html
    Despite dramatic reductions in the rates of bacteremia and meningitis since the 1980s, febrile illness in children younger than 36 months continues to be a concern with potentially serious consequences. […] Urinary tract infections are the most common serious bacterial infection in children younger than three years, so evaluation for such infections should be performed in those with unexplained fever. […] Abnormal white blood cell counts have poor sensitivity for invasive bacterial infections; procalcitonin and C-reactive protein levels, when available, are more informative. […] Lumbar puncture is not recommended for children older than three months without localizing signs; it may also be considered for those from one to three months of age with abnormal laboratory test results. […] Rapid influenza testing and tests for coronavirus disease 2019 (COVID-19) may be of value when those diseases are circulating.
  • #18 Management of Fever in Infants and Young Children | AAFP
    https://www.aafp.org/pubs/afp/issues/2020/0615/p721.html
    The evaluation of children younger than 36 months presenting with fever has long been challenging for physicians. […] For febrile children older than 28 days but younger than three months, diagnostic evaluation should include a thorough history, physical examination, and urinalysis. […] Febrile children older than two months but younger than three years should be assessed for possible urinary tract infection if no other source of fever has been identified. […] Guidelines from the American Academy of Pediatrics recommend obtaining urine samples with suprapubic aspiration or bladder catheterization when the risk of UTI is high or if immediate antimicrobial therapy is being considered. […] Although UTIs are the most common serious bacterial infection in children presenting with fever, not all children with UTI develop fever.
  • #19 Management of Fever in Infants and Young Children | AAFP
    https://www.aafp.org/pubs/afp/issues/2020/0615/p721.html
    Blood cultures are recommended for evaluation of febrile neonates younger than one month because occult bacteremia is more common in this age group. […] Inflammatory biomarkers procalcitonin (PCT) and C-reactive protein (CRP) are associated with serious illness in young children. […] Lumbar puncture for cerebrospinal fluid culture is recommended as part of the evaluation of febrile neonates one month and younger. […] Chest radiography is recommended for most children up to three years of age who exhibit signs of pneumonia, such as chest retractions, cough, hypoxia, or tachypnea. […] During influenza season, children younger than three years who present with fever and subsequently test positive for influenza have low rates of coincident serious bacterial infection. […] Several algorithms have been developed to help assess clinical risk for infants one to three months of age. […] No empiric antibiotic treatment is needed for febrile older infants and children three to 36 months of age who have normal urinalysis and no localizing signs.
  • #20 Fever in Infants and Children – Pediatrics – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/pediatrics/symptoms-in-infants-and-children/fever-in-infants-and-children
    Fever usually is defined as a core body (rectal) temperature 38.0 C (100.4 F). […] The most common causes of acute fever in infants and young children are viral respiratory or gastrointestinal infections and certain bacterial infections (otitis media, pneumonia, urinary tract infections). […] Most febrile children 1 month to 2 years of age without an obvious focus of infection on examination (fever without source [FWS]) have self-limited viral disease. […] Fever that occurs daily for 2 weeks and for which initial cultures and other investigations fail to yield a diagnosis is considered fever of unknown origin (FUO). […] Evaluation varies by age group. Accepted categories are neonates ( 28 days), young infants (1 to 3 months), and older infants and children (3 to 36 months). […] A febrile child who looks quite ill, especially when the temperature has come down, is of great concern and requires immediate, in-depth evaluation and continued observation.
  • #21 Fever in Infants and Children – Pediatrics – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/pediatrics/symptoms-in-infants-and-children/fever-in-infants-and-children
    Acute fever is infectious in most cases, and, of these, most are viral. […] Febrile infants between 1 month and 3 months of age who are ill-appearing (eg, abnormal cry, lethargy, rectal temperature 38.5 C) or who have risk factors for serious bacterial infection should be admitted to the hospital and have a WBC count with a manual differential, blood cultures, urinalysis and urine culture, and lumbar puncture with CSF evaluation. […] Well-appearing febrile infants between 29 days and 60 days of age with all of the following are at low risk of serious bacterial infections: Rectal temperature 38.5 C, Normal WBC count, Normal inflammatory marker levels, Normal urinalysis. […] For chronic fever (fever of unknown origin [FUO]), laboratory tests and imaging should be directed toward likely causes of fever based on the patient’s age and findings from the history and physical examination.
  • #22 Fever in Infants and Children – Children’s Health Issues – Merck Manual Consumer Version
    https://www.merckmanuals.com/home/children-s-health-issues/symptoms-in-infants-and-children/fever-in-infants-and-children
    The need for hospitalization depends on how well or ill children look, the results of any tests done, and whether a follow-up examination can be done in a timely fashion. […] If the fever results from a disorder, that disorder is treated. Other fever treatment is focused on making children feel better. […] Fever in an otherwise healthy child does not necessarily require treatment. However, medications called antipyretic (fever-lowering) medications may make children feel better by lowering their temperature. […] The likely causes of fever and need for testing depend on the age of the child. […] Infants under 3 months of age with a temperature of 100.4 F (approximately 38 C) or higher need to be evaluated promptly by a doctor. […] Children age 3 months to 3 years with fever who have no symptoms suggesting a specific disorder but who look ill or have a temperature of 102.2 F (39 C) or higher need to be evaluated promptly by a doctor.
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  • #24 Fever – Pocket Book of Hospital Care for Children – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK154436/
    Some causes of persistent fever may have no localizing diagnostic signs, such as septicaemia, Salmonella infections, miliary TB, HIV infection or urinary tract infection. […] Early diagnosis is essential for effective treatment. […] Bacterial meningitis is a serious illness that is responsible for considerable morbidity and mortality. […] Diagnosis of rheumatic fever is important because penicillin prophylaxis can prevent further episodes and avoid worsening damage to the heart valves.
  • #25
    https://www.nuhsplus.edu.sg/article/when-should-you-be-concerned-about-your-childs-fever
    In general, screening blood tests with a Full Blood Count can help to differentiate between bacterial and viral infections, but they do not identify the source. […] In rare cases, fever may be a sign of something more serious, such as cancer, autoimmune diseases or immune system disorders. […] Often, there will be other accompanying signs such as a pale appearance, weight loss and persistently swollen lymph nodes among others, depending on the underlying condition in question. […] This, coupled with the pattern of infections and other associated symptoms, will enable doctors to investigate for specific underlying conditions if required.
  • #26 Unexplained Fever | Norton Children’s
    https://nortonchildrens.com/services/infectious-diseases/unexplained-fever/
    The board-certified, fellowship-trained pediatric infectious disease specialists with Norton Children’s Infectious Diseases have the training and experience to evaluate and treat unexplained fever, also called fever of unknown origin. […] A pediatric infectious disease specialist with Norton Children’s Infectious Diseases can evaluate a child experiencing an unexplained fever to help determine a potential underlying cause. […] The pediatric infectious disease specialists with Norton Children’s Infectious Diseases will work to create a treatment plan based on the child’s age, current condition and medical history. Depending on the type of fever, current symptoms and other factors, our specialists may order tests to check for infections as well as other conditions that may be causing fever. Fever of unknown origin often is caused by unusual symptoms of a common disease rather than by an uncommon disease. […] Unexplained fever is not treated with antibiotics or anti-inflammatory medicines unless there is evidence that a child may have tuberculosis or juvenile idiopathic arthritis.
  • #27 Fever – Pocket Book of Hospital Care for Children – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK154436/
    This chapter gives treatment guidelines for the management of the most important conditions for which children aged between 2 months and 5 years present with fever. Management of febrile conditions in young infants ( 2 months) is described in Chapter 3. […] Special attention should be paid to children presenting with fever. The main aim is to differentiate serious, treatable infections from mild self-resolving febrile illness. […] The four major categories of fever in children are: due to infection, with non-localized signs (Table 16), due to infection, with localized signs (Table 17), with rash (Table 18), lasting longer than 7 days. […] As there are many causes of prolonged fever, it is important to know the commonest causes in a given area. Investigations to determine the most likely cause can then be started and treatment decided.
  • #28 Fever – Symptoms & causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/fever/symptoms-causes/syc-20352759
    Fever or elevated body temperature might be caused by: […] Children between the ages of 6 months and 5 years are at increased risk of a seizure that occurs during a fever (febrile seizure). […] If your child doesn’t need emergency care, see your child’s health care provider as soon as possible for further evaluation.
  • #29 Causes of High Fever in Children and When to Worry | UPMC
    https://share.upmc.com/2019/06/children-with-fevers-when-to-worry/
    A child’s fever: when to worry […] A temperature of higher than 99 degrees Fahrenheit is a sign that your child’s body is fighting an infection. […] If your infant is under 3 months of age and has a fever of 100.4 Fahrenheit or higher, you should seek immediate medical attention. […] If your child is between the ages of 3 months and 3 years old and has a fever of 102.2 Fahrenheit (39 Celsius) or higher, contact your child’s pediatrician to determine if your child should be seen. […] If your child demonstrates the following with an elevated body temperature, it’s probably not serious and needs to run its course: […] However, if your child has any of the following symptoms, call your child’s pediatrician immediately: […] If your child has a fever, chances are high that one of the following conditions caused it:
  • #30 Causes of High Fever in Children and When to Worry | UPMC
    https://share.upmc.com/2019/06/children-with-fevers-when-to-worry/
    Viral infections are the most common cause of fever in children, and they do not require antibiotics. […] Treatable with antibiotics and contagious, bacterial infections can wait for 12 hours until your child is seen by a doctor. […] If your child is otherwise healthy and not under 3 months of age or exhibiting any of the other serious symptoms that requires immediate attention, you can ease the discomfort a fever brings. […] Most fevers and accompanying cold-like symptoms can last from three to five days. If your child’s fever lasts longer than that, they should see the doctor to eliminate any risk of complications. […] If your child is between the ages of 3 months and 3 years old and exhibits fever lower than 102.2 degrees Fahrenheit, but also: […] If your child experiences any of these symptoms:
  • #31 Fever: Causes, Symptoms, and Treatment
    https://www.webmd.com/first-aid/fevers-causes-symptoms-treatments
    A fever can make you uncomfortable, but it’s generally not cause for concern. You can often manage a fever at home, but in some cases you should call your doctor. […] You should reach out to your pediatrician if your child 6 months to 2 years: […] Call 911 or go to the ER if your child has a seizure. […] Contact your doctor if your fever lasts for more than 3 days or gets worse. […] If you see your doctor, they’ll do a physical exam and ask questions about your symptoms, other health conditions you have, medications you take, and if you’ve recently traveled to areas that have health risks. […] Your doctor may need to run tests to figure out the cause.
  • #32 Fever in children | NHS inform
    https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/fever-in-children/
    It can be extremely worrying if your child has a high temperature. But its very common and often clears up by itself without treatment. […] A quick and easy way to find out whether your child has a fever is to take their temperature using a thermometer. […] Your child: is over 3 months and has a temperature of 39C (102F) or above […] has a high temperature thats lasted for 5 days or more […] has a high temperature that does not come down with paracetamol. […] Childrens paracetamol or ibuprofen work as antipyretics, which help to reduce fever, as well as being painkillers. […] Sometimes a high temperature in children is associated with more serious signs and symptoms, such as: breathlessness, vomiting, rash, fits or seizures. […] Possible serious bacterial illnesses include: meningitis infection of the meninges, the protective membranes that surround the brain and spinal cord, septicaemia infection of the blood, pneumonia inflammation of the lung tissue, usually caused by an infection.
  • #33 Fever – Diagnosis & treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/fever/diagnosis-treatment/drc-20352764
    To evaluate a fever, your care provider may: […] Because a fever can indicate a serious illness in a young infant, especially two months of age or younger, your baby might be admitted to the hospital for testing and treatment. […] Infants, especially those younger than two months old, might need to be admitted to the hospital for testing and treatment. In babies this young, a fever could indicate a serious infection that requires intravenous (IV) medications and round-the-clock monitoring.
  • #34 Fever Symptoms & Treatment (for Parents) (for Parents) | Nemours KidsHealth
    https://kidshealth.org/en/parents/fever.html
    If your child feels warm or is acting unwell, use a digital thermometer to confirm a fever. […] It’s a fever when a child’s temperature is at or above one of these levels: rectal (in the bottom), tympanic (in the ear), or temporal artery (across the forehead): 100.4F (38C). […] Treating a fever with medicine isn’t needed if a child is still playing and drinking normally and doesnt have pain. […] If your child is uncomfortable from a fever or not drinking liquids well, you can give one of these medicines: acetaminophen (such as Tylenol or a store brand) or ibuprofen (such as Advil, Motrin, or a store brand). […] The temperature that should trigger a call to the doctor depends on a child’s age, the illness, and whether they have other symptoms. […] In general, call the doctor if your child is: younger than 3 months old with a rectal temperature of 100.4F (38C) or higher, 3 months or older with a temperature higher than 102.2F (39C).
  • #35 Fever in Children (High Temperature): Symptoms and Treatment
    https://patient.info/childrens-health/fever-in-children-high-temperature
    A fever occurs when the body temperature is higher than normal. Normal body temperature varies a little, but a temperature above 38C is considered a fever. […] This article is specifically regarding fever in children. […] How is the cause of fever in children diagnosed? […] The healthcare professional will try to work out why your child has a fever. This will usually include asking about your child’s health and symptoms. […] Usually the healthcare professional who assesses your child will decide that no further tests are necessary. […] Occasionally, however, they are uncertain. […] If this is the case you may be asked to go to the paediatric ward or Accident and Emergency department. […] You may be discharged home from the hospital after this or, if doctors are still not certain that your child is at very low risk of a more serious condition, your child may be kept for observation or treatment.