Materiały źródłowe

• #1 Pediatric fever – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/pediatric-fever/

  Fever is the presenting concern in: 30% of pediatric primary care visits […] 15% of emergency room visits in children of age. Epidemiological data refers to the US, unless otherwise specified.

• #2 Case Series of Prolonged Febrile Illness in Pediatric Age Group: A Diagnostic Challenge – Journal of Pediatrics Review

  https://jpr.mazums.ac.ir/browse.php?a_id=511&sid=1&slc_lang=en&html=1

  Fever, defined as a rectal temperature of 100.4oF or more, is a physiological response characterized by an elevation of body temperature above normal. Fever is one of the common causes of medical consultation in children, responsible for 15%25% of consultations in pediatrics practice. […] The causes of fever can be classified under 4 main categories: Infectious, inflammatory, neoplastic, and miscellaneous causes. […] The persistence of fever raises clinical queries towards diagnosis, especially in patients without identifiable cause. […] Infections, connective tissue conditions, and neoplasms are the 3 most frequent causes of prolonged fever in children. […] The infectious diseases are usually salmonellosis, tuberculosis, malaria, rickettsia, and so on. […] The connective tissue disorder commonly linked to prolonged fever is juvenile rheumatoid arthritis.

• #3 Pediatric fever of uncertain source – WikEM

  https://wikem.org/wiki/Pediatric_fever_of_uncertain_source

  Fever accounts for 30% of pediatric visits […] Serious bacterial illness (SBI) includes UTI, meningitis, pneumonia, bacteremia […] 0.3% of previously well children aged 3-36 months who have a fever without a source will develop significant sequelae, 0.03% will develop sepsis or meningitis […] Non-UTI SBI incidence of .4% in children 6 mo.

• #4 Fever | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/fever

  On average, a child has up to 10 infections per year. […] Body temperature isn’t a reliable indicator of illness for babies and young children a child may have a mild temperature according to the thermometer (slightly over 37C), but seem happy and healthy. […] See a doctor right away if your child: is aged six months or less, has a rash, has a fever of 40C or more, is still feverish after a day or so, despite 4-hourly doses of baby paracetamol, vomits or has persistent diarrhoea, refuses food or drink, cries inconsolably, seems listless, floppy or just looks ill, convulses or twitches, has trouble breathing, is in pain. […] If you feel at all worried or concerned at any stage, consult with your doctor. […] A febrile convulsion is a fit or seizure that occurs in babies and children when they have a high fever, usually from an ear infection or a viral upper respiratory infection.

• #5 Diagnosis and Treatment of the Febrile Child – Reproductive, Maternal, Newborn, and Child Health – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK361919/

  Fever is one of the most common presenting symptoms of pediatric illnesses. Fever in children under age five years signifies systemic inflammation, typically in response to a viral, bacterial, parasitic, or less commonly, a noninfectious etiology. Patients ages and geographic settings can help direct the appropriate diagnostic approach and treatment, if local epidemiology is well understood. […] The combined proportion of deaths due to AIDS, diarrheal diseases, pertussis, tetanus, measles, meningitis/encephalitis, malaria, pneumonia and sepsis was 58.5 percent for children ages 159 months in 2015; it was 23.4 percent for neonates. […] Evidence regarding fever incidence is variable, with country-specific reports from cross-sectional surveys or weekly active case detection ranging from two to nine febrile episodes per child under age five years per year, a mean of 5.88 fever episodes per child under age five years per year.

• #6 Diagnosis and Treatment of the Febrile Child – Reproductive, Maternal, Newborn, and Child Health – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK361919/

  National survey data from 42 Sub-Saharan African countries were collected and analyzed for an estimated 655.6 million under-five fever episodes in 2007; 32 percent of these episodes occurred in 11 outpatient units in the Democratic Republic of Congo, Ethiopia, and Nigeria. […] At the health facility and community levels, fever is by far the most common pediatric presenting symptom. […] The epidemiology of pediatric febrile illness is undoubtedly shifting; understanding the etiology of nonmalarial fevers in each context is the logical next step to improve pediatric clinical outcomes of other treatable serious febrile illnesses, such as pneumonia, sepsis, bacterial meningitis, enteric fever, rickettsioses, and influenza. […] Given rampant and expanding antimicrobial drug resistance globally, care must be taken to use antibiotics only when indicated and to develop careful guidelines when resources are limited. Present guidelines are based on clinical features that are unfortunately poorly predictive of the diseases causing fever. Low-cost, accurate, point-of-care diagnostics are needed to determine which children can benefit from antibacterial therapies to guide the most effective use of antibiotics.

• #7 Fever in Children: Pearls and Pitfalls

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5615271/

  Fever in children is a common concern for parents and one of the most frequent presenting complaints in emergency department visits, often involving non-pediatric emergency physicians. […] Although the incidence of serious infections has decreased after the introduction of conjugate vaccines, fever remains a major cause of laboratory investigation and hospital admissions. […] We performed a narrative review on the epidemiology, assessment, and management of fever in children, with the aim of providing non-pediatric physicians with up-to-date information on the approach to febrile children. […] The risk of SBI in infants 3 months of age is higher than at any other age in childhood (approximately 3.75/1000 live full term births). […] The introduction of conjugate vaccines for Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis has led to a significant reduction in SBI, with a reduction of bacteremia rates from 2.0-3.4% in the pre-conjugate vaccine era to 0.3-4% in the post-conjugate vaccine era.

• #8 Fever in Children: Pearls and Pitfalls

  https://www.mdpi.com/2227-9067/4/9/81

  Fever in children is a common concern for parents and one of the most frequent presenting complaints in emergency department visits, often involving non-pediatric emergency physicians. […] Although the incidence of serious infections has decreased after the introduction of conjugate vaccines, fever remains a major cause of laboratory investigation and hospital admissions. […] We performed a narrative review on the epidemiology, assessment, and management of fever in children, with the aim of providing non-pediatric physicians with up-to-date information on the approach to febrile children. […] The risk of SBI in infants <3 months of age is higher than at any other age in childhood (approximately 3.75/1000 live full term births). [...] The introduction of conjugate vaccines for Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis has led to a significant reduction in SBI, with a reduction of bacteremia rates from 2.0–3.4% in the pre-conjugate vaccine era to 0.34% in the post-conjugate vaccine era.

• #9 Fever in the Infant and Toddler: Practice Essentials, Background, Neonates

  https://emedicine.medscape.com/article/1834870-overview

  The prevalence of a serious bacterial infection in infants younger than 3 months is approximately 6-10%, most often urinary tract infections (UTIs). […] Historically, children aged 3 months to 3 years with rectal temperatures of 38.5C (101.3F) or higher had a risk of 2-4% for occult bacteremia. […] The incidence of occult bacteremia in this population now ranges from 0.25% to 0.7%; moreover, 2 of every 3 blood isolates from these children represent a contamination and not a true pathogen. […] After the COVID-19 pandemic, invasive group A streptococcal infections increased in children in the United States and in several European countries.

• #10 Fever in the Infant and Toddler: Practice Essentials, Background, Neonates

  https://emedicine.medscape.com/article/1834870-overview

  Fever is an abnormal elevation in body temperature (38.0C or 100F) and is a sign of infection. It is one of the most common problems in infants and toddlers. […] Fever may indicate a mild, self-limiting viral infection or a severe, life-threatening bacterial infection. Serious bacterial infection (SBI) implies bacteremia, bacterial meningitis, and bacterial urinary tract infection. An invasive bacterial infection (IBI) implies bacteremia and bacterial meningitis. The prognosis depends upon the cause and severity of the infection. Fever in infants and toddlers poses a challenge for pediatricians and often requires a workup, especially in situations of a fever without any other focus of infection. […] The risk of invasive bacterial infection (IBI) such as bacteremia and bacterial meningitis is age dependent. The risk of IBI is highest in febrile neonates aged 21 days: it is estimated at 3-5% for bacteremia and 1.1-2.7% for meningitis.

• #11 Management of Fever in Infants and Young Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0615/p721.html

  The incidence of bacteremia and meningitis has decreased markedly since vaccines for Streptococcus pneumoniae and Haemophilus influenzae type B (Hib) infections were introduced. The incidence of invasive pneumococcal disease in children younger than five years dropped by more than 90% after the initiation of pneumococcal conjugate vaccines. […] Incidence of meningitis caused by Hib infections in children younger than five years fell by more than 99% in the first eight years following the introduction of the vaccine in the United States. […] The use of intrapartum prophylaxis against group B Streptococcus has increased, and rates of invasive group B streptococcal infection within the first week of life have dropped from 0.7 per 1,000 births in 1997 to 0.24 per 1,000 births in 2016. […] The incidence of urinary tract infections (UTIs) is increasing, as is resistance of the causative organisms to ampicillin. UTIs are currently the most common serious bacterial infection among children 36 months and younger. […] Overall, rates of occult bacteremia with any organism, formerly 3% to 12%, are now less than 2%.

• #12 Fever in children – wikidoc

  https://www.wikidoc.org/index.php/Fever_in_children

  The prognosis of fever depends on the underlying cause. […] There is an association with a greater likelihood of serious bacterial infection (SBI) for temperatures 39 C. […] In a prospective cohort study on more than 12,800 children presenting with febrile illness, fever 39 C was associated with an increased risk of SBI, especially in infants under 6 months. […] In a prospective series of 103 children with a temperature 41 C, almost 50% had an SBI. […] Temperatures above 41 C have also been associated with a higher risk of meningitis. […] Children with SBI may also have a normal temperature or be hypothermic.

• #13 Evaluation of Fever in Infants and Young Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0215/p254.html

  Febrile illness in children younger than 36 months is common and has potentially serious consequences. […] With the widespread use of immunizations against Streptococcus pneumoniae and Haemophilus influenzae type b, the epidemiology of bacterial infections causing fever has changed. […] Studies of infants and young children presenting with fever have documented a dramatic reduction in the incidence of Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) infections following the widespread use of immunizations against these organisms. […] Rates of invasive Hib infection, including meningitis, in children five years and younger have fallen by more than 99 percent since the 1990s. […] Invasive pneumococcal infection in children declined by 77 percent from 1998 to 2005, and is expected to decline further with the use of the pneumococcal 13-valent conjugate vaccine (Prevnar 13).

• #14 Fever in children – wikidoc

  https://www.wikidoc.org/index.php/Fever_in_children

  Fever in children can sometimes associated with more serious signs and symptoms, such as: […] Serious bacterial infections include: […] Following the widespread use of immunizations against Streptococcus pneumoniae and Haemophilus influenzae b, incidence of fever caused by infection due to these organisms has been decreased. […] Since 1990, rates of invasive Hib infection (including meningitis) in children 5 years and younger have declined by more than 99%. […] In 2005, the incidence of fever caused by invasive pneumococcal infection in children declined by 77% from 1998. […] Fever caused by urinary tract infections (UTIs) are the most common source of serious bacterial infection in children younger than 3 months, commonly from E.coli or Klebsiella species. […] According to a case series, fever caused by pneumonia is the most common serious bacterial infection in children 3 to 36 months of age, followed by UTI.

• #15 Evaluation of Fever in Infants and Young Children | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0215/p254.html

  Rates of invasive Hib and S. pneumoniae infections have also decreased in non- or partially vaccinated children, perhaps because of herd immunity. […] Urinary tract infections (UTIs) are the most common source of serious bacterial infection in children younger than three months, commonly from Escherichia coli or Klebsiella species. […] A case series found that pneumonia is the most common serious bacterial infection in children three to 36 months of age, followed by UTI. […] A large study found that the rate of hospitalization for UTI, including pyelonephritis and urosepsis, in children younger than 12 months has notably increased. […] This increase coincides with an increase in E. coli and other infections that are resistant to penicillin and ampicillin. […] The cause for this shift in infection and resistance patterns is not clear.

• #16 Are children with prolonged fever at a higher risk for serious illness? A prospective observational study | Archives of Disease in Childhood

  https://adc.bmj.com/content/108/8/632

  A prolonged fever of five days or more is considered a warning sign for serious infection in childhood fever management guidelines. […] Prolonged fever is believed to be associated with serious bacterial infections (SBI) and with non-infectious and inflammatory conditions such as Kawasaki disease. […] In this multicentre prospective observational study, 10.6% of 35,705 febrile children had a fever for five days, with a higher risk of SBI (8.4% vs 5.7%). […] Children with prolonged fever have a higher risk of SBI, warranting a careful clinical assessment and considerate diagnostic workup. […] In children with prolonged fever, there is a higher risk of SBI, warranting a careful clinical assessment and considerate diagnostic workup.

• #17 Fever in Children: Pearls and Pitfalls

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5615271/

  This shifting epidemiology has led to a modification in the emergency department evaluation of fever, with a decline in laboratory testing. […] The NICE guidelines similarly suggest that children with unexplained fever should have urine tested to exclude UTI, without specifying a pre-selection of patients. […] Fever of unknown origin (FUO) in children is defined as a fever lasting more than 1 week with negative preliminary investigations. […] Infections are the most frequent cause of FUO, followed by non-infectious causes, with 23% remaining unexplained. […] Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening inflammatory syndrome resulting from an excessive and uncontrolled activation of the immune system that may be due to a genetic disorder or secondary to acquired conditions, both infectious and non-infectious.

• #18 Fever in Children: Pearls and Pitfalls

  https://www.mdpi.com/2227-9067/4/9/81

  This shifting epidemiology has led to a modification in the emergency department evaluation of fever, with a decline in laboratory testing. […] The NICE guidelines similarly suggest that children with unexplained fever should have urine tested to exclude UTI, without specifying a pre-selection of patients. […] Fever of unknown origin (FUO) in children is defined as a fever lasting more than 1 week with negative preliminary investigations. […] Infections are the most frequent cause of FUO (51% in a series), followed by non-infectious causes (25%), with 23% remaining unexplained.

• #19 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

  Most acute fever is caused by viral infections. […] Causes and evaluation of acute fever differ depending on the age of the child; in young infants, fever may indicate a serious, life-threatening infection and requires careful evaluation. […] A small but real number of children 36 months of age with fever without localizing signs (primarily those who are incompletely immunized) can have pathogenic bacteria in their bloodstream (occult bacteremia) and be early in the course of a potentially life-threatening infection. […] 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). […] Potential categories of causes include localized or generalized infection, systemic rheumatic disease, and cancer. […] In children, despite the numerous possible causes, true FUO is more likely to be an uncommon manifestation of a common disease rather than an uncommon disease; respiratory infections account for almost half of cases of infection-associated FUO.

• #20 Case Series of Prolonged Febrile Illness in Pediatric Age Group: A Diagnostic Challenge – Journal of Pediatrics Review

  https://jpr.mazums.ac.ir/browse.php?a_id=511&sid=1&slc_lang=en&html=1

  Fever, defined as a rectal temperature of 100.4oF or more, is a physiological response characterized by an elevation of body temperature above normal. Fever is one of the common causes of medical consultation in children, responsible for 15%25% of consultations in pediatrics practice. […] The causes of fever can be classified under 4 main categories: Infectious, inflammatory, neoplastic, and miscellaneous causes. […] The persistence of fever raises clinical queries towards diagnosis, especially in patients without identifiable cause. […] Infections, connective tissue conditions, and neoplasms are the 3 most frequent causes of prolonged fever in children. […] The infectious diseases are usually salmonellosis, tuberculosis, malaria, rickettsia, and so on. […] The connective tissue disorder commonly linked to prolonged fever is juvenile rheumatoid arthritis.

• #21 Case Series of Prolonged Febrile Illness in Pediatric Age Group: A Diagnostic Challenge – Journal of Pediatrics Review

  https://jpr.mazums.ac.ir/browse.php?a_id=511&sid=1&slc_lang=en&html=1

  The third most common cause of prolonged fever in children is malignancy. […] Here, we present a series of children with prolonged fever who presented as a diagnostic challenge. […] Common causes of prolonged fever in children comprise infections, connective tissue disorder, and malignancy. […] Epidemiological factors like seasonal variations and endemic areas of disease prevalence exposure to wild animals should be considered while evaluating infectious causes. […] If a patient is not clinically responding to treatment, it could be due to antibiotic resistance or suspected coinfections. […] A practical, systematic, and stepwise approach can be helpful in assessing and managing prolonged fever in children.

• #22

  https://nuhsplus.edu.sg/article/when-should-you-be-concerned-about-your-childs-fever

  While having fluctuating body temperature is common for children who are ill, a fever above 38 degree Celsius in infants less than three months old is often a red flag. […] A doctor may also decide whether further investigation is needed if there is prolonged high fever of five days or more, especially if the child does not seem to be getting better. […] 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.

• #23 Estimating the incidence of enteric fever in children in India: a multi-site, active fever surveillance of pediatric cohorts | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-5498-2

  Estimating the burden of disease in children who are the most likely beneficiaries of typhoid conjugate vaccines in national immunization programs will permit us to predict the potential utility of such a vaccine introduction. […] Active, community-based surveillance will estimate the true incidence of typhoid fever and provide a better understanding of transmission of typhoid in the population than available data from hospital based extrapolations. […] The incidence of acute typhoid fever in children aged 6 months to 15 years in India was previously estimated to be between 6 and 12 per 1000 child years (CY) with the highest rates in 14 year olds. […] Active surveillance studies are resource intensive and challenging to perform. However, in the absence of alternative diagnostic methods that are uninfluenced by health utilization patterns and prior antibiotics, these remain the gold standard to ascertain the transmission and age-specific incidence of typhoid in the community.

• #24 Fever observational study v1.0 – Health Research Authority

  https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/fever-observational-study-v10/

  An observational study of the epidemiology of fever due to infection in critically ill children following an unplanned admission to a paediatric intensive care unit. […] A fever (high temperature) is a normal response by the body to infection. […] There is strong evidence, however, that fever is an important bodily response that may help a child to recover from infection. […] Most of the evidence for this recommendation came from research in non-critically ill children, therefore, it is unknown whether this recommendation should be applied to very sick children. […] The FEVER Observational Study is one of these studies, with the aim of identifying: current temperature threshold(s) for fever management, how many children would need to take part in a full trial, and which are the best outcomes to use.

• #25 Fever – Wikipedia

  https://en.wikipedia.org/wiki/Fever

  Fever is one of the most common medical signs. It is part of about 30% of healthcare visits by children, and occurs in up to 75% of adults who are seriously sick. […] Fever is often viewed with greater concern by parents and healthcare professionals than might be deserved, a phenomenon known as fever phobia, which is based in both caregiver’s and parents’ misconceptions about fever in children. […] Fever can result from a reaction to an incompatible blood product.

• #26 Information About Fever in Children — Northwestern Children’s Practice

  https://www.nwcppediatrics.com/fever

  The primary goal of treating a child with a fever should be to improve the child’s comfort rather than focusing on the normalization of the body temperature. The desire to improve the overall comfort of the febrile child should be balanced against the desire to simply lower the body temperature. Parents should focus on monitoring activity, observing for signs of serious illness and maintaining appropriate fluid intake to maintain hydration. […] Treating with fever medication does not prevent febrile seizures. […] Fever by itself is not something to panic about. How does the child look and how are they acting—are they behaving normally? Once you’ve identified a fever, you can begin treating it if needed based on your child’s age and other symptoms. While you may instinctively want to bring your child to the doctor’s office, it may not be necessary, especially if the child seems fine once the fever is reduced.

• #27 Symptomatic fever management in children: A systematic review of national and international guidelines | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245815

  The threshold question is of fundamental importance and has not yet been answered. […] Guidelines for the most frequent intervention (antipyresis) remain problematic. […] A comparison of worldwide fever management guidelines revealed striking discrepancies with each other and with scientific literature on all parameters. […] The heterogeneity of the recommendations and the low quality of evidence on which they are based point to a need for better data. […] Our findings are in line with the previous work of other authors and demonstrate that many discordant suggestions in guidelines at national or international could be improved. […] The majority of CPGs recommend against treatment of fever itself, regardless of temperature. […] In the guidelines that give a threshold for antipyresis, there is little agreement about the temperature, with values ranging from 37.5°C to 40.5°C and no rationale provided.

• #28 Symptomatic fever management in children: A systematic review of national and international guidelines | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245815

  Divergent attitudes towards fever have led to a high level of inconsistency in approaches to its management. […] To date, a comprehensive assessment of the evidence level of the recommendations made in these CPGs has not been carried out. […] 74 guidelines were retrieved. Recommendations for antipyretic threshold, type and dose; ambient temperature; dress/covering; activity; fluids; nutrition; proctoclysis; external applications; complementary/herbal recommendations; media; and age-related treatment differences all varied widely. […] OCEBM evidence levels for most recommendations were low (Level 3–4) or indeterminable. […] The GRADE assessment revealed a very low level of evidence for a threshold for antipyresis. […] There is no recommendation on which all guidelines agree, and many are inconsistent with the evidence–this is true even for recent guidelines.

• #29 When is a fever too high for a child? Guidance and outlook

  https://www.medicalnewstoday.com/articles/when-is-a-fever-too-high-child

  Parents or caregivers should consult a doctor if their child of any age has repeated temperature readings above 104F (40C). […] A fever in children is a temperature of 100.4F (38C) or higher. […] Experts recommend that caregivers contact a doctor under the following circumstances: The child is 2 months old or younger and has a rectal temperature of 100.4F (38C) or higher. […] Children should see a doctor if they have a fever and symptoms of serious illness or are under 3 months old. Children of all ages require medical attention if their fever is very high or persistent. […] Only around 1% of childhood fevers are due to serious medical problems that require treatment. Most of these more serious problems are bacterial infections, such as pneumonia.

• #30 Fever | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/fever

  On average, a child has up to 10 infections per year. […] Body temperature isn’t a reliable indicator of illness for babies and young children a child may have a mild temperature according to the thermometer (slightly over 37C), but seem happy and healthy. […] See a doctor right away if your child: is aged six months or less, has a rash, has a fever of 40C or more, is still feverish after a day or so, despite 4-hourly doses of baby paracetamol, vomits or has persistent diarrhoea, refuses food or drink, cries inconsolably, seems listless, floppy or just looks ill, convulses or twitches, has trouble breathing, is in pain. […] If you feel at all worried or concerned at any stage, consult with your doctor. […] A febrile convulsion is a fit or seizure that occurs in babies and children when they have a high fever, usually from an ear infection or a viral upper respiratory infection.

• #31 Fever | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/fever

  Approximately 3% of otherwise healthy children will have one or more febrile convulsions between the ages of 6 months and 6 years. […] The symptoms of febrile convulsion include: loss of consciousness (black out) the child will fall if standing and may pass urine, twitching or jerking of arms and legs, breathing difficulty, foaming at the mouth, going pale or bluish in skin colour, eye rolling, so only the whites of their eyes are visible, your child may take 15 minutes to wake up properly afterwards they may be irritable and appear not to recognise you. […] Convulsions are rarely serious. […] If your child has a convulsion you should: Try to stay calm and don’t panic. […] Have your child checked by your local doctor or nearest hospital emergency department as soon as possible after the fit stops to find the cause of the fever.

• #32 Fever and high temperature in children and babies – when to see a doctor | healthdirect

  https://www.healthdirect.gov.au/fever-and-high-temperature-in-children

  Babies under 3 months are most at risk of fever complications. If your child is under 3 months, with a fever, get medical advice. […] You can prevent complications by monitoring your child’s symptoms and seeking medical attention if needed. […] Febrile convulsions are seizures (fits) that happen because of a fever. […] Febrile convulsions occur in about 1 in every 30 children between the ages of 6 months and 6 years.

• #33 Fever: Symptoms, treatments, types, and causes

  https://www.medicalnewstoday.com/articles/168266

  Children with a high temperature may develop a febrile seizure. These are most likely to occur between the ages of 12 and 18 months. […] These often result from an ear infection, gastroenteritis, or a respiratory virus, and they are not usually serious. Less commonly, they may stem from a more severe illness, such as meningitis, a kidney infection, or pneumonia. […] Seizures can occur when the body temperature rises quickly. […] A doctor may wish to carry out tests to identify the cause. If the fever is due to a bacterial infection, they may prescribe an antibiotic. […] If it stems from a viral infection, the doctor may recommend using NSAIDs to relieve the symptoms. […] A child who has a complex febrile seizure is more likely to experience epilepsy as they grow older.

• #34 Symptomatic fever management in children: A systematic review of national and international guidelines | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245815

  Our GRADE assessment suggests–with a very low quality of evidence–that there is no need for a threshold for antipyresis below 39.5 °C because that was the maximum threshold used in the studies. […] Antipyretics should not be combined (Level 1), or routinely alternated (Level 1), and be used, if at all, only as long as the child appears distressed (Level 5). […] Antipyretics should not be given with the intention of preventing febrile seizures (Level 1). […] External cooling may increase discomfort and metabolic strain (Level 1).

• #35

  https://nuhsplus.edu.sg/article/when-should-you-be-concerned-about-your-childs-fever

  Dr Jasmine Ho, Consultant with the Childrens Emergency at Khoo Teck Puat National University Children’s Medical Institute (KTP-NUCMI) at National University Hospital (NUH), shared that a fever in itself is not harmful. […] Most fevers in children will range between 38 and 40 degree Celsius, and last for three to five days. […] The height of the fever does not necessarily reflect the severity of the illness. […] Parents should seek medical attention if the child displays any red flag signs such as breathlessness, dehydration and lethargy. […] Contrary to popular belief, fever itself doesn’t lead to brain damage, though there may be associations of high fever in young children with febrile fits. […] A healthy child can experience up to two episodes of fever per month, especially if they are exposed to common childhood illnesses.

• #36 Fever and high temperature in children and babies – when to see a doctor | healthdirect

  https://www.healthdirect.gov.au/fever-and-high-temperature-in-children

  If you have a baby under 3 months old with a fever above 38C, take them to the nearest hospital emergency department immediately. […] Fever is common in children. […] Fevers are usually caused by viral infections. […] If your child has a fever, they will have a high temperature and may also be flushed, shivering or sweating. […] If your child with a fever is under 3 months old, seek medical attention. […] Fever is one of the ways your body fights infection. […] Infections are by far the most common cause of fever in children. […] You need to see a doctor if you think your child has any of these infections. […] If you have a baby under 3 months old with a fever above 38C, take them to the nearest hospital emergency department immediately. […] You should also see or contact your doctor straight away if you are concerned, or if your child: is over 6 months and shows other signs of being unwell.

• #37 Information About Fever in Children — Northwestern Children’s Practice

  https://www.nwcppediatrics.com/fever

  Fever in a child is one of the most common symptoms managed by pediatricians and is a frequent cause of parental concern. Fever accounts for one-third of all presenting conditions in children. Fever, however, is not the primary illness, but is a physiological mechanism that has beneficial effects in fighting infection. Fever slows the growth and reproduction of viruses and bacteria, and enhances the body’s immune response. Most fevers are of short duration, are benign and may actually be protective. Fever, in and of itself, is not known to endanger a generally healthy child; in contrast, fever actually may be of benefit. Some studies have shown that fever actually helps the body recover more quickly from viral infections. The degree of fever does not always correlate with the severity of illness. In addition, there is no evidence that fever worsens the course of an illness or that it causes long-term neurological complications.

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