ABSTRACT
A parent’s tactile assessment of the child’s forehead identifies the presence of fever in approximately 50%–75% of cases. Fever is by far the commonest presenting complaint in childhood and a cause of immense parental anxiety. An acutely unwell or toxic-looking child may have signs of poor perfusion such as mottling, cool peripheries and delayed capillary refill time. A detailed history and examination, paying particular attention to the vital signs, overall appearance of the child and searching for potential sources of infection, can help guide further management and determine whether further investigations and treatment are required. Children with pharyngitis are non-toxic and may present with a fever, sore throat and refusal to feed. Examination reveals an erythematous pharynx with cervical lymphadenopathy. The commonest causative agent is a common virus. Viral infections have a gradual onset. Physical examination reveals fever, tachypnoea and signs of accessory muscle use.
