This guideline covers the assessment and early management of fever with no obvious cause in children aged under 5. It aims to improve clinical assessment and help healthcare professionals diagnose serious illness among young children who present with fever in primary and secondary care.

In August 2017, we added recommendation 1.2.1.2. to cross-refer to the NICE guideline on sepsis: recognition, diagnosis and early management. We also added recommendation 1.4.3.3 to highlight that clinicians should not use a response to antipyretic therapy alone as a means to differentiate between serious and non-serious infection. A footnote was also added to recommendation 1.2.2.10 and Table 1 to highlight that some vaccinations have been found to induce fever in children younger than 3 months.

Recommendations

This guideline includes recommendations on:

Who is it for?

  • Healthcare professionals
  • Parents and carers of children under 5 with feverish illness

Is this guideline up to date?

We checked this guideline in April 2017. We will not update the guideline at this time, but we have made editorial or factual corrections to three of the recommendations.

Guideline development process

How we develop NICE guidelines

This guideline updates and replaces NICE guideline CG47 (May 2007).

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.


Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)