Update information

Update information

November 2019: We have reviewed the evidence and made new recommendations on assessment for Kawasaki disease. These recommendations are marked [2019].

In recommendations 1.2.14 and 1.7.3 (and table 2) the duration of fever was changed from 'more than 5 days' to '5 days or longer' for consistency with the wording of the 2019 recommendations and to avoid ambiguity about the duration of fever that should prompt action. These changes were made without an evidence review and are marked [2007, amended 2019] or [2013, amended 2019].

Recommendations marked [2007] or [2007, amended 2013] last had an evidence review in 2007. Recommendations marked [2013] last had an evidence review in 2013.

August 2017: Recommendation 1.2.2 was added to cross-refer to the NICE guideline on suspected sepsis: recognition, diagnosis and early management. Recommendation 1.4.8 was added 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 note was added to recommendation 1.2.12 and table 2 to highlight that some vaccinations have been found to induce fever in children younger than 3 months.

Minor updates since publication

March 2024: We updated links to our guidance on bacterial meningitis and meningococcal disease following the launch of NICE's guideline on meningitis (bacterial) and meningococcal disease: recognition, diagnosis and management.

January 2024: Various links were updated throughout to point to the newly updated NICE guideline on suspected sepsis.

October 2022: We added text to indicate that pulse oximetry may be less reliable in people with dark skin. We also added a link to the NHS patient safety alerton the risk of harm from inappropriate placement of pulse oximeter probes. See recommendations 1.2.22, 1.2.28, 1.5.21.

In recommendation 1.5.16 we updated the volume of fluid bolus used for intravenous fluid therapy from 20 ml/kg to 10 ml/kg in children under 5 with fever and shock. See the surveillance report for more information.

July 2022: We updated the symptoms and signs that increase the likelihood of a UTI being present in table 3 and updated links to the NICE guideline on urinary tract infection in under 16s throughout.

November 2021: We added a definition of sepsis to recommendation 1.2.2. We also added a cross reference to table 2 to guide users to the risk stratification tool for children aged under 5 years with suspected sepsis (table 1 in the NICE guideline on suspected sepsis).

ISBN: 978-1-4731-3611-3

  • National Institute for Health and Care Excellence (NICE)