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What investigations are appropriate for a child under 5 years with fever and no obvious source of infection?
Answer
In children under 5 years presenting with a fever and no obvious source of infection, appropriate investigations include:
- Full blood count (FBC)
- Blood culture
- C-reactive protein (CRP)
- Urine testing for urinary tract infection (UTI)
In children with 'red' features, lumbar puncture and chest X-ray should also be considered, and serum electrolytes and blood gas may be indicated based on clinical assessment 1.
For children with 'amber' features, urine testing, blood tests (FBC, CRP, blood cultures), and lumbar puncture (especially in children under 1 year) are recommended, with chest X-ray if fever exceeds 39°C and WBC >20×109/L 1.
Children with 'green' features generally do not require routine blood tests or chest X-ray unless indicated by clinical assessment, but urine testing for UTI is advised if no focus of infection is apparent 1.
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