The patient is suffering from fever from past 2 days

Clinical answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 25 December 2025Updated: 25 December 2025 Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Management and investigations for a patient with fever lasting two days:

  • Perform a thorough clinical assessment to identify any immediately life-threatening features such as compromised airway, breathing, circulation, or decreased consciousness, and consider sepsis as a differential diagnosis .
  • Use the NICE traffic light system to assess the risk of serious illness based on symptoms and signs .
  • If the patient is a child under 5 years, assess for specific signs of serious infections such as meningitis, pneumonia, urinary tract infection (UTI), septic arthritis, osteomyelitis, or Kawasaki disease, especially if fever persists beyond 5 days ,.
  • For infants under 3 months, perform investigations including full blood count, blood culture, C-reactive protein, urine testing for UTI, chest X-ray if respiratory signs are present, and stool culture if diarrhoea is present .
  • Consider lumbar puncture in infants younger than 1 month, or 1 to 3 months if unwell or with abnormal white blood cell counts .
  • In children older than 3 months with fever without apparent source, consider observation in hospital to differentiate serious from non-serious illness .
  • Do not routinely prescribe oral antibiotics without an apparent source of infection ,.
  • Advise on symptomatic management with antipyretics such as paracetamol or ibuprofen to reduce distress, but do not rely on temperature reduction after antipyretics to differentiate serious illness .
  • Advise on self-care measures including adequate fluid intake and appropriate clothing to prevent dehydration and discomfort .
  • If red features (signs of serious or life-threatening illness) are present, arrange emergency hospital transfer .
  • If amber features are present, arrange urgent face-to-face assessment to guide further management .
  • If green features only, the patient can usually be managed at home with safety-netting advice and follow-up as needed .

Related Knowledge Topics

Educational content only. Always verify information and use clinical judgement.