fever in children

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Pyrexia is a physiological response to illness, and may be is due to an increase in the set point of temperature in the hypothalamic regulatory centre. Older children suffer higher fevers than neonates in whom mechanical thermogenesis by shivering is limited.

There is little evidence that reducing fever improves the outcome of childhood infections. It is not clear if fever act as a defence against infection but what evidence there is suggests it does.

Some pathogens such as Strep.pneumoniae may be directly inhibited by fever.

Notes (1):

  • NICE state that:

    • recognise that children younger than 3 months with a temperature of 38°C or higher are in a high-risk group for serious illness

    • recognise that children aged 3-6 months with a temperature of 39°C or higher are in at least an intermediate-risk group for serious illness

  • do not use duration of fever to predict the likelihood of serious illness. However, children with a fever lasting 5 days or longer should be assessed for Kawasaki disease


  • NICE (November 2019). Feverish illness in children Assessment and initial management in children younger than 5 years

Last edited 11/2019 and last reviewed 06/2021