Pediatric Fever

A fever is a sign, not a diagnosis. The first clinical question is not how high the temperature is, but whether the child is perfusing, breathing comfortably, interacting, feeding, and producing urine. Age then changes the meaning of the same temperature: a rectal temperature of 38.0 °C in a 10-day-old demands a very different response from the same reading in a vaccinated 2-year-old. In infants aged 90 days or less, infection can be subtle. A reliable rectal temperature recorded at home remains clinically meaningful even if the infant appears well or has a normal temperature on arrival. Conversely, a rectal temperature below 36.0 °C in this age group can signal sepsis and follows the same urgent pathway. Canadian Paediatric Society guidance connects accurate measurement, age-based risk assessment, investigations, treatment, and safety-netting.