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The list of possible diagnoses for febrile children seen in primary care is long. Identifying children who may have a serious illness can be difficult and is at the heart of decisions to prescribe, investigate, and refer to hospital. Serious infections (including pneumonia, meningitis, septicaemia, appendicitis) account for less than 1% of children presenting to primary care, yet they are leading causes of morbidity and mortality in children. One of the key challenges for primary care practitioners is trying to balance the risk of missing a serious disease against unnecessary investigation or referral. The diagnostic process hinges on the need to rule out (exclude) serious illnesses.
This document has been peer reviewed.