[Summary of the practice guideline 'Children with fever' (Second Revision) from the Dutch College of General Practitioners].

In the second revision of the practice guideline 'Children with fever' from the Dutch College of General Practitioners, due to its greater reliability rectal measurement of the body temperature above measurement with an ear thermometer is recommended in the case of children younger than 3 months, where the classical signs of infectious diseases are often less apparent. The practice guideline distinguishes between alarm signs which can be recognised by the parents and alarm symptoms which can be diagnosed by the physician during a physical examination. In children younger than 2 years who are feverish with no apparent cause, the urine should be examined at the first consultation. An X-ray of the thorax of a child with fever is only necessary if pneumonia is suspected. As it is not possible at an early stage to identify serious cases among children who are feverish without an apparent cause, these children should be re-examined within 24-48 hours. Children with fever who are younger than 3 months should be referred to a paediatrician. A typical febrile seizure is harmless, nevertheless an underlying meningitis should be excluded.