UrgentEmergency Guide
Fever: Red Flags & Emergency Signs
While most fevers are due to self-limiting viral infections, fever can be the only early sign of bacterial meningitis, sepsis, or malaria — pattern recognition is life-saving.
🚨 Call 999 / 112 Immediately
- ⚠Fever with non-blanching petechial or purpuric rash — meningococcal septicaemia (IV benzylpenicillin, 999 immediately)
- ⚠Fever with neck stiffness, photophobia, or confusion — bacterial meningitis
- ⚠Fever with rigors, altered consciousness, and recent tropical travel — cerebral malaria
- ⚠Fever with hypotension, tachycardia, and confusion — septic shock
- ⚠Any fever in an infant under 3 months — emergency assessment required
⚡ See a Doctor Today
- •Fever >38°C for more than 5 days without diagnosis
- •Fever with localising signs of infection (stiff neck, focal chest signs, dysuria)
- •Fever in an immunocompromised patient (chemotherapy, HIV, transplant)
- •Fever returning after apparent resolution (possible malaria relapse, secondary infection)
High-Risk Combinations
When fever occurs together with any of these symptoms, urgency increases significantly:
Conditions to Rule Out Urgently
Bacterial Meningitisemergency
IV ceftriaxone within 1 hour; LP after CT if no contraindications
Sepsisemergency
Sepsis-6 bundle within 1 hour; source identification
Malariaurgent
Blood films × 3; RDT; travel history mandatory
Encephalitisemergency
MRI + LP; empirical IV aciclovir 10mg/kg TDS
Appendicitisurgent
Low-grade fever + RIF tenderness + raised CRP
Condition Authority Pages
Differential diagnosis analyses:
Side-by-side comparisons:
When to Call Emergency Services
- →Fever with any non-blanching rash — 999 immediately
- →Fever with neck stiffness or confusion
- →Fever in a baby under 3 months
- →Fever with recent tropical travel and rigors