Fever Assistant

Source identification & sepsis screen

Red flags
  • qSOFA ≥2, hypotension, lactate >2
  • Petechial rash, neck stiffness
  • Immunocompromise, neutropenia

First steps

  • Vitals + qSOFA
  • Two large-bore IV, blood cultures BEFORE antibiotics
  • Lactate, CBC, CRP, RFT, LFT, urine

Key investigations

  • Blood/urine/sputum cultures
  • Malaria, dengue, typhoid (regional)
  • CXR, USG abdomen as indicated

Differentials

  • Pneumonia, UTI, cellulitis
  • Malaria, dengue, enteric fever
  • Meningitis/encephalitis
  • Endocarditis, abscess

Initial management

  • Antipyretic: paracetamol 15 mg/kg
  • IV crystalloid 30 ml/kg over 3 h if septic shock
  • Empirical antibiotics within 1 h of sepsis recognition

Referral

  • ICU if septic shock
  • Infectious disease for resistant/tropical

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