Septic arthritis
Urinary tract infection
Meningococcal disease
Pneumonia
Kawasaki disease
Herpes simplex encephalitis
Bacterial meningitis
Non-blanching rash, particularly with 1 or more of the following: • an ill-looking child • lesions larger than 2 mm in diameter (purpura) • capillary refill time of ≥3 seconds • neck stiffness
Tachypnoea (respiratory rate >60 breaths/minute) age 0–5 months; >50 breaths/minute, age 6–12 months; >40 breaths/minute, age >12 months Crackles in the chest Nasal flaring Chest indrawing Cyanosis Oxygen saturation ≤95%
Swelling of a limb or joint Not using an extremity Non-weight bearing
Neck stiffness Bulging fontanelle Decreased level of consciousness Convulsive status epilepticus
Vomiting Poor feeding Lethargy Irritability Abdominal pain or tenderness Urinary frequency or dysuria
Fever for more than 5 days and at least 4 of the following: • bilateral conjunctival injection • change in mucous membranes • change in the extremities • polymorphous rash • cervical lymphadenopathy
Focal neurological signs Focal seizures Decreased level of consciousness
