Fever is often a misunderstood symptom among parents, but it typically signals that the body’s immune system is actively responding to an infection, according to Dr. Manu Sundaram, Attending Physician at the Paediatric Intensive Care Unit of Sidra Medicine. Speaking ahead of World Sepsis Day on September 13, Dr. Sundaram highlighted the distinction between fever as a natural defence mechanism and the serious condition of sepsis, which remains a leading cause of death globally.
Sepsis occurs when the body’s response to infection becomes uncontrolled, causing damage to its own organs. While relatively rare, it can rapidly deteriorate a child’s health within hours if not recognized and treated promptly. Dr. Sundaram emphasized that most childhood fevers are not dangerous in themselves; rather, they indicate the immune system is working. Fever often triggers concern among parents, leading many to seek medical attention in the middle of the night, though the temperature reading alone offers limited insight into the severity of illness.
According to Dr. Sundaram, the critical factor parents should monitor is their child’s behaviour. Children who remain alert, continue drinking fluids, and show some improvement after taking paracetamol are generally managing well. Conversely, a child who is unusually lethargic, difficult to wake, refuses fluids, or remains severely unwell despite lowering the fever may require urgent medical evaluation.
Common infections such as pneumonia, urinary tract infections, meningitis, or skin infections can sometimes progress to sepsis, especially in young infants, newborns, or children with chronic illnesses or weakened immune systems. Early identification and treatment are crucial to prevent this progression.
The misuse of antibiotics is a significant concern highlighted by Dr. Sundaram. Many parents request antibiotics to reduce fever, despite most childhood fevers being viral and therefore unaffected by such medications. Inappropriate use contributes to antibiotic resistance, which complicates treatment when bacterial infections do occur by reducing the effectiveness of standard antibiotics and potentially delaying correct treatment.
“Antibiotic resistance makes it harder not only to treat sepsis but also to recognize it,” Dr. Sundaram explained. Resistant infections may not respond predictably to first-line treatments and can obscure early signs, making timely diagnosis more challenging. Clinical guidelines stress two main points: early detection of sepsis and judicious use of antibiotics to preserve their effectiveness.
To combat these challenges, Dr. Sundaram advises parents to administer antibiotics only when bacterial infection is confirmed or strongly suspected, completing the prescribed course to ensure efficacy. Fever should be managed with rest, hydration, and fever-reducing medications like paracetamol rather than reflexive antibiotic use. Vaccination plays a key role in preventing many infections that might otherwise require antibiotic treatment. Healthcare facilities must also prioritize antibiotic stewardship programs to safeguard these medicines for future use.
Parents should seek immediate medical help if a child with a fever shows signs such as cold or mottled extremities, unusual breathing patterns, altered consciousness, absence of urine output for several hours, or a persistent rash that does not fade under pressure. Promptly asking healthcare providers whether sepsis might be a factor can make a critical difference.
Sidra Medicine is set to host its National Paediatric Symposium on October 22, 2026, aiming to advance paediatric sepsis diagnosis through collaboration among experts in the field. More information about the event is available on Sidra’s website.