Childhood fever and rash: what parents should know

Fever is the body's raised-temperature response and a rash may appear with an infection, irritation or inflammation. The rash's colour, texture, location, speed of spread and whether it fades under gentle pressure can help a clinician assess it. The child's behaviour, breathing, hydration and pain are equally important.

Viral illnesses such as chickenpox, a common cold or COVID-19 can include fever and skin changes. Bronchiolitis, croup, cellulitis and other conditions have different patterns and may need different care. A rash with fever cannot be identified reliably from a description alone, especially in a young child.

Offer frequent fluids and allow rest. Keep clothing light and comfortable, and check the child's temperature using a reliable method as directed. Photograph the rash in good light and note when it began, where it started, whether it blanches, and any new medicine, food, product or exposure.

Use fever medicine only according to the label or clinician's advice for the child's age and weight. Do not alternate medicines unless instructed, give aspirin to a child, or apply unprescribed creams to a spreading rash. Wash hands and avoid close contact with vulnerable people until an infectious cause has been considered.

Seek emergency help for a rash that does not fade under gentle pressure, severe breathing difficulty, swelling of the lips or tongue, a seizure, confusion, unusual sleepiness, a stiff neck, or a child who is difficult to wake. Arrange prompt medical assessment if the child is not drinking, has very few wet nappies or toilet visits, has severe pain, or is getting worse.

Tell the clinician the fever's timing, the rash's first location and how it changed, any medicines or exposures, and whether the child is drinking and behaving normally. Ask what symptoms require reassessment and whether the child should stay away from school or nursery.