When to worry about unexplained fever with childhood cancer

Unexplained Fever is a common presentation of Childhood Cancer. Fever can occur with infection, the cancer itself, or treatment. Children receiving cancer care may have reduced immune protection, and they may not describe pain or early illness clearly. Look for changes in alertness, feeding, drinking, breathing, urine, skin, or behaviour, while remembering that a child can need assessment without these additional signs.

Take the child’s temperature as your oncology team has shown you and record the reading and time. Call the child’s oncology contact immediately using the agreed number. Mention the latest treatment, medicines, a central line, sick contacts, and any change in behaviour or intake. Do not give fever medicine or antibiotics unless the team has provided instructions. Offer usual fluids if the child is awake and able to swallow, but do not delay advice.

Call emergency services for breathing difficulty, blue or grey lips, a seizure, collapse, severe sleepiness, confusion, or a child who cannot be roused. Seek urgent assessment for repeated vomiting, inability to drink, very little urine, shaking chills, uncontrolled bleeding, or a rapidly worsening rash. Bring the child’s treatment information and state that the child has cancer.

Ask which temperature readings require a call, who to contact at night, how to check temperature safely, and what to do if the child vomits or cannot drink while waiting for assessment.