When the child has a fever.

Fever in a child is usually due to a self-limiting viral infection, with recovery occurring quickly without intervention. However, fever may also be the presenting feature of severe illnesses such as meningitis, septicaemia, urinary tract infections and pneumonia, and trying to exclude such causes is a key part of management. In a review 17 years ago, we concluded that there was no evidence that reducing fever improved the outcome of childhood infections, but that it probably alleviated distress and discomfort caused by fever. We also advised that parents should give paracetamol only if the child seemed uncomfortable or had previously had a febrile convulsion, and said that tepid sponging may further comfort the child, while recognising evidence that it added little to the effect of paracetamol alone. Does this advice still hold?