Aadapted from Simon and Everitt, 2008 (Free access)





Clinical features


What to do




Fever, photophobia, stiff neck, rash, photophobia, limb pain, cold peripheries, mottled skin and bulging fontanelle(babies).



Immediate admission




Fever, confusion and reduced level of consciousness.



Immediate admission


Subarachnoid haemorrhage


‘Thunderclap’ headache, possibly with sore neck. Other clinical signs may be scanty.



Immediate admission


Head injury


Physical signs (e.g. bruising) or history of head injury.


Consider admission


Acute febrile illness


Fever and other symptoms of the underlying cause. E.g. tonsillitis or upper respiratory infection



Treat the underlying cause




Tender over sinuses.  History of sinus pain or upper respiratory infections.



Consider steam inhalation, antibiotics and/or steroid nasal spray.


Dental caries


Facial pain and tenderness.



Consider antibiotics. Refer to dentist



Tropical illness


Recent travel to tropics and fever.



Consider admission

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