Fever

• Paracetamol

Fever without a clear focus in a clinic patient. Test by duration and danger signs, not by routine.

First visit

• No tests in the first 2 days — If the patient looks well, has no danger signs and fever is under 48–72 h, treat symptoms and review.
• CBC with platelets — From day 3 of fever, or earlier if unwell: leucopenia and low platelets point to dengue, malaria or rickettsia.
• Malaria RDT or peripheral smear — From day 3, or at once in an endemic area or with chills.
• Dengue NS1 antigen — Fever days 1–5 in season; IgM ELISA from day 5.

Only if indicated

• Urine routine and culture — Dysuria, flank pain, or any febrile infant or young child without a focus.
• Blood culture — Fever over 5 days, toxic look, or suspected typhoid — before antibiotics.
• Scrub typhus and leptospirosis IgM ELISA — Fever over 5 days, eschar, myalgia with jaundice or reduced urine, or flood or farm exposure.
• LFT, creatinine, chest X-ray — Fever over 5 days, jaundice, breathlessness or a sick patient.
• USG abdomen, Mantoux/NAAT for TB — Fever over 7 days without a cause.