Fever in children is not always just viral infection: Paediatrician Dr Amit Vij lists 7 signs that could indicate sepsisUpdated on: Sep 16, 2026, 10:30:57 IST

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A fever in children can sometimes lead to sepsis, which is a runway reaction of the immune system. Dr Amit Vij shares cautionary signs to watch out for.

Fever is one of the most common reasons parents seek medical help for their children. In most cases, it is linked to a viral infection and settles with adequate fluids, rest and care. However, fever can sometimes signal a more serious infection that may lead to sepsis.

In an interaction with Lifestyle, paediatrician Dr Amit Vij explained that sepsis is the body's extreme immune response to an infection. It can affect vital organ function and, in children, can worsen quickly.

“Fever on its own does not mean that a child has sepsis. What matters is whether the child is showing other signs of being seriously unwell,” he stated, before sharing a list of warning signs that parents will do well to look out for.

1. Breathing becomes fast or difficult

“If a child is breathing much faster than usual, struggling to breathe, grunting or showing signs of the chest pulling in while breathing, it should not be ignored,” noted Dr Vij, explaining that these symptoms may occur when an infection affects the lungs or when the body is under significant stress.

2. The child is unusually sleepy or difficult to wake

A child may sleep more than usual when they have a fever. However, if the child is extremely drowsy, confused, not responding normally or is difficult to wake, medical attention is needed, highlighted the paediatrician.

3. The child is not drinking or feeding properly

In the words of Dr Vij, “A sick child may eat less for a short period, but refusing fluids altogether can be concerning. In infants, a noticeable reduction in breastfeeding or feeding should also be taken seriously. Repeated vomiting can further increase the risk of dehydration.”

4. Urine output becomes very low

Dr Vij suggested that parents keep an eye on how often their child is passing urine. “Going for an unusually long period without urinating can be a sign of dehydration or poor circulation and requires medical evaluation,” he stated.

5. The skin looks unusually pale, blue or mottled

“A change in the child's normal skin colour can be an important warning sign,” shared the paediatrician. “Pale, greyish, bluish or mottled skin, particularly when the child also appears very unwell, requires urgent medical attention.”

6. Hands and feet become cold, and the child appears very weak

Cold hands and feet can sometimes occur during a fever. However, Dr Vij pointed out that if they are accompanied by extreme weakness, unusual sleepiness or other signs that the child's condition is worsening, parents should seek medical help rather than simply waiting for the fever to come down.

7. A rash does not fade when pressed

“A rash that does not become lighter when pressed can sometimes be associated with serious infections,” noted the paediatrician. “If such a rash appears along with fever and the child looks very unwell, the child should be taken for urgent medical evaluation.”

It is important for parents to look at the child's overall condition rather than focusing only on the temperature. A child with a relatively mild fever can still be seriously ill, while a high fever does not necessarily mean that the child has sepsis.

Dr Vij further noted that sepsis cannot be diagnosed based on these symptoms alone. “Doctors assess the child's breathing, circulation, hydration, alertness and other clinical signs before deciding whether further tests or treatment are needed,” he stated.

According to the paediatrician, the most important thing is to seek medical help when a child with a fever seems significantly different from their usual self.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

Dr Amit Vij is a senior consultant in the department of paediatrics at ShardaCare – Healthcity, with over 15 years of clinical experience.

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