Immediate medical care may be needed when fever, vomiting, or a seizure occurs along with signs of a serious illness.

Symptoms of serious illness include:

• Severe neck stiffness or pain and fussiness.
• Extreme sleepiness, difficulty waking up, or a lack of alertness.
• A bulging soft spot (fontanel) on a baby's head.
• Rapid, difficult breathing.
• Drooling and not wanting to swallow.
• Severe pain.
• Signs of severe dehydration.
• Blue or purple skin or mucous membranes (cyanosis).
• New skin rash or spontaneous bruising.
• New swelling, pain, redness, or warmth in one or more joints.
• Fever of 105°F (40.6°C) or higher 30 to 60 minutes after giving medication for fever.
• Any signs of a urinary tract infection, such as pain or burning with urination or urinating frequently and in small amounts.

By	Healthwise Staff
Primary Medical Reviewer	David Messenger, MD
Specialist Medical Reviewer	Kathleen Romito, MD - Family Medicine
Last Revised	February 25, 2010