---
title: "Fever-related discomfort in children: international Delphi consensus definition"
id: "pubmed-42680903"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42680903"
content_type: "clinical_feed_article"
specialty: "Pediatrics"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42680903/"
doi: "10.1007/s00431-026-07340-4"
published_at: "2026-09-02T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Fever-related discomfort in children: international Delphi consensus definition
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42680903
- **Specialty:** [Pediatrics](https://medichelpline.com/clinical-feed/pediatrics.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42680903/)
- **DOI:** [10.1007/s00431-026-07340-4](https://doi.org/10.1007%2Fs00431-026-07340-4)
- **Published At:** 2026-09-02T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The article titled “Defining fever-related discomfort in children: an international Delphi consensus” reports an international expert consensus process (Delphi) addressing how to define **fever-related discomfort** in **children**. - Publication metadata: Eur J Pediatr, 2026 Sep 2;185(9):707. DOI 10.1007/s00431-026-07340-4. PubMed PMID 42680903. - Multi-author, multi-center work with numerous contributors from Europe, North America, and Oceania; several authors are noted as having contributed equally. - Participating institutions include university departments of pediatrics, pharmacy, family medicine, emergency departments, and pediatric specialty units across Italy, UK, Germany, France, New Zealand, USA, The Netherlands, Spain, Switzerland. - The corresponding lead and first-listed author is Gregorio P Milani (University of Calabria; Pediatric Unit, Annunziata Hospital). Multiple coauthors are listed including Edward Purssell, David Martin, François Corrard, Eunicia Tan, Janice E Sullivan, Eefje de Bont, Santiago Mintegi, Mario G Bianchetti, Sebastiano A G Lava, and Elena Chiappini. - The source excerpt does not include the study abstract, methods, Delphi rounds, panel composition, specific items or criteria agreed on, outcome measures, or detailed results. Those details were not reported in the provided source text. - Because the provided PubMed page excerpt contains primarily bibliographic and affiliation information, no clinical recommendations, specific consensus statements, or validated definition elements can be extracted from this text alone. - Readers should consult the full article (journal or DOI) for the complete methodology, panel membership, Delphi process details, consensus statements, and any proposed definition or clinical implications for assessing **fever-related discomfort** in pediatric patients.
## Clinical Analysis & Structured Key Points
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](https://pubmed.ncbi.nlm.nih.gov/42680903/#abstract) * [ Conflict of interest statement ](https://pubmed.ncbi.nlm.nih.gov/42680903/#conflict-of-interest) * [ References ](https://pubmed.ncbi.nlm.nih.gov/42680903/#references) * [ Publication types ](https://pubmed.ncbi.nlm.nih.gov/42680903/#publication-types) * [ MeSH terms ](https://pubmed.ncbi.nlm.nih.gov/42680903/#mesh-terms) Title & authors Abstract Conflict of interest statement References Publication types MeSH terms Eur J Pediatr Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Eur+J+Pediatr%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Eur+J+Pediatr%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42680903/) . 2026 Sep 2;185(9):707. doi: 10.1007/s00431-026-07340-4. # Defining fever-related discomfort in children: an international Delphi consensus [Gregorio P Milani](https://pubmed.ncbi.nlm.nih.gov/?term=Milani+GP&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-1 "Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy. gregorio.milani@unical.it.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-2 "Pediatric Unit, Annunziata Hospital, Ospedale Annunziata, Via Felice Migliori, 1, 87100, Cosenza, CS, Italy. gregorio.milani@unical.it."), [Edward Purssell](https://pubmed.ncbi.nlm.nih.gov/?term=Purssell+E&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-equal-contrib-explanation "Contributed equally")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-3 "Little Havens Children's Hospice, Benfleet, Essex, UK.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-4 "Anglia Ruskin University, Chelmsford, Essex, UK."), [David Martin](https://pubmed.ncbi.nlm.nih.gov/?term=Martin+D&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-equal-contrib-explanation "Contributed equally")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-5 "School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-6 "Department of Pediatrics, University of Tübingen, Tübingen, Germany."), [François Corrard](https://pubmed.ncbi.nlm.nih.gov/?term=Corrard+F&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-equal-contrib-explanation "Contributed equally")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-7 "ACTIV, 31 Rue Le Corbusier, 94000, Créteil, France.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-8 "AFPA, 15 Rue Maurice Berteaux, 33400, Talence, France."), [Eunicia Tan](https://pubmed.ncbi.nlm.nih.gov/?term=Tan+E&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-equal-contrib-explanation "Contributed equally")[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-9 "Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.")[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-10 "Emergency Department, Middlemore Hospital, Health New Zealand Counties Manukau, Auckland, New Zealand."), [Janice E Sullivan](https://pubmed.ncbi.nlm.nih.gov/?term=Sullivan+JE&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-equal-contrib-explanation "Contributed equally")[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-11 "University of Louisville School of Medicine, Louisville, USA."), [Eefje G P M de Bont](https://pubmed.ncbi.nlm.nih.gov/?term=de+Bont+EGPM&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-equal-contrib-explanation "Contributed equally")[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-12 "Department of Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands."), [Santiago Mintegi](https://pubmed.ncbi.nlm.nih.gov/?term=Mintegi+S&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-equal-contrib-explanation "Contributed equally")[ 13 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-13 "Pediatric Emergency Department, Biobizkaia Health Research Institute Cruces University Hospital EHU, University of the Basque Country, Osakidetza, Biscay, Spain."), [Mario G Bianchetti](https://pubmed.ncbi.nlm.nih.gov/?term=Bianchetti+MG&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-equal-contrib-explanation "Contributed equally")[ 14 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-14 "Faculty of Biomedical Sciences, Family Medicine Institute, Università Della Svizzera Italiana, Lugano, Switzerland."), [Sebastiano A G Lava](https://pubmed.ncbi.nlm.nih.gov/?term=Lava+SAG&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-equal-contrib-explanation "Contributed equally")[ 15 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-15 "Pediatric Cardiology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, and University of Lausanne, Lausanne, Switzerland."), [Elena Chiappini](https://pubmed.ncbi.nlm.nih.gov/?term=Chiappini+E&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-equal-contrib-explanation "Contributed equally")[ 16 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-16 "Department of Health Sciences, University of Florence, Florence, Italy.")[ 17 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#full-view-affiliation-17 "Paediatric Infectious Diseases Unit, Meyer Children's University Hospital, IRCCS, Florence, Italy.") Affiliations Expand ### Affiliations * 1 Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy. gregorio.milani@unical.it. * 2 Pediatric Unit, Annunziata Hospital, Ospedale Annunziata, Via Felice Migliori, 1, 87100, Cosenza, CS, Italy. gregorio.milani@unical.it. * 3 Little Havens Children's Hospice, Benfleet, Essex, UK. * 4 Anglia Ruskin University, Chelmsford, Essex, UK. * 5 School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany. * 6 Department of Pediatrics, University of Tübingen, Tübingen, Germany. * 7 ACTIV, 31 Rue Le Corbusier, 94000, Créteil, France. * 8 AFPA, 15 Rue Maurice Berteaux, 33400, Talence, France. * 9 Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. * 10 Emergency Department, Middlemore Hospital, Health New Zealand Counties Manukau, Auckland, New Zealand. * 11 University of Louisville School of Medicine, Louisville, USA. * 12 Department of Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands. * 13 Pediatric Emergency Department, Biobizkaia Health Research Institute Cruces University Hospital EHU, University of the Basque Country, Osakidetza, Biscay, Spain. * 14 Faculty of Biomedical Sciences, Family Medicine Institute, Università Della Svizzera Italiana, Lugano, Switzerland. * 15 Pediatric Cardiology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, and University of Lausanne, Lausanne, Switzerland. * 16 Department of Health Sciences, University of Florence, Florence, Italy. * 17 Paediatric Infectious Diseases Unit, Meyer Children's University Hospital, IRCCS, Florence, Italy. # Contributed equally. * PMID: **42680903** * DOI: [ 10.1007/s00431-026-07340-4 ](https://doi.org/10.1007/s00431-026-07340-4) Item in Clipboard # Defining fever-related discomfort in children: an international Delphi consensus Gregorio P Milani et al. Eur J Pediatr. 2026. Show details Display options Display options Format Abstract PubMed PMID Eur J Pediatr Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Eur+J+Pediatr%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Eur+J+Pediatr%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42680903/) . 2026 Sep 2;185(9):707. doi: 10.1007/s00431-026-07340-4. ### Authors [Gregorio P Milani](https://pubmed.ncbi.nlm.nih.gov/?term=Milani+GP&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-1 "Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy. gregorio.milani@unical.it.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-2 "Pediatric Unit, Annunziata Hospital, Ospedale Annunziata, Via Felice Migliori, 1, 87100, Cosenza, CS, Italy. gregorio.milani@unical.it."), [Edward Purssell](https://pubmed.ncbi.nlm.nih.gov/?term=Purssell+E&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-equal-contrib-explanation "Contributed equally")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-3 "Little Havens Children's Hospice, Benfleet, Essex, UK.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-4 "Anglia Ruskin University, Chelmsford, Essex, UK."), [David Martin](https://pubmed.ncbi.nlm.nih.gov/?term=Martin+D&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-equal-contrib-explanation "Contributed equally")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-5 "School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-6 "Department of Pediatrics, University of Tübingen, Tübingen, Germany."), [François Corrard](https://pubmed.ncbi.nlm.nih.gov/?term=Corrard+F&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-equal-contrib-explanation "Contributed equally")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-7 "ACTIV, 31 Rue Le Corbusier, 94000, Créteil, France.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-8 "AFPA, 15 Rue Maurice Berteaux, 33400, Talence, France."), [Eunicia Tan](https://pubmed.ncbi.nlm.nih.gov/?term=Tan+E&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-equal-contrib-explanation "Contributed equally")[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-9 "Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.")[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-10 "Emergency Department, Middlemore Hospital, Health New Zealand Counties Manukau, Auckland, New Zealand."), [Janice E Sullivan](https://pubmed.ncbi.nlm.nih.gov/?term=Sullivan+JE&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-equal-contrib-explanation "Contributed equally")[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-11 "University of Louisville School of Medicine, Louisville, USA."), [Eefje G P M de Bont](https://pubmed.ncbi.nlm.nih.gov/?term=de+Bont+EGPM&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-equal-contrib-explanation "Contributed equally")[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-12 "Department of Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands."), [Santiago Mintegi](https://pubmed.ncbi.nlm.nih.gov/?term=Mintegi+S&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-equal-contrib-explanation "Contributed equally")[ 13 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-13 "Pediatric Emergency Department, Biobizkaia Health Research Institute Cruces University Hospital EHU, University of the Basque Country, Osakidetza, Biscay, Spain."), [Mario G Bianchetti](https://pubmed.ncbi.nlm.nih.gov/?term=Bianchetti+MG&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-equal-contrib-explanation "Contributed equally")[ 14 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-14 "Faculty of Biomedical Sciences, Family Medicine Institute, Università Della Svizzera Italiana, Lugano, Switzerland."), [Sebastiano A G Lava](https://pubmed.ncbi.nlm.nih.gov/?term=Lava+SAG&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-equal-contrib-explanation "Contributed equally")[ 15 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-15 "Pediatric Cardiology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, and University of Lausanne, Lausanne, Switzerland."), [Elena Chiappini](https://pubmed.ncbi.nlm.nih.gov/?term=Chiappini+E&cauthor_id=42680903)[#](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-equal-contrib-explanation "Contributed equally")[ 16 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-16 "Department of Health Sciences, University of Florence, Florence, Italy.")[ 17 ](https://pubmed.ncbi.nlm.nih.gov/42680903/#short-view-affiliation-17 "Paediatric Infectious Diseases Unit, Meyer Children's University Hospital, IRCCS, Florence, Italy.") ### Affiliations * 1 Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy. gregorio.milani@unical.it. * 2 Pediatric Unit, Annunziata Hospital, Ospedale Annunziata, Via Felice Migliori, 1, 87100, Cosenza, CS, Italy. gregorio.milani@unical.it. * 3 Little Havens Children's Hospice, Benfleet, Essex, UK. * 4 Anglia Ruskin University, Chelmsford, Essex, UK. * 5 School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany. * 6 Department of Pediatrics, University of Tübingen, Tübingen, Germany. * 7 ACTIV, 31 Rue Le Corbusier, 94000, Créteil, France. * 8 AFPA, 15 Rue Maurice Berteaux, 33400, Talence, France. * 9 Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. * 10 Emergency Department, Middlemore Hospital, Health New Zealand Counties Manukau, Auckland, New Zealand. * 11 University of Louisville School of Medicine, Louisville, USA. * 12 Department of Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands. * 13 Pediatric Emergency Department, Biobizkaia Health Research Institute Cruces University Hospital EHU, University of the Basque Country, Osakidetza, Biscay, Spain. * 14 Faculty of Biomedical Sciences, Family Medicine Institute, Università Della Svizzera Italiana, Lugano, Switzerland. * 15 Pediatric Cardiology
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