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EasyPaediatricsFever in under 5s red flaguk-plab-1

A 2-year-old boy presents with fever 39.5°C, tachycardia and tachypnoea. He is irritable but responding, with capillary refill of 2 seconds and no non-blanching rash. According to NICE fever in under 5s guidance, which of the following is a red flag feature requiring urgent assessment?

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