Infectious Diseases

Fevers

What is a fever?

A temperature of up to 100.3º F may be normal. A temperature greater than this may be a sign of a health problem. Your child's age and behavior may be a more important indicator.

The body has several ways to maintain normal body temperature. The organs involved in helping with temperature regulation include the brain, skin, muscle, and blood vessels. The body responds to changes in temperature by:

• increasing or decreasing sweat production.
• moving blood away from, or closer to, the surface of the skin.
• getting rid of, or holding on to, water in the body.
• naturally wanting to seek a cooler or warmer environment.

When your child has a fever, the body works the same way to control the temperature, but it resets its thermostat at a higher temperature. The temperature increases for a number of reasons:

• Chemicals, called cytokines and mediators, are produced in the body in response to an invasion from a microorganism, malignancy, or other intruder.
  
  
• The body is making more macrophages, which are cells that go to combat when intruders are present in the body. These cells actually "eat-up" the invading organism.
  
  
• The body is busily trying to produce natural antibodies, which fight infection. These antibodies will recognize the infection next time it tries to invade.
  
  
• Many bacteria are enclosed in an overcoat-like membrane. When this membrane is disrupted or broken, the contents that escape can be toxic to the body and stimulate the brain to raise the temperature.

What conditions can cause a fever?

The following conditions can cause a fever:

• infectious diseases
• certain medications
• illness
• blood transfusion
• disorders in the brain

What are the benefits of a fever?

A fever actually helps the body destroy its microbial invader. It also stimulates an inflammatory response, which sends all kinds of substances to the area of infection to protect the area, prevent the spread of the invader, and start the healing process.

What are the symptoms that my child may have a fever?

Children with fevers may become more uncomfortable as the temperature rises. The following are the most common symptoms of a fever. However, each child may experience symptoms differently. In addition to body temperature greater than 100.4º F, symptoms may include:

• Your child may not be as active or talkative as usual.
  
  
• He/she may seem fussier, less hungry, and thirstier.
  
  
• Your child may feel warm or hot. Remember that even if your child feels like he/she is “burning up," the actual rectal or oral temperature may not be that high.

The symptoms of a fever may resemble other medical conditions. According to the American Academy of Pediatrics, if your child is younger than two months of age and has a rectal temperature of 100.4 degrees Fahrenheit or higher, you should call your pediatrician. If you are unsure, always consult your child’s physician for a diagnosis.

When should a fever be treated?

In children, a fever that is equal to or greater than 102.2° should be treated. Children older than two months of age with a fever of 102° or higher that does not respond to fever-reducing medication should be seen by a physician. Children between the ages of 6 months and 5 years can develop seizures from a high fever (called febrile seizures). If your child does have a febrile seizure, there is a chance that the seizure may occur again, but, usually, children outgrow the febrile seizures. A febrile seizure does not mean your child has epilepsy.

What can I do to decrease my child's fever?

Specific treatment for a fever will be determined by your physician based on:

• your child's age, overall health, and medical history
  
  
• extent of the condition
  
  
• your child's tolerance for specific medications, procedures, or therapies
  
  
• expectations for the course of the disease
  
  
• your opinion or preference

Administer an anti-fever medication, such as acetaminophen or ibuprofen. DO NOT give your child aspirin, as it has been linked to a serious, potentially fatal disease, called Reye syndrome.

Other ways to reduce a fever:

• Dress your child lightly if this makes him/her feel better. Excess clothing will trap body heat and cause the temperature to rise.
  
  
• Give your child a lukewarm bath.
  
  
• Encourage your child to drink plenty of fluids, such as juices, soda, punch, or popsicles.
  
  
• Place cold washcloths over areas of the body where the blood vessels are close to the surface of the skin such as the forehead, wrists, and groins.
  
  
• Do not use alcohol baths.

When should I call my child's physician?

Call your child's physician immediately if your child is:

• younger than 3 months old with any fever greater than 100.4º F
  
  
• your child is crying inconsolably
  
  
• your child is difficult to awaken
  
  
• your child's neck is stiff
  
  
• your child has a convulsion
  
  
• any purple spots are present on the skin
  
  
• breathing is difficult AND no better after you clear the nose
  
  
• your child is unable to swallow anything and is drooling saliva
  
  
• your child looks or acts very sick

Call your child's physician within 24 hours if your child is > 3 months old and any of the following conditions are present:

• burning or pain occurs with urination
  
  
• your child has had a fever for more than 24 hours without an obvious cause or location of infection and seems to be getting worse

Call your child's physician during office hours if any of the following conditions are present:

• your child has had a fever more than 72 hours
• the fever went away for more than 24 hours and then returned
• you have other concerns or questions