What is a fever?
Although a fever could be considered any body temperature above the normal 98.6 F (37 C), medically, a person is not considered to have a significant fever until the temperature is above 100.4 F (38.0 C).
Most fever is beneficial, causes no problems, and helps the body fight off infections. The main reason for treating a fever is to increase comfort.
Fever is the result of an immune response by your body to a foreign invader. These foreign invaders include viruses, bacteria, fungi, drugs or other toxins.
Children under 3 months of age with a temperature of 100.4 F (38.0 C) or greater should be seen by a health care professional. They may be quite ill and not show any signs or symptoms besides a fever. Infants less than 6 weeks of age should be seen immediately by their doctor.
Acetaminophen (Tylenol and others) and ibuprofen (Advil, Motrin) can be used to treat a fever. Aspirin should not be used in children or adolescents to control fever.
The prognosis for a fever depends on the cause. Most cases of fever are self-limited and resolve with symptomatic treatment.
A person who is taking immunosuppressant drugs or who has a history of or diagnosis of cancer, AIDS, or other serious illness, such as heart disease or diabetes, should seek medical care if a fever develops.
Fever refers to an elevation in body temperature. Technically, any body temperature above the normal oral measurement of 98.6 F (37 C) or the normal rectal temperature of 99 F (37.2 C) is considered to be elevated. However, these are averages, and one's normal body temperature may actually be 1 F (0.6 C) or more above or below the average of 98.6 F. Body temperature can also vary up to 1 F (0.6 C) throughout the day.
Fever is not considered medically significant until body temperature is above 100.4 F (38 C). Anything above normal but below 100.4 F (38 C) is considered a low-grade fever. Fever serves as one of the body's natural defenses against bacteria and viruses which cannot live at a higher temperature. For that reason, low fevers should normally go untreated, unless accompanied by troubling symptoms.
Also, the body's defense mechanisms seem to work more efficiently at a higher temperature. Fever is just one part of an illness, many times no more important than the presence of other symptoms such as cough, sore throat, fatigue, joint pains or aches, chills, nausea, etc.
Fevers of 104 F (40 C) or higher demand immediate home treatment and subsequent medical attention, as they can result in delirium and convulsions, particularly in infants and children.
Fever should not be confused with hyperthermia, which is a defect in your body's response to heat (thermoregulation), which can also raise the body temperature. This is usually caused by external sources such as being in a hot environment.
A fever is a symptom of an underlying condition, not a disease. It’s an abnormal elevation of the body’s temperature and is defined as:
•Axillary (armpit)temperature > 99°F/37.2°C
•Oral (mouth) temperature > 100°F/37.8°C
•Rectal (buttocks) temperature > 100.4°F/38°C
•Temporal artery (forehead) temperature > 100.4°F/38°C
•Tympanic (ear) temperature > 100.4°F/38°C
Generally, a temperature of 102 degrees F (38.9 degrees C) or higher when taken by mouth is a fever that may be serious.
If you or a loved one of any age registers a fever temperature of over 104 degrees F, visit your nearest ER immediately.
Fever
It is a common sign of an infection.
Fever is defined as a body temperature that is 1 or more degrees higher than normal. Normal body temperature varies from person to person, by age, by the time of day, and by the part of the body where it is measured. Other factors such as strenuous exercise, medicines, or even excitement can also affect body temperature.
Your temperature can be measured with a thermometer in the mouth, ear, rectum, or under the armpit. Generally, a temperature of 102 degrees F (38.9 degrees C) or higher when taken by mouth is a fever that may be serious. Fever can be a sign that the body is fighting an infection or that you have a medical problem, such as dehydration, a hormone disorder, certain cancers, an immune system problem, or a reaction to certain medicines that you are taking. Most often the fever is associated with other symptoms of illness. Sometimes, the cause of the fever may not be known.
What are the symptoms of infection?
Fever
Diarrhea
Fatigue
Muscle aches
Coughing
There can be other symptoms depending on the human organ system involved.
What causes a fever?
A fever might be caused by:
A virus
A bacterial infection
Heat exhaustion
Extreme sunburn
Certain inflammatory conditions such as rheumatoid arthritis — inflammation of the lining of your joints (synovium)
A malignant tumor
Some medications, such as antibiotics and drugs used to treat high blood pressure or seizures
Some immunizations, such as the diphtheria, tetanus and acellular pertussis (DTaP) or pneumococcal vaccines
Sometimes it's not possible to identify the cause of a fever. If you have a temperature of 101 F (38.3 C) or higher for more than three weeks and your doctor isn't able to find the cause after extensive evaluation, the diagnosis may be fever of unknown origin.
What are the signs and symptoms of fever?
A symptom is something the patient reports and feels, while a sign is something other people, including a doctor may detect. For example, a headache may be a symptom while a rash may be a sign.
When somebody has a fever, signs and symptoms are linked to what is known as sickness behavior, and may include:
Feeling cold when nobody else does
Shivering
Anorexia - lack of appetite
Dehydration - preventable if the patient drinks plenty of fluids
Depression
Hyperalgesia - the individual is much more sensitive to pain
Lethargy
Problems concentrating
Sleepiness
Sweating
If the fever is high there may also be extreme irritability, confusion, delirium and convulsions.
Fever in infants
If your child is younger than 90 days old, emergency care should be sought out if he or she has a fever above 100.4 degrees F, or if the child’s fever is accompanied by any of the following symptoms:
•Rash
•Vomiting
•Difficulty waking up to feed
•Difficulty breathing
•Non-stop crying/inconsolable
Baby fever
If your child is between the ages of 90 days and 36 months old, you should visit an emergency room near you if the fever temperature is above 102.2 degrees F, or if the child’s fever is accompanied by any of the following symptoms:
•Rash
•Unable to keep fluids down
•Difficulty waking
•Difficulty breathing
•Not urinating
•Not immunized
•Non-stop crying/inconsolable
Fever in children
If your child is older than 36 months and has maintained a fever temperature of 102 degrees F for more than two days, or if the fever is accompanied by any of the following symptoms, you should visit the ER:
•Rash
•Unable to keep fluids down
•Difficulty breathing
•Not urinating/burning while urinating
•Stiff neck
•Abdominal pain
•Generally does not look well
Cold & Flu Quiz
Caring for a Child with a Fever
Caring for a Child with a Fever
Adult fever
You should seek emergency treatment If you or a loved one has had a fever for more than two days or if the fever is accompanied by any of the following symptoms:
•Headache
•Abdominal pain
•Difficulty breathing
Additionally, if you have either of following conditions visit an ER immediately.
•Compromised immune system
•Recent chemotherapy
How is a fever diagnosed?
Along with having the generalized symptoms of a fever, taking your temperature with a thermometer can confirm the diagnosis of a fever. A temperature greater than 100.4 F in adults or children is considered a fever.
SYMPTOMS DIAGNOSIS SELF-CARE
Begin here
1. Is the person an infant or child? Yes --> See "Fever In Infants and Children."
No, go down
2. Does your fever come and go and does your temperature stay between 97° and 102°? No --> Go to Question 8.*
Yes, go down
3. Have you had a fever for weeks along with tiredness and a sore throat?
Yes --> You may have MONONUCLEOSIS. --> See your doctor.
No, go down
4. Do you have a sore throat, a dry cough, tiredness, mild headaches or muscle aches? Yes --> You may have a COLD or FLU. --> Get plenty of rest and drink lots of fluids. Over-the-counter- medicines may help relieve your symptoms. See your doctor if your symptoms become severe. Prevent the flu by getting the flu vaccine in the fall.
No, go down
5. Do you have aches, chills, nausea, vomiting, cramps or watery diarrhea? Yes --> You may have GASTROENTERITIS, an intestinal infection commonly called the STOMACH FLU. --> Get plenty of rest. Stop eating and drinking for a few hours to let your stomach settle. Ease back into eating gradually and start with bland foods. Take small, frequent sips of water or clear liquids to avoid dehydration. See your doctor if you have bloody diarrhea, if you've been vomiting for more than 2 days or if you're vomiting blood.
No, go down
6. Are you short of breath and do you have a cough that produces yellow, green or tan mucus? Yes --> You may have BRONCHITIS, or a more serious infection, such as PNEUMONIA. --> Get plenty of rest, drink lots of fluids and take an over-the-counter cough medicine. Bronchitis usually clears on its own in a few days. If your symptoms persist, if you have a high fever or are coughing up blood, see your doctor.
No, go down
7. Have you lost weight unintentionally and do you have a fever that comes and goes, night sweats or swollen lymph nodes? Yes --> You may have a serious infection, such as TUBERCULOSIS or AIDS. --> See your doctor right away.
No, go down
*8. Do you have a fever between 101° and 103°? No --> Go to Question 15.**
Yes, go down
9. Do you have a sore throat and headache? Yes --> You may have a bacterial infection, such as STREP THROAT. --> Get plenty of rest, drink lots of fluids and treat yourself with cold and fever-reducing medicines. If you don't feel better in 48 hours, see your doctor. A quick test can determine whether you have strep throat. Antibiotics are effective in treating the bacteria that causes this infection.
No, go down
10. Do you have stomach pain, nausea and/or vomiting? Yes --> You may have a severe medical problem, such as APPENDICITIS, DIVERTICULITIS, PANCREATITIS, HEPATITIS or COLITIS. --> EMERGENCY
See your doctor or go to the emergency room right away.
No, go down
11. Do you have a rash that's red, tender and warm or a red streak on your arm or leg? Yes --> You may have an infection of the skin or lymph system, such as CELLULITIS or LYMPHANGITIS. --> Both conditions need to be treated with antibiotics. See your doctor right away.
No, go down
12. Do you have an earache? Yes --> You may have a middle ear infection (OTITIS MEDIA) or an outer ear infection (SWIMMER'S EAR or OTITIS EXTERNA). --> These infections could lead to complications if not treated. See your doctor right away.
No, go down
13. Have you been outside under high temperatures and are you feeling nauseous or faint? Yes --> You may have HEAT EXHAUSTION. --> Drink cool liquids and rest in a cool location. Lay down and elevate your legs slightly. Recheck your temperature often until it has returned to normal. If your temperature goes higher, have someone take you to the emergency room.
No, go down
14. Have you recently started taking a new medicine? Yes --> Your fever may be a side effect of your MEDICINE. --> Call your doctor.
No, go down
**15. Is your temperature consistently above 103°? No --> Go to conclusion.***
Yes, go down
16. Are you short of breath or are you coughing up mucus or blood? Yes --> You may have PNEUMONIA or PULMONARY EMBOLUS. --> See your doctor right away.
No, go down
17. Are you experiencing pain or burning when you urinate, or do you have back pain? Yes --> You may have PYELONEPHRITIS, a kidney infection. --> See your doctor right away.
No, go down
18. Do you have a severe headache, neck stiffness, drowiness and vomiting, and are your eyes sensitive to light? Yes --> You may have MENINGITIS, an inflammation of the membranes that cover the brain and spinal cord. --> EMERGENCY
See your doctor or go to the emergency room right away.
No, go down
19. Have you been outside in extremely hot weather, and are you hot but not sweating, possibly feeling faint or having some confusion? Yes --> You may have HEATSTROKE. -->
EMERGENCY
Have someone take you to the emergency room right away. Get out of the sun and go somewhere shady or air-conditioned.
Fever in Adults Overview
A fever is higher-than-normal body temperature. It is a symptom caused by a variety of illnesses.
Every one of us has experienced the wave of chills and exhaustion that a fever causes. Fever usually occurs in response to an infection or inflammation. However, many other causes are possible, including drugs, poisons, cancer, heat exposure, injuries or abnormalities to the brain, or disease of the endocrine (hormonal) system.
A fever rarely comes without other symptoms. It is often accompanied by specific complaints, which may help to identify the illness causing the fever. This can help the doctor determine which treatment is necessary.
Normal body temperature can vary depending on the individual, the time of day, and even the weather. For most people, a temperature of 98.6°F is baseline.
Temperature is usually controlled by the part of the brain called the hypothalamus. The hypothalamus is like a thermostat for the body. It maintains normal temperature through heating mechanisms, such as shivering and metabolism, and cooling mechanisms, such as sweating and dilating (opening) blood vessels close to the skin.
Fever occurs when the body’s immune response is triggered by pyrogens (fever-producing substances). Pyrogens usually come from a source outside the body and, in turn, stimulate the production of pyrogens inside the body. Pyrogens tell the hypothalamus to increase the temperature set point. In response, our body begins to shiver; our blood vessels constrict (close); we get under the covers in an attempt to reach the new temperature that is higher than our baseline.
Pyrogens (fever-producing substances) that occur outside the body
Viruses
Bacteria
Fungi
Drugs
Toxins
Fever in Adults Causes
Viral fever
Illnesses caused by viruses are among the most frequent causes of fever in adults. Symptoms include a runny nose, sore throat, cough, hoarseness, and muscle aches. Viruses also may cause diarrhea, vomiting, or an upset stomach.
For the most part, these viral illnesses will improve simply with time. Antibiotics will not treat a virus. Symptoms can be treated using decongestants and cough medicine bought over the counter. If diarrhea or vomiting occurs, then the person needs to be encouraged to drink fluids. Gatorade will replace lost electrolytes. If fluids are not staying down, then the doctor should be called. Viral illnesses can last as long as 1-2 weeks.
The influenza virus occurs annually and is a major cause of death and serious illness in the elderly. Symptoms include headaches and muscle and joint aches, as well as the other common viral symptoms, including fever. An influenza vaccine is recommended for people older than 50 years and for anyone who has a high risk of being exposed to the virus. Also, there is medication to fight the influenza virus immediately after the symptoms start. This illness usually occurs during the winter.
Bacterial fever
Bacterial illnesses causing fever can affect almost any organ system in the body. They can be treated with antibiotics.
Central nervous system (brain and spinal cord) infections can cause fever, headache, neck stiffness, or confusion. A person may feel lethargic and irritable, and light may irritate the eyes. This could represent meningitis or a brain infection, so the person should go immediately to the doctor. Many colleges are now requiring the meningococcal vaccine for all students to prevent the contraction of meningitis.
Lower respiratory system infections include pneumonia and bronchitis. Symptoms include coughing, difficulty breathing, thick mucus production, and sometimes chest pain. People who smoke should stop smoking immediately. A fever that causes night sweats and blood in the mucus can sometimes indicate tuberculosis. Anyone with these symptoms needs to go to the hospital.
Upper respiratory system infections occur in the throat, ears, nose, and sinuses. A runny nose, headache, or sore throat accompanied by a fever may indicate a bacterial infection.
Infection of the genitourinary system may cause a person to have a burning sensation when urinating, blood in the urine, the urge to urinate frequently, and back pain along with a fever. This would indicate an infection in the bladder, kidney, or urinary tract. Antibiotics would treat such an infection.
If the reproductive system is affected, people often see a discharge from the penis or vagina and have pelvic pain along with the fever. This may represent pelvic inflammatory disease (PID), which does significant damage to the reproductive organs. In this case, the person and any sexual partners should see a physician.
Gastrointestinal system (digestive system) infections are indicated by diarrhea, vomiting, stomach upset, and sometimes blood in the stool. Blood in the stool usually indicates a bacterial infection and can be treated with antibiotics. Abdominal pain may be caused by an infection of the appendix, gallbladder, or liver, and the doctor should be called.
Circulatory system (including the heart and lungs) can be invaded by bacteria. There may not be any specific symptoms with the fever. A person may feel body aches, chills, weakness, or confusion. The condition of sepsis exists when bacteria enter the bloodstream. An infection of a heart valve can occur in people who had heart surgery in the past and in people who use IV drugs. This condition requires hospitalization and immediate treatment with IV antibiotics.
Skin, the largest organ in our body, can also be the source of a bacterial infection. Redness, swelling, warmth, pus, or pain occurs at the site of the infection. An infection may result from trauma to the skin or even a clogged pore that becomes an abscess. Sometimes the infection needs to be drained. Antibiotics are often needed.
Fungal fever
Fungal infections can affect any organ system. Often a physician can identify these infections through a physical examination. Sometimes further testing is required. An antifungal medication will usually treat the infection.
Animal exposure fever
Certain people who work with animals can be exposed to rare bacteria that can cause fevers. In addition to the fever, the person may have chills, headache, and muscle and joint aches. These bacteria can exist in livestock, in unpasteurized dairy products, and in the urine of infected animals.
Travelers' fever
Anyone who travels, especially outside the United States, may develop fever after exposure to various new foods, toxins, insects, or vaccine-preventable diseases.
The only vaccines required by law at this time are yellow fever and cholera. Childhood vaccines such as those against measles, mumps, rubella, diphtheria, tetanus, and polio should be current prior to travel. Vaccines against hepatitis A, meningitis, and typhoid can be obtained before people travel to an area where exposure to those diseases is likely. The Centers for Disease Control and Prevention can advise you on the current vaccines recommended for travel to various countries.
When traveling, consumption of contaminated water, uncooked vegetables, or unpasteurized dairy products can cause a low-grade fever and traveler's diarrhea. Pepto-Bismol, Imodium, and certain antibiotics can help. The symptoms of abdominal cramping, nausea, vomiting, headache, and bloating should go away in 3-6 days. A fever higher than 101°F or blood in the stool is an indication to go to a doctor immediately.
Insect bites are a common way that infections are spread in some countries. Malaria is a serious infection that can occur after a mosquito bite. The bitten person may have fevers that come and go every few days. A blood test must be done to make the diagnosis. In certain infected areas, a traveler can take medication to prevent malaria. Lyme disease is spread by the bite of a tick. This is common in areas of the US where the deer tick is found. Any infection caused by an insect bite should be evaluated by a doctor.
Drug fever
A fever that occurs after starting a new medication, without another source, may be a drug fever. The fever can occur at any time after starting the drug and should go away after the drug is stopped.
Antibiotics often cause a fever after a week of treatment.
Certain heart and seizure medications have caused fever after months of treatment.
An immediate fever may be caused by an allergic response to the medication or a preservative in the medication.
Excess aspirin and thyroid hormone can increase metabolism and cause a fever.
Antihistamines, certain antidepressant medications, and sedatives can prevent heat loss from the body.
Cocaine and amphetamines can increase muscle activity and cause a fever.
Blood clot fever
Occasionally a blood clot can develop in a person’s leg and cause swelling and pain in the calf. Part of this clot may break off and travel to the lungs. This may cause chest pain and trouble breathing. In either case, a person may develop a fever because of inflammation in the blood vessels. A person with any of these symptoms should go to the hospital.
Tumor fever
Cancer can cause fever in a variety of ways. Sometimes the tumor makes pyrogens, which cause a fever on their own. Some tumors may become infected. Tumors in the brain may prevent the hypothalamus (the body’s thermostat) from regulating the temperature. Many of the medications that a cancer patient takes can cause a fever. Finally, immune systems in cancer patients may be weakened, which makes them prone to various infections.
Environmental fever
Occasionally a very high body temperature can be reached when the body becomes overheated. This condition is called hyperthermia. This often occurs with strenuous exercise or when the body is exposed to hot or humid weather. Certain drugs that alter a person’s behavior may prevent that person from taking shelter from the heat. People with hyperthermia may be confused, lethargic, or even comatose. They may have an extremely high temperature and may not be able to sweat. Hyperthermia is treated differently than other causes of fever. The affected person must be cooled immediately.
Special medical conditions
Many people have medical illnesses that prevent their immune system (defense system) from working normally. This may make it easier for a fever-causing infection to invade their body. Depending on the illness, it may be difficult to find the source of the fever. A fever in a person with limited ability to fight off infection can be very dangerous.
How should I take a temperature for fever?
Digital thermometers can be used to measure rectal, oral, or axillary (under the armpit) temperatures. The American Academy of Pediatrics does not recommend use of mercury thermometers (glass), and they encourage parents to remove mercury thermometers from their households to prevent accidental exposure to this toxin.
Measuring an axillary (under the armpit) temperature for fever
Axillary temperatures are not as accurate as rectal or oral measurements, and these generally measure 1 degree lower than a simultaneously obtained oral temperature.
Place the tip of the digital thermometer in your child's armpit.
Leave in place about one minute or until you hear a beep to check a digital reading.
Measuring fever by eardrum temperature
Tympanic (ear) thermometers must be placed correctly in your child's ear to be accurate. Too much earwax can cause the reading to be incorrect.
Eardrum temperature measurements are not accurate in small children and should not be used in children under 3 years (36 months) of age. This is especially true in infants below 3 months of age when obtaining an accurate temperature is very important.
Measuring fever by oral temperature
People 4 years old and older can have their temperature taken with a digital thermometer under the tongue with their mouth closed.
Clean the thermometer with soapy water or rubbing alcohol and rinse.
Turn the thermometer on and place the tip of the thermometer as far back under the tongue as possible.
The mouth should remain closed, as an open mouth can cause readings to be inaccurate.
The thermometer should remain in place for about one minute or until you hear the beep. Check the digital reading.
Avoid hot or cold drinks within 15 minutes of oral temperature measurement to ensure correct readings.
Measuring fever by rectal temperature
The American Academy of Pediatrics recommends rectal temperature measurements for children under 3 years of age, as this gives the most accurate reading of core temperature.
Clean the thermometer with soapy water or rubbing alcohol and rinse with cool water.
Use a small amount of lubricant, such as petroleum jelly, on the end.
Place the child or baby prone (belly-side down) on a firm surface, or place your child face up and bend his legs to his chest.
After separating the buttocks, insert the thermometer approximately ˝ to 1 inch into the rectum. Do not insert it too far.
Hold the thermometer in place, loosely keeping your hand cupped around your child's bottom, and keep your fingers on the thermometer to avoid it accidently sliding further into the rectum. Keep it there for about one minute, until you hear the beep.
Remove the thermometer, and check the digital reading.
Label the rectal thermometer so it's not accidentally used in the mouth.
A rectal temperature will read approximately 1 degree higher than a simultaneously obtained oral temperature.
Complications
What are complications of a fever?
Complications of a fever may include:
Severe dehydration
Hallucinations
Fever-induced seizure (febrile seizure), in a small number of children ages 6 months to 5 years
Febrile seizures
Febrile seizures usually involve loss of consciousness and shaking of limbs on both sides of the body. Although alarming for parents, the vast majority of febrile seizures cause no lasting effects.
If a seizure occurs:
Lay your child on his or her side or stomach on the floor or ground
Remove any sharp objects that are near your child
Loosen tight clothing
Hold your child to prevent injury
Don't place anything in your child's mouth or try to stop the seizure
Most seizures stop on their own. Take your child to the doctor as soon as possible after the seizure to determine the cause of the fever.
Call for emergency medical assistance if a seizure lasts longer than 10 minutes.
Fever is the result of an immune response by your body to a foreign invader. These foreign invaders include viruses, bacteria, fungi, drugs, or other toxins.
These foreign invaders are considered fever-producing substances (called pyrogens), which trigger the body's immune response. Pyrogens tell the hypothalamus to increase the temperature set point in order to help the body fight off the infection.
Fever is a common symptom of most infections. In children, immunizations or teething in may cause low-grade fever. Autoimmune disorders, medication reactions, seizures, or cancer may also cause fevers.
When should you worry?
Doctors classify fevers according to how long they last, whether or not they come and go, and how high they are.
Severity
Core body temperature varies from person to person.
Most experts consider a temperature of 100.4° F (38°C) to be a fever, but in children, this may be lower, at 99.5°F (37.5°C).
Hyperpyrexia can occur when a person’s temperature rises above 106°F (41.1°C). Without treatment, this can lead to complications.
Learn more about normal body temperature and when a person should worry here.
Duration
A fever can be:
acute if it lasts for under 7 days
subacute if it lasts for up to 14 days
chronic or persistent if it lasts for over 14 days
Fevers that exist for days or weeks with no explanation are called fevers of unknown origin.
When should I seek medical care for a fever?
Any child below 3 months of age who has a temperature of 100.4 F (38 C) or greater should be seen by a physician. If a child or adult has a history or diagnosis of cancer, AIDS, or other serious illness, such as heart disease, diabetes, or is taking immunosuppressant drugs, medical care should be sought for a fever.
Otherwise, observe the person with the fever. If they appear sick or have symptoms that would suggest a major illness, such as meningitis (headache, stiff neck, confusion, problems staying awake), urinary tract infection (shaking chills, burning with urination), pneumonia (shortness of breath, cough), or any other signs of a serious illness, contact your health care professional.
Other symptoms that may be indicative of a severe illness include repeated vomiting, severe diarrhea, or skin rashes (could be a sign of dengue fever, Rocky Mountain spotted fever, scarlet fever, rheumatic fever, strep throat, or chickenpox).
Fever blisters (herpangina) are small blisters that turn into ulcers, usually on the lips, mouth or tongue, caused by a virus. When a child contracts this virus for the first time, the symptoms and the fever blisters can be quite severe. If the child is not eating or drinking, contact your child's doctor.
On the other hand, if the fever accompanies a simple cold or virus, you can treat the fever as described above and be assured that the fever is only a symptom of the illness. This is not to say that you should ignore a fever. If there are other associated symptoms that are bothersome, you should contact your doctor.
Some vaccines given in childhood can cause a low-grade fever within a day or two of getting the injection. This fever is usually self-limited and short-lived. If the reaction seems severe or the skin at the injection site is red, hot, and painful, contact your child's doctor.
About 3% of all children between 18 months to 3 years of age will have a seizure (convulsion) with a high fever. Of those with a history of febrile seizure, approximately one-third will have another seizure associated with another febrile episode. Febrile seizures, while frightening to the parents, are not associated with long-term nervous-system side effects. Children used to be prescribed phenobarbital following a febrile seizure as a preventive measure (prophylaxis). This has not been shown to be beneficial and possibly may be harmful, so it is not always recommended.
What is the treatment for a fever? How is fever treated?
Generally, if the fever does not cause discomfort, the fever itself need not be treated. It is not necessary to awaken an adult or child to treat a fever unless instructed to do so by your doctor.
The following fever-reducing medications may be used at home:
Acetaminophen (Tylenol and others) can be used to lower a fever. The recommended pediatric dose can be suggested by the child's pediatrician. Adults without liver disease or other health problems can take 1,000 mg (two "extra strength" tablets) every six hours or as directed by your physician.
Ibuprofen (Motrin/Advil) can also be used to break a fever in patients over 6 months of age. Discuss the best dose with your doctor. For adults, 400 mg-600 mg (two to three 200 mg tablets) can be used every six hours.
Aspirin should not be used for fever in children or adolescents. Aspirin use in children and adolescents during a viral illness (especially chickenpox and influenza, or flu) has been associated with Reye's syndrome. Reye's syndrome is a dangerous illness which causes prolonged vomiting, confusion, and even coma and liver failure.
An individual with a fever should be kept comfortable and not overdressed. Overdressing can cause the temperature to rise further. Tepid water (85 F [30 C]) baths are a home remedy that may help bring down a fever. Never immerse someone in ice water. This is a common misconception. Never sponge a child or an adult with alcohol; the alcohol fumes may be inhaled, causing many problems.
What is the prognosis for a fever?
The prognosis for a fever depends on the cause. Most cases of fever are self-limited and resolve with symptomatic treatment. Depending on the cause, antibiotics or other appropriate medications may be used.
Fevers associated with severe infections, or in patients whose immune system is compromised (such as those with cancer, elderly people, newborn infants, patients with HIV/AIDS, or people with autoimmune disorders) can be life threatening.
Can fevers be prevented?
Yes.
How to prevent fever?
Can fevers be prevented?
What is the prevention for a fever?
Proper hygiene
Wash hands frequently.
Protective clothing for infants
save from mosquito bite
Proper disposal of waste
Safe drinking water
Fresh & hot food
Save from weather change
Warm clothing in winters
Daily bath
Avoid contact with sick people.
Vaccination against diseases
Maintain physical fitness
Fever is preventable only to the extent that the specific cause of the fever can be prevented. Most fevers are caused by infection. Avoiding sources the infection and maintaining good hygiene practices are your best way to prevent a fever.
Prevention
Typhoid
Hygiene
Safe food, water
Hand washing before eating food.
Proper sanitation.
Avoid eating outside.
Vaccination
Typhoid vaccine, a bacterial vaccine prepared from an inactivated, dried strain of Salmonella typhi. It is given for primary immunization against typhoid fever for adults and children.
Malaria
General
Individual prophylaxis includes insect repellent, covering of skin, use of mosquito netting for bed, and avoidance of outdoors at night when in endemic areas;
Community prophylaxis includes control of mosquito breeding grounds and protection of the blood supply
Antimalarial drugs for acute attacks and as prophylaxis if traveling to endemic areas;
Worldwide destruction of the disease has not been possible.
Insecticide-immune mosquitoes and drug-immune protozoa have developed.
Through the use of insecticides and destruction of swamps, the disease has disappeared from many parts of the world.
Vaccines are experimental
Cholera
A cholera vaccine is available for people traveling to areas where the infection is common.
Other preventive measures include drinking only boiled or bottled water and eating only cooked foods.
Viral Pandemic 2019-2020: What are the preventive directives in this situation?
High Fever Symptoms: When to Go to the ER
In addition to a high fever, other symptoms may be present, such as body aches, chills, sweats, loss of appetite, and fatigue.
You should get emergency medical care for a high fever with these symptoms:
•Seizures
•Hallucinations
•Confusion
•Shortness of breath
•Rapid pulse or heart rate
•Dehydration
•Unusual drowsiness or fatigue
•Severe headache
•Abdominal pain
•Stiff neck
•Purplish-red, dotted rash
A high fever in infants can signal a serious infection and should be treated promptly by a doctor. You should see a doctor for high fever lasting more than 48 hours. If you have a chronic medical condition or if you have been out of the country and you have a high fever, see a doctor as soon as possible.
"Should You Go to the ER for a Fever?"
Mild fever is generally easy to treat at home with rest, fluids and over-the-counter medicine. However, sometimes fever is an indicator of a more serious infection. See below to help determine whether you need to seek emergency care for yourself or your child.
Babies Under 90 Days
If your child is under 90 days old, seek emergency care if he or she has a temperature over 100.4 degrees, or if your child’s fever is accompanied by the following symptoms:
•Vomiting
•Rash
•Difficulty breathingv
•Non-stop crying or inconsolable
•Difficulty waking up to feed
Babies 90 Days to 36 Months
If your child is between 90 days and 36 months, seek emergency care if he or she has a temperature over 102.2 degrees, or if he/she is also has the following symptoms:
•Inconsolable
•Not immunized
•Unable to keep fluids down
•Not urinating
•Difficulty breathing
•Rash
•Difficulty waking up
Children 36 Months and Older
If your child is 36 months or older, seek emergency care if he or she has temperature over 102 degrees for two or more days, or if the fever is accompanied by any of the following symptoms:
•Does not look well
•Cannot keep fluids down
•Burning during urination or does not urinate
•Rash
•Difficulty breathing or swallowing
•Stiff neck
•Abdominal pain
Adults
Seek emergency care if you or a loved one has a fever that:
•Lasts for more than two days
•If the fever is accompanied by any of these symptoms: ?Difficulty breathing
Headache
Abdominal pain
•Is accompanied by another medical condition: ?Compromised immune system
Recent chemotherapy
Causes of High Fever
High-grade fevers are typically caused by viral or bacterial infections, including:
•Kidney infection
•Influenza (flu)
•Appendicitis
•Encephalitis
•Pneumonia
•Meningitis
Other causes of fever can include:
•Autoimmune diseases, such as lupus, rheumatoid arthritis, and inflammatory bowel disease
•Drug reactions
•Cancer
High Fever Treatment
Treatment for high fever depends on the underlying cause and your personal preferences.
Causes of High Fever
High-grade fevers are typically caused by viral or bacterial infections, including:
•Kidney infection
•Influenza (flu)
•Appendicitis
•Encephalitis
•Pneumonia
•Meningitis
Other causes of fever can include:
•Autoimmune diseases, such as lupus, rheumatoid arthritis, and inflammatory bowel disease
•Drug reactions
•Cancer
Mild fever is generally easy to treat at home with rest, fluids and over-the-counter medicine. However, sometimes fever is an indicator of a more serious infection. See below to help determine whether you need to seek emergency care for yourself or your child.
Babies Under 90 Days
If your child is under 90 days old, seek emergency care if he or she has a temperature over 100.4 degrees, or if your child’s fever is accompanied by the following symptoms:
•Vomiting
•Rash
•Difficulty breathing
•Non-stop crying or inconsolable
•Difficulty waking up to feed
Babies 90 Days to 36 Months
If your child is between 90 days and 36 months, seek emergency care if he or she has a temperature over 102.2 degrees, or if he/she is also has the following symptoms:
•Inconsolable
•Not immunized
•Unable to keep fluids down
•Not urinating
•Difficulty breathing
•Rash
•Difficulty waking up
Children 36 Months and Older
If your child is 36 months or older, seek emergency care if he or she has temperature over 102 degrees for two or more days, or if the fever is accompanied by any of the following symptoms:
•Does not look well
•Cannot keep fluids down
•Burning during urination or does not urinate
•Rash
•Difficulty breathing or swallowing
•Stiff neck
•Abdominal pain
Adults
Seek emergency care if you or a loved one has a fever that:
•Lasts for more than two days
•If the fever is accompanied by any of these symptoms: ?Difficulty breathing
?Headache
?Abdominal pain
•Is accompanied by another medical condition: ?Compromised immune system
?Recent chemotherapy
High Fever Treatment
Treatment for high fever depends on the underlying cause and your personal preferences.
Causes of High Fever
High-grade fevers are typically caused by viral or bacterial infections, including:
•Kidney infection
•Influenza (flu)
•Appendicitis
•Encephalitis
•Pneumonia
•Meningitis
Other causes of fever can include:
•Autoimmune diseases, such as lupus, rheumatoid arthritis, and inflammatory bowel disease
•Drug reactions
•Cancer
What is the person’s medical history?
History: Fever
How long have you had the fever?
What is the pattern of the fever?
Thermometer used and by what route?
What was peak temperature?
Did fever occur at predictable time of day?
Did fever occur daily, or intervening afebrile days?
What was response to antipyretics?
History: Systemic Symptoms
A.Weight loss
B.Decreased appetite
C.Decreased activity
D.Onset of symptoms (Do symptoms precede fever?)
E.Rash
F.Arthralgia
History: Localized Symptoms
A.Headache
B.Personality change
C.Cough
D.Abdominal Pain
E.Urinary Symptoms
F.Bone pain
1.Local pain in Osteomyelitis
2.Multifocal pain in malignancy
History: Travel history and Exposures
A.Travel outside United States (Vaccines or prophylaxis?)
1.Tuberculosis
2.Malaria
3.Hepatitis
4.Salmonellosis
5.Brucellosis,
6.Leptospirosis
7.Various mycoses and parasites
B.Camping or travel in wooded areas (Tick bites)
1.Rocky Mountain Spotted Fever
2.Lyme Disease
3.Relapsing Fevers
C.Contagious Contacts
1.Tuberculosis
2.Salmonellosis
D.Daycare
1.Cytomegalovirus
2.Tuberculosis
3.Hepatitis
4.Salmonellosis
History: Dietary
A.See Foodborne Illness
B.Recent potential infectious sources
1.Unpasteurized dairy products
2.Raw Meat
3.Raw Fish
4.Wild rabbit
C.Pica suggests possible underlying infections
1.Visceral Larva Migrans
2.Toxoplasmosis
3.Brucella
4.Salmonellosis
History: Animal Exposure
A.Dogs or Rodents or their urine (Leptospires)
B.Pet turtles (Salmonella)
C.Rats (Rat bite fever)
D.Cats (Toxoplasmosis)
E.Parrots or psittacine birds (Psittacosis)
F.Pigeons (Coccidioides)
I. Identify whether the infection has any organ localization or not
Symptoms of febrile illness may be divided into
a. Constitutional symptoms comprising of fatigue, myalgia, loss of appetite, nausea ,
headache , etc
b. Symptoms suggestive of specific organ involvement
Tonsillo-pharyngeal region - sore throat, cough and painful swallowing
Maxillary/Frontal sinus – rhinitis,nasal blockade, headache
Brain and Meninges- headache, vomiting and altered sensorium
Lungs and pleura - cough, sputum production,hemoptysis, breathlessness and
chest pain
Myopericardium- chest pain, breathlessness and palpitation
Liver- intractable vomiting, epigastric or right hypochondrial pain , jaundice
Gall bladder and biliary tract- abdominal pain and vomiting
Appendix- right iliac pain, vomiting and/or constipation or loose stools.
Urinary tract – burning micturition and low back pain
Joints- joint pain and swelling.
Soft tissue- focal swelling, reddish discoloration and pain over the soft tissue
Peripheral Lymphnode- Swelling of extremities
What can you expect in the hospital?
You may need to stay in the hospital because:
•You have had a low-grade fever for 3 weeks or more without a known cause.
•You have a high-grade fever without a known cause.
•You have other chronic medical conditions which need careful observation and treatment.
Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:
Monitoring
•You will be checked often by the hospital staff.
•Your heart rate, blood pressure, and temperature will be checked regularly.
•Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
Testing
Testing may include:
•Blood and urine tests to check for dehydration, infections, or other possible causes for your fever.
•Blood, urine, or other tests to monitor how well your organs are functioning.
•X-rays: Pictures of the inside of your chest to check for infection.
•Computed tomography (CT) scan: A series of X-rays taken from different angles and arranged by a computer to show thin cross sections of the abdomen, pelvis, or other sites.
Treatment
The treatment for fever depends on its cause, your symptoms, your overall health, and any complications you may have.
•You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.
•You may receive oxygen through a small tube placed under your nose or through a mask placed over your face.
•Your provider may prescribe medicine to: ?Reduce your fever
?Treat or prevent an infection
A mild fever is part of the immune system’s response to bacteria, viruses, and other pathogens. It helps the body fight off infection.
However, it can be uncomfortable, and a high fever can sometimes lead to complications.
For this reason, doctors may sometimes recommend medications called antipyretics to lower a person’s temperature.
Examples include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Acetaminophen (Tylenol) can also reduce a fever. Aspirin can help, but it is not suitable for children, and it may not be suitable for people who take blood thinners.
If a person is sweating a lot, they may experience dehydration. In this case, they should consume plenty of fluids to prevent complications.
Treating the cause
A fever is a symptom, not an illness.
A doctor may wish to carry out tests to identify the cause. If the fever is due to a bacterial infection, they may prescribe an antibiotic.
If it stems from a viral infection, the doctor may recommend using NSAIDs to relieve the symptoms.
Antibiotics will not stop a virus. A doctor will not prescribe them for a viral infection.
NSAIDs will not help if the fever is due to hot weather or sustained strenuous exercise. In these cases, it is essential to cool the person down. If they are confused or unconscious, they need immediate medical care.
Viral Pandemic 2019-2020
A person with symptoms of Viral Pandemic 2019-2020 may not need any medical treatment.
However, if they develop severe chest pains and have difficulty breathing, they may need hospital treatment.
Some people will need to spend time on a ventilator, which is a device that will help them breathe.
What can you do to help?
You will need to tell your healthcare team if you have new or worsening:
Shortness of breath
Severe headache or a headache that does not go away with treatment
Severe pain when you straighten your neck or back
Vomiting
Sensitivity to bright lights
Abdominal pain
Back pain
Pain or burning with urination
Redness, swelling, tenderness, or other signs of infection on the skin
•Ask questions about any medicine or treatment or information that you do not understand.
How long will you be in the hospital?
How long you stay in the hospital depends on many factors. The average amount of time to stay in the hospital with a fever is 2 to 3 days.
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