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When you or your children aren’t feeling well, one of the first things you may do is check for a fever. Although a fever isn’t an illness itself, it’s usually a sign that something’s going on in your body. Yet fevers aren’t necessarily bad. In fact, they seem to play a key role in helping your body fight off a number of bacterial and viral infections.
If you’re an adult, a fever may be uncomfortable, but it usually isn’t dangerous unless it measures 103 F or higher. For very young children and infants, however, even slightly elevated temperatures may indicate a serious infection. In newborns, a subnormal temperature — rather than a fever — may be a sign of serious illness.
Because a fever can occur with many different conditions, other signs and symptoms can often help identify the cause. If you don’t know why you have a fever, it’s best not to try to lower your temperature. This may only mask your symptoms and make it harder to determine the cause. In addition, some experts think that aggressively treating all fevers actually interferes with your body’s immune response. That’s because the viruses that cause colds and other respiratory infections thrive at cool temperatures. By producing a low-grade fever, your body may actually be helping eliminate the virus. What’s more, most fevers go away in a relatively short time is usually within a few days.
Signs and symptoms
A fever occurs when your temperature rises above its normal range. What’s normal for you may be a little higher or lower than the average temperature of 98.6 F. That’s why it’s hard to say just what a fever is. But a “significant” fever is usually defined as an oral or ear temperature of 102 F or a rectal temperature of 103 F. A rectal temperature reading is generally 1 degree Fahrenheit higher than an oral reading.
Depending on what’s causing your fever, additional signs and symptoms may include:
* Sweating
* Shivering
* Headache
* Muscle aches
* Lack of appetite
* Dehydration
* General weakness
Very high fevers, between 103 and 106 F, may cause hallucinations, confusion, irritability and even convulsions.
Approximately four percent of children younger than age 5 experience fever-induced seizures (febrile seizures). The signs of febrile seizures, which occur when a child’s temperature rises or falls rapidly, include a brief loss of consciousness and convulsions. Although these seizures can be extremely alarming, most children don’t experience any lasting effects. Febrile seizures are often triggered by a fever from a common childhood illness such as roseola, a viral infection that causes a high fever, swollen glands and a rash.
Causes
Even when you’re well, your body temperature varies throughout the day — it’s lower in the morning and higher in the late afternoon and evening. In fact, your normal temperature can range from about 97 to 99 F. Although most people consider 98.6 F a healthy body temperature, yours may vary by a degree or more.
Your body temperature is set by your hypothalamus, an area at the base of your brain that acts as a thermostat for your whole system. When something’s wrong, your normal temperature is simply set a few points higher. The new set-point, for example, may be 102 F instead of 97 or 98 F.
What happens with a fever
When a fever starts and your body tries to elevate its temperature, you feel chilly and may shiver to generate heat. At this point, you probably wrap yourself in your thickest blanket and turn up the heating pad. But eventually, as your body reaches its new set-point, you likely feel hot. And when your temperature finally begins to return to normal, you may sweat profusely, which is your body’s way of dissipating the excess heat.
A fever usually means your body is responding to a viral or bacterial infection. Sometimes heat exhaustion, an extreme sunburn or certain inflammatory conditions such as temporal arteritis — inflammation of an artery in your head — may trigger fever as well. In rare instances, a malignant tumor or some forms of kidney cancer may cause a fever.
Fever can be a side effect of some medications such as antibiotics and drugs used to treat hypertension or seizures. Some infants and children develop fevers after receiving routine immunizations, such as the diphtheria, tetanus and pertussis (DTaP) or pneumococcal vaccines.
Sometimes it’s not possible to identify the cause of a fever. If you have a temperature higher than 100.9 F 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. In most cases, though, the reason for your fever can be found and treated.
When to seek medical advice
Fevers by themselves may not be a cause for alarm — or a reason to call a doctor. Yet there are some circumstances when you should seek medical advice for your baby, your child or yourself.
For infants
An unexplained fever is greater cause for concern in infants and children than in adults. Call your baby’s doctor if your baby:
* Is younger than 2 months of age and has a rectal temperature of 100.4 F or higher. Even if your baby doesn’t have other signs or symptoms, call your doctor just to be safe.
* Is older than 2 months of age and has a temperature of 102 F or higher.
* Is a newborn who has a lower-than-normal temperature — under 95 F rectally.
* Has a fever and unexplained irritability, such as marked crying when you change your baby’s diapers or when he or she is moved. Some infants might have a fever and seem lethargic and unresponsive. In infants and children younger than age 2, these may be signs of meningitis — an infection and inflammation of the membranes and fluid surrounding your brain and spinal cord. If you’re worried that your baby might have meningitis, see your doctor right away. Don’t wait until morning to see your usual physician — meningitis is an emergency.
For children
Children often tolerate fevers quite well, although high temperatures may cause parents a great deal of concern. Still, it’s best to be guided more by how your child acts than by any particular temperature measurement. If your child has a fever but is responsive and is drinking plenty of fluids and wanting to play, there’s probably no cause for alarm.
Call your pediatrician if your child is listless or irritable, vomits repeatedly, has a severe headache or stomachache or has any other symptoms causing significant discomfort. If your child has a fever after being left in a very hot car, seek medical care immediately.
Also call your doctor if fever persists longer than one day in a child younger than age 2 or longer than three days in a child age 2 or older.
Don’t treat fevers below 101 F with any medications unless advised by your doctor.
For adults
Call your doctor about a fever if:
* Your temperature is more than 104 F
* You’ve had a fever for more than three days
In addition, call your doctor immediately if any of these signs and symptoms accompany a fever:
* A severe headache
* Severe swelling of your throat
* Unusual skin rash
* Unusual eye sensitivity to bright light
* A stiff neck and pain when you bend your head forward
* Mental confusion
* Persistent vomiting
* Difficulty breathing or chest pain
* Extreme listlessness or irritability
* Abdominal pain or pain when urinating
* Any other unexplained symptoms
Screening and diagnosis
Your doctor will likely diagnose the cause of your fever based on your other symptoms and a physical exam. Sometimes you may need additional tests to confirm a diagnosis. If your doctor suspects pneumonia, for instance, you may have a chest X-ray following your physical exam. In other cases you may have blood or urine tests to check for signs of infection.
If you have a low-grade fever that persists for three weeks or more, but have no other symptoms, your doctor may recommend a variety of tests to help find the cause. These may include blood tests and X-rays.
Complications
A rapid rise or fall in temperature may cause a febrile seizure in a small percentage of children younger than age 5. Although they’re 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. Remove any sharp objects that are near your child, loosen tight clothing and hold your child to prevent injury. Don’t place anything in your child’s mouth or try to stop the seizure. Although most seizures stop on their own, call for emergency medical assistance if the seizure lasts longer than 10 minutes.
If possible, try to time the seizure using your watch or a clock. Because they’re so alarming, seizures often seem to last longer than they really do. Also try to note which part of your child’s body begins to shake first. This can help your doctor understand the cause of the seizure. Your pediatrician should see your child as soon as possible.
Treatment
Medical treatment depends on the cause of your fever. Your doctor will likely prescribe antibiotics for bacterial infections, such as pneumonia or strep throat. For viral infections, including stomach flu (gastroenteritis) and mononucleosis, the best treatment is often rest and plenty of fluids.
Your doctor may also suggest taking over-the-counter medications, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) to lower a very high fever. Adults may also use aspirin. But don’t give aspirin to children. It may trigger a rare, but potentially fatal, disorder known as Reye’s syndrome.
Prevention
The best way to prevent fevers is to reduce your exposure to infectious diseases. One of the most effective ways to do that is also one of the simplest — frequent hand washing.
Teach your children to wash their hands often, especially before they eat and after using the toilet, spending time in a crowded public place or petting animals. Show them how to wash their hands vigorously, covering both the front and back of each hand with soap, and rinsing thoroughly under running water. Carry hand-washing towelettes with you for times when you don’t have access to soap and water. When possible, teach your kids not to touch their noses, mouths or eyes — the main way viral infections are transmitted.
Self-care
Because your body loses more water with a fever, be sure to drink plenty of fluids to avoid dehydration. Water is best, but if it’s hard to get your children to drink water, encourage them to drink juices or sports drinks containing electrolytes, or to eat frozen ice pops. Adults and children should also get enough rest. Don’t be concerned with treating a fever just because it’s a fever. Often, a low-grade fever is actually helping fight off an infection. In addition, follow these guidelines for both children and adults:
For temperatures less than 102 F
Don’t use any medication for a fever in this range unless advised by your doctor. And don’t give children aspirin because of the risk of Reye’s syndrome. Instead, dress in comfortable, light clothing and try bathing in lukewarm water. At bedtime, cover yourself or your child with just a sheet or light blanket.
For temperatures between 102 and 104 F
Take acetaminophen or ibuprofen according to the label instructions or as recommended by your doctor. If you’re not sure about the proper dosage, be sure to check with your doctor or pharmacist. Adults may use aspirin instead.
Be careful not to give too much medication. High doses or long-term use of acetaminophen may cause liver or kidney damage, and acute overdoses can be fatal. If you’re not able to get your child’s fever down, don’t give more medication. Call your doctor instead. Side effects of aspirin and other nonsteroidal anti-inflammatory drugs such as Motrin and Advil include stomach pain, bleeding and ulcers.
For temperatures greater than 104 F
Give adults or children acetaminophen or ibuprofen following the manufacturer’s instructions or as recommended by your doctor. Adults may use aspirin instead. If you’re not sure about the dosage, check with your doctor or pharmacist. Be careful not to give too much medication.
Acetaminophen is available in liquid, chewable and suppository forms for children, but it’s often easiest to give medications in liquid form. For a small child, use a syringe with measurements on the side and a bulb on the tip. Gently squirt the medicine in the back corners of your child’s mouth.
Use a five- to ten-minute sponge bath of lukewarm water to try to bring your own or your child’s temperature down. A sponge bath is most likely to help if it’s used shortly after a dosage of acetaminophen or ibuprofen, so that the medication can work to keep the fever down after the bath takes effect.
If your child shivers in the bath, stop the bath, dry your child and wait. Shivering actually raises the body’s internal temperature — shaking muscles generate heat. If the fever doesn’t moderate or your child has a febrile seizure that lasts longer than five minutes, seek immediate medical care.
Taking a temperature
To check your or your child’s temperature level, you can choose from several types of thermometers, including electronic thermometers and ear (tympanic) thermometers. Thermometers with digital readouts and those that take the temperature quickly from the ear canal are especially useful for young children and older adults. Because glass mercury thermometers harm both humans and the environment, they have been phased out and are no longer recommended.
Although it’s not the most accurate way to take a temperature, you can also use an oral thermometer for an armpit (axillary) reading. Place the thermometer in the armpit with arms crossed over the chest. Wait four to five minutes. The axillary temperature is about 1 degree Fahrenheit less than an oral temperature.
Use a rectal thermometer for infants. Place a dab of petroleum jelly on the bulb. Lay your baby on his or her tummy. Carefully insert the bulb one-half inch to one inch into your baby’s rectum. Hold the bulb and your baby still for three minutes. Don’t let go of the thermometer while it’s inside your baby. If your baby squirms, it could go deeper and cause an injury.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.
From MayoClinic.Com & Special to CNN.com
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