Fever In Children

Definition of Fever In Children

Fever is a higher-than-normal body temperature. Normal temperature is usually defined as 98.6 degrees Fahrenheit (F) or 37 degrees Celsius (C), when measured orally. Many healthcare professionals would say a child truly has a fever when his or her temperature is greater than 99.5 degrees F or 37.5 degrees C. In infants a rectal temperature of 100.4 F or over is considered a fever.

What is going on in the body?

Normally, body temperature changes throughout the day. Exercise, stress, or dehydration may cause a child's temperature to go up. In these cases, it is not considered a true fever.

Fever is a symptom, not a disease. Fever helps the body fight infections by making its defense systems work more efficiently. Bacteria and viruses cannot live at higher temperatures and so are killed by fever.

In very young children, even minor ailments can create fevers of 105 degrees F or more. On the other hand, serious viral infections sometimes bring only moderate fevers.

What other signs and symptoms are associated with this symptom?

The signs and symptoms of a fever depend on what is causing it. At first, a fever can cause a chill. When the brain raises the body's "thermostat," the body responds by shivering to raise the temperature. Shivering produces heat in the body. Once the temperature goes up, the person often feels warm.

Conversely, when the thermostat goes down, the person may start to sweat in order to bring the temperature back down.

Signs of infection that may accompany a fever in children include the following:

• breathing difficulties, including grunting
• cough
• diarrhea
• headache
• irritability
• joint pain
• lack of social response, such as a smile in an infant
• lethargy, meaning the child is listless and doesn't move around normally
• muscle aches
• nausea and vomiting
• painful urination
• rash
• weak or high-pitched cry in infants

In judging how ill a child is, the height of the fever is not the most important factor. Parents also need to look at the other symptoms. They have to take into account their child's alertness and general appearance. These elements can all help a parent gauge how sick the child is.

However, a fever in an infant under 2 months old is more likely to be due to a serious illness. Therefore, in this case, the parent should always call the healthcare professional.

What are the causes and risks of the symptom?

Usually, fevers in children are caused by viral infections. The most common are colds, flu, and gastroenteritis, which tend to be more inconvenient than dangerous. Other viral illnesses in children include fifth disease, chickenpox, and other rash-related illnesses.

Some other common causes of fever in children include the following:

• acute otitis media, or middle ear infection
• bacterial meningitis, which is inflammation of the spinal cord lining
• cancer
• childhood immunizations, such as the DTaP vaccine
• heat emergencies, such as heatstroke or heat exhaustion
• pneumonia
• rheumatoid diseases, such as rheumatoid arthritis
• skin infections
• strep throat or scarlet fever
• urinary tract infections
• overbundling or overdressing a small child

What can be done to prevent the symptom?

Immunizations are available for some of the illnesses that cause fevers in children. The MMR vaccine, for example, protects against measles, mumps, and rubella. Good hand-washing can prevent the spread of other illnesses to children.

How is the symptom diagnosed?

Temperature is measured with an oral or rectal thermometer, or one that takes the temperature in the ear.

The diagnosis of fever in a child starts with a medical history and physical exam. The healthcare provider may order additional tests, including the following:

• blood cultures for aerobic or anaerobic organisms
• antibody titer blood tests
• blood tests, such as a complete blood count, or CBC, which includes a white blood cell count
• chest X-ray
• throat culture
• urinalysis or urine culture

What are the long-term effects of the symptom?

Parents often worry that a high fever may lead to brain damage. Brain damage can occur with a fever of 106 degrees F to 107 degrees F. This level of fever is very unusual. It is most often associated with unusual conditions such as heat emergencies, severe meningitis, or preexisting brain problems. Brain damage from fevers brought on by common illnesses is almost unheard of.

What are the risks to others?

Fever itself is not contagious. However, many of the infections that cause fever in children are highly contagious.

What are the treatments for the symptom?

Treatment of fever is fairly simple. Parents need to keep in mind that most fevers are part of the body's defense against infection. Treatment should be directed at making the child more comfortable. A fever should be treated only if it is above 104 degrees F or if it is causing discomfort. Fevers of 100 degrees F to 102 degrees F that go along with many common illnesses do not need treatment.

When necessary, fever can be treated the following way:

• The child should stay cool by dressing in light clothes such as shorts and a T-shirt. If the child is cold or is shivering, he or she should not be bundled up in blankets. Shivering means that the body is raising its temperature. Bundling the child will only insulate the body and make the temperature go higher. Letting the child wrap up in a bedsheet is a better idea.
• A child with a temperature of 103 degrees F or higher may be given a sponge bath in a shallow tub of warm water for 10 minutes. This will help to lower the fever. Cold water or alcohol rubs should be avoided because these make the child too uncomfortable.
• The child can be given medicines such as acetaminophen or ibuprofen if he or she seems uncomfortable. Aspirin should not be used in children or adolescents. The use of aspirin, especially in cases of chickenpox or flu, has been connected with a serious disease called Reye's syndrome. This complication causes severe inflammation of the brain and liver.
• A child with a fever needs more fluids, so generous amounts of liquids should be offered.

The healthcare provider may prescribe antibiotics, such as amoxicillin, for bacterial infections. These infections include strep throat, urinary tract infections, and acute otitis media.

What are the side effects of the treatments?

Acetaminophen, ibuprofen, and antibiotics may cause stomach upset or allergic reactions.

What happens after treatment for the symptom?

Children generally recover from fever with no further problems. They can generally resume normally activities when they feel well enough to do so.

How is the symptom monitored?

It is important to monitor the mental status of a child with fever. Children with minor illness may be fussy and uncomfortable. But they will be alert and responsive to their surroundings. Children who have serious illnesses, however, will seem "out of it." They may appear "glassy-eyed" or not quite aware of what is going on around them. These symptoms are not specific to a particular illness. These are indications that a child is very ill and should get medical attention promptly. Any new or worsening symptoms should be reported to the healthcare provider.