Fever
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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).
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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.
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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.
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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.
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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.
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The prognosis for a fever depends on the cause. Most cases of
fever are self-limited and resolve with symptomatic treatment.
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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.
What is a fever?
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 simple cold or other viral infection can sometimes cause a high fever (102
- 104 °F, or 38.9 - 40 °C). This does not usually mean you or your child have
a serious problem. Some serious infections may cause no fever or even a
very low body temperature, especially in infants.
If the fever is mild and you have no other problems, you do not need
treatment. Drink fluids and rest.
The illness is probably not serious if your child:
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Is still interested in playing
Is eating and drinking well
Is alert and smiling at you
Has a normal skin color
Looks well when their temperature comes down
Take steps to lower a fever if you or your child is uncomfortable, vomiting,
dried out (dehydrated), or not sleeping well. Remember, the goal is to lower,
not eliminate, the fever.
When trying to lower a fever:
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Do NOT bundle up someone who has the chills.
Remove excess clothing or blankets. The room should be comfortable,
not too hot or cool. Try one layer of lightweight clothing, and one
lightweight blanket for sleep. If the room is hot or stuffy, a fan may
help.
A lukewarm bath or sponge bath may help cool someone with a fever.
This is especially effective after medication is given -- otherwise the
temperature might bounce right back up.
Do NOT use cold baths, ice, or alcohol rubs. These cool the skin, but
often make the situation worse by causing shivering, which raises the
core body temperature.
Here are some guidelines for taking medicine to lower a fever:
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Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) help reduce
fever in children and adults. Sometimes doctors advise you to use both
types of medicine.
Take acetaminophen every 4 - 6 hours. It works by turning down the
brain's thermostat.
Take ibuprofen every 6 - 8 hours. DO NOT use ibuprofen in children
younger than 6 months old.
Aspirin is very effective for treating fever in adults. DO NOT give
aspirin to a child unless your child's doctor tells you to.
Know how much you or your child weighs, and then always check the
instructions on the package.
In children under age 3 months, call your doctor first before giving
medicines.
Eating and drinking with a fever:
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Everyone, especially children, should drink plenty of fluids. Water,
popsicles, soup, and gelatin are all good choices.
Do not give too much fruit or apple juice and avoid sports drinks in
younger children.
Although eating foods with a fever is fine, do not force foods.
When to Contact a Medical Professional
Call a doctor right away if your child:
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Is younger than 3 months old and has a rectal temperature of 100.4 °F
(38 °C) or higher
Is 3 -12 months old and has a fever of 102.2 °F (39 °C) or higher
Is under age 2 and has a fever that lasts longer than 24 - 48 hours
Is older and has a fever for longer than 48 - 72 hours
Has a fever over 105 °F (40.5 °C), unless it comes down readily with
treatment and the person is comfortable
Has other symptoms that suggest an illness may need to be treated,
such as a sore throat, earache, or cough
Has been having fevers come and go for up to a week or more, even if
they are not very high
Has a serious medical illness, such as a heart problem, sickle cell
anemia, diabetes, or cystic fibrosis
Recently had an immunization
Has a new rash or bruises appear
Has pain with urination
Has trouble with the immune system (chronic steroid therapy, after a
bone marrow or organ transplant, spleen was removed, is HIVpositive, or is being treated for cancer)
Has recently traveled to a third world country
Go to the emergency room if you or your child has a fever and:
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Is crying and cannot be calmed down (children)
Cannot be awakened easily or at all
Seems confused
Cannot walk
Has difficulty breathing, even after their nose is cleared
Has blue lips, tongue, or nails
Has a very bad headache
Has a stiff neck
Refuses to move an arm or leg (children)
Has a seizure
Call your doctor right away if you are an adult and you:
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Have a fever over 105 °F (40.5 °C), unless it comes down readily with
treatment and you are comfortable
Have a fever that stays at or keeps rising above 103 °F
Have a fever for longer than 48 - 72 hours
Have had fevers come and go for up to a week or more, even if they
are not very high
Have a serious medical illness, such as a heart problem, sickle cell
anemia, diabetes, cystic fibrosis, COPD, or other chronic lung
problems
Have a new rash or bruises appear
Have pain with urination
Have trouble with your immune system (chronic steroid therapy, after
a bone marrow or organ transplant, had spleen removed, HIVpositive, were being treated for cancer)
Have recently traveled to a third world country