Fever remains the most common concern prompting parents to present their child to the emergency department. Fever has traditionally been defined as a rectal temperature over 100.4 F or 38 C. Temperatures measured at other body sites are usually lower. The threshold for defining a fever does vary significantly among different individuals, since body temperatures can vary by as much as 1 F. Low-grade fevers are usually considered less than 102.2 F (39 C).
Fever itself is not life-threatening unless it is extremely and persistently high, such as greater than 107 F (41.6 C) when measured rectally. Risk factors for worrisome fevers include age under 2 years (infants and toddlers) or recurrent fevers lasting more than one week. Fever may indicate the presence of a serious illness, but usually a fever is caused by a common infection. However, many conditions other than infections may cause a fever.
Call your doctor if:
Call a child's doctor if any of the following are present with fever.
- The child is younger than 6 months of age (regardless of prematurity).
- One is unable to control the fever.
- One suspects a child may become dehydrated from vomiting, diarrhea, or not drinking (for example, the child has sunken eyes, dry diapers, tented skin, cannot be roused, etc.).
- The child has been to a doctor but is now getting worse or new symptoms or signs have developed.
Tips for helping your child with a fever:
- When giving fever medication follow the dosage and frequency instructions printed on the label. Please consult your pharmacist or doctor before giving a dose.
- Do not use aspirin to treat fever in children, especially for a fever with chickenpox or other viral infection. Aspirin has been linked to liver failure in some children.
- A sponge bath in warm water will help reduce a fever.
- Children should not be overdressed indoors, even in winter.
- To prevent dehydration, give the child clear fluids
Reference:
Chiappini, E., N. Principi, R. Longhi, P.A. Tovo, P. Becherucci, F. Bonsignori, et al. "Management of Fever in Children: Summary of the Italian Pediatric Society Guidelines." Clin Ther 31 (2009): 1826-1843.
Enarson MC, Ali S, Vandermeer B, Wright RB, Klassen TP, Spiers JA. Beliefs and expectations of Canadian parents who bring febrile children for medical care. Pediatrics. 2012 Oct 1;130(4):e905-12.
Pierce, C.A., and B. Voss. "Efficacy and Safety of Ibuprofen and Acetaminophen in Children and Adults: A Meta-analysis and Qualitative Review." Ann Pharmacother44 (2010): 489-506.
Sullivan JE, Farrar HC. Fever and antipyretic use in children. Pediatrics. 2011 Mar 1;127(3):580-7.
Tolan Jr., R.W. "Fever of Unknown Origin: A Diagnostic Approach to This Vexing Problem." Clin Pediatr (Phila) 49 (2010): 207-213.