Fever Instructions – Pediatric Associates of Madison

DEFINITION Your child has a fever if any of the following apply:

• Rectal temperature is over 100.4° F (38.0° C).
• Oral temperature is over 100.4° F (38.0° C).
• Axillary (armpit) temperature is over 99.4° F (37.5° C)
• Ear (tympanic) and temporal temperatures are not as accurate and should not be used in children less than 6 months.

The body’s average temperature when it is measured orally is 98.6° F (37.0° C), but it normally fluctuates during the day. Mild elevation (100.4° to 101.3° F or 38° to 38.5° C) can be caused by exercise, excessive clothing, a hot bath, or hot weather. Warm food or drink can also raise the oral temperature. If you suspect such an effect on the temperature of your child, take his or her temperature again in one-half hour.

Causes


Fever is a symptom, not a disease. Fever is the body’s normal response to infections and plays a role in fighting them. Fever turns on the body’s immune system. The usual fevers (100° to 104° F [37.8° to 40° C]) that all children get are not harmful. Most are caused by viral illnesses; some are caused by bacterial illnesses. Teething does not cause fever.

Expected Course


Most fevers with viral illnesses range between 101° and 104° F (38.3° to 40° C) and last for 2 to 3 days. In general, the height of the fever does not relate to the seriousness of the illness. How sick your child acts is what counts. Fever causes no permanent harm until it reaches 107° F (41.7° C). Fortunately, the brain’s thermostat keeps untreated fevers below this level.

HOME CARE:

Treat All Fevers with Extra Fluids and Less Clothing

. Encourage your child to drink extra fluids, but do not force him or her to drink. Popsicles and iced drinks are helpful. Body fluids are lost during fevers because of sweating.

Clothing should be kept to a minimum because most heat is lost through the skin. Do not bundle up your child; it will cause a higher fever. During the time your child feels cold or is shivering (the chills), give him or her a light blanket.

Acetaminophen Products for Reducing Fever.

Children older than 2 months of age can be given any one of the acetaminophen products. Remember that fever is helping your child fight the infection. Use drugs only if the fever is over 102° F (39° C) and preferably only if your child is also uncomfortable. Give the correct dosage for your child’s age every 4 to 6 hours, but no more often.

Two hours after they are given, these drugs will reduce the fever 2° to 3° F (1° to 1. 5° C). Medicines do not bring the temperature down to normal unless the temperature was not very elevated before the medicine was given. Repeated dosages of the drugs will be necessary because the fever will go up and down until the illness runs its course. If your child is sleeping, don’t awaken him for medicines.

Caution: The dropper that comes with one product should not be used with other brands. Dosages of Acetaminophen.

Avoid Aspirin


The American Academy of Pediatrics has recommended that children (through 21 years of age) not take aspirin if they have chickenpox or influenza (any cold, cough or sore throat symptoms). This recommendation is based on several studies that have linked aspirin to Reye’s syndrome, a severe encephalitis-like illness. Most pediatricians have stopped using aspirin for fevers associated with any illness.

Alternating Acetaminophen and Ibuprofen


If you are instructed by your physician to alternate both products, do it as follows:

• Use both if the fever is over 104° F (40° C) and unresponsive to one medicine alone.
• Give a fever medicine every 4 hours (acetaminophen every 8 hours and ibuprofen every 8 hours).
• Only alternate medicines for 24 hours or less, than return to a single product.

Beware of dosage errors and poisoning (especially if you give one or both products too frequently).

Sponging


Sponging is usually not necessary to reduce fever. Never sponge your child without giving him/her acetaminophen or ibuprofen first. Sponge immediately only in emergencies such as heatstroke, delirium, a seizure from fever, or any fever over 106° F (41.1° C). In other cases, sponge your child only if the fever is over 104° F (40° C), the fever stays that high when you take the temperature again 30 minutes after your child has taken acetaminophen or ibuprofen, and your child is uncomfortable. Until the acetaminophen or ibuprofen has taken effect (by resetting the body’s thermostat to a lower level), sponging will just cause shivering, which is the body’s attempt to raise the temperature.

If you do sponge your child, sponge him/her in lukewarm water (85° to 90° F [29° to 32° C]). Sponging works much faster than immersion, so sit your child in 2 inches of water and keep wetting the skin surface. Cooling comes from evaporation of the water. If your child shivers, raise the water temperature or wait for the acetaminophen or ibuprofen to take effect. Do not expect to get the temperature below 101° F (38.3° C). Do not add rubbing alcohol to the water; it can be breathed in and cause a coma.

Call our office immediately if:

• Your child is less than 3 months old and has a fever.
• The fever is over 105° F (40. 6° C).
• Your child looks or acts very sick.
  

Call our office within 24 Hours if:

• Your child is 3 to 6 months old.
• The fever is between 104° and 105° F (40° to 40.6° C), especially if your child is less than 2 years old.
• Your child has had a fever more than 24 hours without an obvious cause of location of infection.
• Your child has had a fever more than 3 days.
• The fever went away for more than 24 hours and then returned.
• You have other concerns or questions.

Symptoms, treatment, and when to seek help

A fever is a part of the body’s protective response to illness. When certain pathogens, such as bacteria and viruses, enter the body, the immune system signals the body to increase its temperature in an attempt to destroy them.

However, severe illness can cause the mechanisms that maintain a normal body temperature to go awry, and the results can lead to extremely high temperatures that can be life-threatening.

This article will discuss how a fever affects an adult’s body and when it is cause for concern.

If a person is concerned about a fever or how they feel overall, they should talk to a doctor.

Share on PinterestDoctors consider a temperature above 104°F (40°C) to be a high-grade fever.

As a general rule, adults should consider seeking medical attention if their temperature reaches above 104 °F (40°C). Doctors consider this temperature to be a high-grade fever.

However, a fever is not the only symptom a person has when they are ill. A person should consider other symptoms, such as vomiting, breathing issues, confusion, or how they feel overall when deciding whether they need medical attention.

Doctors categorize a fever by the reading on the thermometer, how long the fever lasts, and whether it keeps going up and down.

Normal body temperature can fluctuate. According to a 2019 systematic review, typical body temperatures vary according to a person’s age, and whether they take their temperature orally or rectally. The table below indicates a range of normal body temperatures.

It is important to note that temperatures can fluctuate. A normal rectal body temperature ranges from 98.6–100.4°F.

The following are the classifications of body temperature ranges, according to an article in the Journal of Infection and Public Health:

• Mild or low-grade fever: 100. 4–102.2°F (38–39°C)
• Moderate grade fever: 102.2–104.0°F (39°C–40°C)
• High-grade fever: 104.1–106.0°F (40°C–41.1°C)

These temperature values are rectal measurements, which doctors consider the most accurate.

However, the article also emphasizes that doctors can better diagnose a person’s condition by considering their other symptoms rather than the severity of their temperature.

Sustained or continuous fever

A sustained fever is when a person has a temperature above normal that does not fluctuate by more than 1.5°F (1°C) for 24 hours.

Causes may include:

• Gram-negative bacteria: These are bacteria that can cause pneumonia, bloodstream infections, and surgical site infections.
• Typhoid: Typhoid is a bacterial infection that can cause fever.
• Acute bacterial meningitis: This is a severe infection that requires emergency medical help.
• Urinary tract infection (UTI): Cystitis is an infection of the bladder, and urethritis is an infection of the urethra.

Intermittent fever

An intermittent fever occurs when a person experiences a raised temperature for several hours a day. The temperature then goes back to normal before spiking again.

Common causes may include:

• Malaria: This is an infection that some mosquitoes transmit.
• Tuberculosis (TB): This is an infection of the lungs.
• Lymphoma: This is a form of cancer that begins in the cells.
• Sepsis: This occurs when the body has an extreme reaction to an infection.

Remittent fever

This is a daily fever that is always higher than normal but may fluctuate as much as 3.6°F (2°C) throughout the day.

Common causes may include:

• Infective endocarditis: This is an infection of the endocardium, which is the membrane that lines the inside of the heart.
• Rickettsiae infections: This is an infection transmitted by ticks, mites, and lice.

People who experience an internal temperature of 104°F (40°C) and higher for prolonged periods can develop hyperthermia. For this reason, it is essential to try to keep a fever from becoming too high.

Potential complications from a high-grade fever can include:

• seizures
• unsteadiness
• unconsciousness
• lethargy
• coma

A high-grade fever can also cause cognitive dysfunction, which affects a person’s memory, comprehension, reasoning, and problem-solving ability. Some people may also have difficulty paying attention.

Typically, these symptoms are only temporary, and most people recover. However, in extreme circumstances, some people experience permanent changes.

Fever is a common symptom of the novel coronavirus, known as COVID-19.

According to a study published in the New England Journal of Medicine in February 2020, data on 1,099 people in China who had COVID-19 showed that 43. 8% had a fever on admission to the hospital. An estimated 88.7% developed a fever during their hospitalization.

The authors defined a fever as an axillary (armpit) temperature of 99.8°F (37.7°C) or higher.

Other symptoms include:

• a cough
• shortness of breath
• nausea
• vomiting
• diarrhea

If a person suspects they may have COVID-19, they should call a doctor or health department for further testing.

For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.

A low-grade fever can be the body’s protective measure. Scientists are still in debate whether a person should treat a low-grade fever.

However, if a person does have a fever or does not feel well, they could take fever-reducing medications, such as:

• acetaminophen
• ibuprofen
• aspirin

As a fever is typically a symptom of another condition, a person may require different treatments depending on the cause.

If a person has an underlying bacterial illness, a doctor may prescribe antibiotics. These can treat the infection, which can help reduce fever.

Other steps a person can take to make themselves more comfortable include resting, drinking plenty of fluids, wearing loose clothing, and taking cool or lukewarm baths.

There are some steps a person can take to help prevent getting a fever:

• Always cover the mouth and nose when sneezing and wash hands immediately after sneezing or coughing.
• Refrain from sharing personal items, such as utensils, cups, and even toothbrushes.
• Try not to touch the face. A person can easily transmit the pathogen from their face to their nose or mouth, which might allow the germs to enter the body.
• Avoid contact with people who are sick. This can help prevent the transmission of illness.
• Maintain good hygiene. Washing hands may help prevent bacteria and viruses from spreading.

Learn more about washing hands properly here.

A fever is a protective mechanism for the body as the immune system works to fight against illness in a variety of ways.

If a person feels very unwell in addition to having a fever or they are already immunocompromised due to pre-existing conditions, they should seek medical attention.

A person should also see their doctor if they have tried to control their fever at home, but over-the-counter medicines and other treatments are ineffective.

A fever can become dangerous if it reaches 104°F (40°C) or higher.

Taking Your Premature Baby Home from the NICU

Discharge Instructions: Taking Your Premature Baby Home from the NICU

Most premature babies can be taken home if they:

• Keep body temperature stable in open bed

• Completely transitioned to breastfeeding or bottle feeding

• Get enough calories to gain weight

What should I do before taking my child home?

• Make sure you have a car seat that is suitable for transporting premature babies. This should be a rear-facing seat with rigid straps. The child’s head must be fixed in such a way that it does not sway forward or sideways. You may be asked to bring your car seat to the hospital a few days before discharge so they can check if it is suitable for your child.

• Make an appointment with your child’s primary care physician.

• If your child needs any equipment at home, you must discuss this with the doctor or home health care provider prior to discharge.

• Sign up for a CPR course for infants.

Special measures to keep premature babies safe at home

By the time premature babies are ready to be discharged, they are practically no different from normal babies. However, there are some things you should be extra careful about:

• Protect your child from infections. Wash your hands regularly with soap. This also applies to anyone who takes care of the child. Limit your child’s contact with strangers and avoid busy public places. If someone in the house gets sick, try to limit that person’s contact with the child.

• Make your home and car smoke-free. If anyone in your household smokes, they should quit immediately. Guests and household members who are unable or unwilling to quit should only smoke outdoors, away from doors and windows.

• If your child has a apnea alarm, make sure you can hear it anywhere in the house.

• Don’t be afraid to take your baby outdoors, but avoid prolonged exposure to drafts and direct sunlight.

When to call the doctor

Call the neonatal intensive care unit if you have any questions about your discharge instructions. Contact your pediatrician or your family doctor if:

• The child has a fever

  • Rectal temperature is 38.0 ºC (100.4 °F) or higher in a child less than 3 months old

  • Rectal temperature is 39.0 ºC (102 ºF) or higher in a child aged 3-36 months

  • A child of any age has a fever of 40.0 ºC (104 ºF) or more

  • Fever lasts more than 24 hours in a child under 2 years of age or more than 3 days in a child over 2 years of age.

  • The child has convulsions caused by fever

• Child temperature below 36.4 °C (97.5 °F)

• The child has poor appetite

• Baby wets diaper less than 5 times a day

• The child has difficulty breathing

• The child is extremely agitated

• The child looks lethargic and overworked

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

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Legionella pneumophila, antigen test, urine

Method of determination
Immunochromatographic (Legionella pneumophila serogroup 1 antigen is determined)

Test material
Urine

Test designed to detect Legionella pneumophila serogroup 1 antigen in urine samples.

Legionellosis – caused by the pathogen Legionella pneumophila, this is an acute respiratory disease accompanied by fever (Pontiac fever) and proceeds as an acute respiratory viral infection and pneumonia (legionnaires’ disease) that occurs when inhaling a fine aerosol of water infected with the pathogen at a concentration of 104 or more microbial cells in 1 liter. Legionella actively colonize hot and cold water systems, centralized water-cooled air conditioning systems, cooling towers, whirlpools and public hot tubs, humidifiers, and fountains. At the onset of the disease, fever, complaints of a dry, unproductive cough, severe headaches, myalgia, stabbing chest pains, and shortness of breath are characteristic. The fever period usually lasts 10-15 days. In 25% of patients in the initial period, there is a lesion of the gastrointestinal tract – nausea, vomiting, abdominal pain, diarrhea. In 20–30% of patients, acute respiratory failure rapidly develops, requiring respiratory support. In severe cases, the symptoms of encephalopathy are determined: impaired consciousness, disorientation, dysarthria, cerebellar disorders. The kidneys are affected secondarily. The mortality rate as a result of the disease varies from 25% to 40% and can be reduced with timely diagnosis and early administration of appropriate antimicrobial therapy.

Known risk factors, which include immunosuppression, tobacco smoking, excess alcohol consumption and concomitant lung diseases, are usually more susceptible to infection – children and the elderly.

Modern methods of laboratory diagnosis of pneumonia caused by Legionella pneumophila require the collection of samples from the respiratory tract (ie, expectorated sputum, bronchial washings, transtracheal aspirate, lung biopsy) or the study of paired sera (in the acute stage of the disease and after recovery). All this involves either obtaining an adequate sample of material from the lungs to ensure sufficient sensitivity, or collecting serum at intervals of two to six weeks.