What is considered a true fever. How high can a fever safely go. When should you be concerned about a child’s fever. What are the most common misconceptions about fevers. How does the body’s temperature normally fluctuate throughout the day.

Defining Fever: What Temperature Constitutes a True Fever?

Many parents become alarmed when their child feels warm, but it’s crucial to understand what actually constitutes a fever. Contrary to popular belief, temperatures between 98.7°F and 100°F (37.1°C to 37.8°C) are not considered low-grade fevers. These are normal variations in body temperature.

A true fever is defined as a body temperature of 100.4°F (38°C) or higher. It’s important to note that body temperature naturally fluctuates throughout the day, typically being higher in the afternoon and evening. This natural variation is why it’s essential to interpret temperature readings in context.

How is fever measured in different body locations?

The method and location of temperature measurement can affect the reading. Here are the thresholds for fever based on measurement location:

• Rectal (bottom): 100.4°F (38°C) or higher
• Oral (mouth): 99.5°F (37.5°C) or higher
• Axillary (under the arm): 99°F (37.2°C) or higher

For adults, a temperature above 99°F to 99.5°F (37.2°C to 37.5°C) is generally considered a fever, depending on the time of day and other factors.

The Purpose of Fever: Friend or Foe?

One of the most pervasive myths about fever is that it’s inherently dangerous. In reality, fever serves an important protective function in the body. It’s a sign that the immune system is actively working to fight off an infection.

Fever helps combat pathogens by creating an environment that’s less hospitable to them. Most bacteria and viruses that cause infections in humans thrive at the normal body temperature of 98.6°F (37°C). By raising the body temperature, fever makes it more difficult for these pathogens to multiply.

Can fever cause brain damage?

A common concern among parents is that high fevers can cause brain damage. However, this fear is largely unfounded. Brain damage from fever is extremely rare and generally does not occur unless the fever exceeds 107.6°F (42°C). It’s worth noting that fevers caused by infections rarely reach this dangerous level without external factors like overdressing or exposure to high environmental temperatures.

Febrile Seizures: Understanding the Facts

Febrile seizures are another source of anxiety for many parents. While they can be frightening to witness, it’s important to understand that they’re generally not as dangerous as they appear.

Only about 4% of children experience febrile seizures with fever. These seizures typically last less than five minutes and do not cause long-term harm. Children who have had febrile seizures are not at increased risk for developmental delays or learning disabilities.

Are febrile seizures a sign of epilepsy?

Febrile seizures do not indicate that a child has epilepsy. They are a separate phenomenon related to the rapid rise in body temperature rather than a chronic seizure disorder. Most children who experience febrile seizures do not go on to develop epilepsy.

Treating Fever: When and How?

Another common misconception is that all fevers need to be treated with medication. In reality, fevers only need treatment if the child is uncomfortable. For young children, this usually means fevers over 102°F or 103°F (39°C or 39.4°C).

When treatment is given, it’s important to have realistic expectations. Fever-reducing medications like acetaminophen or ibuprofen typically lower the temperature by 2°F to 3°F (1.1°C to 1.7°C) but may not eliminate the fever entirely.

Is it harmful to leave a fever untreated?

Contrary to popular belief, there is no harm in not treating a fever. If the child is comfortable and able to rest, drink fluids, and engage in normal activities, treatment may not be necessary. The fever itself is not harmful and is actually helping the body fight off the infection.

Interpreting Fever: Beyond the Numbers

Many parents fixate on the exact temperature reading, believing that higher numbers indicate more serious conditions. However, pediatricians emphasize that how a child looks and behaves is far more important than the specific temperature reading.

A high fever doesn’t necessarily indicate a severe illness, especially if the child appears otherwise well. Conversely, a lower-grade fever doesn’t guarantee that the illness is mild. It’s the overall clinical picture that matters most.

Are there exceptions to this rule?

While the child’s overall appearance is generally more important than the exact temperature, there is one crucial exception: infants under 3 months of age. Due to their immature immune systems, any fever in this age group warrants immediate medical attention, regardless of how well the baby appears.

Fever Persistence: What It Does (and Doesn’t) Mean

A persistent fever that doesn’t respond well to treatment often causes concern. However, the ability to “break” a fever is not indicative of the severity of the underlying condition. Whether a fever comes down easily or persists does not reliably differentiate between viral and bacterial infections.

Similarly, the duration of a fever doesn’t necessarily correlate with the seriousness of the illness. Some minor viral infections can cause prolonged low-grade fevers, while some serious bacterial infections might cause only brief temperature elevations.

What are fevers of undetermined origin?

Fevers that persist for days or weeks without an apparent cause are termed “fevers of undetermined origin” (FUO). These can be challenging to diagnose and may require extensive testing to identify the underlying cause, which could range from infections to autoimmune diseases or even certain cancers.

Factors Influencing Body Temperature

Understanding fever requires recognizing that body temperature isn’t a static measurement. Various factors can influence an individual’s temperature, leading to fluctuations throughout the day.

1. Time of day: Temperature is typically highest in the evening and lowest in the early morning.
2. Menstrual cycle: Women may experience temperature increases of up to 1°F during the second half of their cycle.
3. Physical activity: Exercise and other strenuous activities can temporarily raise body temperature.
4. Emotional state: Strong emotions can cause slight increases in body temperature.
5. Environment: High room temperatures or humidity can affect body temperature.
6. Clothing: Heavy or insulating clothing can trap heat and raise body temperature.
7. Medications: Some drugs can affect the body’s temperature regulation.
8. Recent food or drink intake: Consuming hot or cold substances can temporarily influence temperature readings.

How do these factors impact fever assessment?

Given these various influences on body temperature, it’s important to consider the context when assessing for fever. A slightly elevated temperature after exercise or on a hot day may not indicate a true fever. Conversely, factors like time of day might mask a mild fever if not taken into account.

When to Seek Medical Attention for Fever

While most fevers are not cause for alarm, there are situations where medical attention is warranted. Understanding these scenarios can help parents make informed decisions about when to contact a healthcare provider.

• Infants under 3 months with any fever
• Children with fever lasting more than 3 days
• Fever accompanied by severe headache, stiff neck, or confusion
• Fever with difficulty breathing
• Fever in individuals with compromised immune systems
• Fever above 104°F (40°C) that doesn’t respond to treatment
• Fever accompanied by severe pain, particularly abdominal pain
• Fever with signs of dehydration (dry mouth, sunken eyes, decreased urination)

What information should you prepare when seeking medical advice for fever?

When contacting a healthcare provider about a fever, it’s helpful to have the following information ready:

1. The highest temperature recorded and how it was measured
2. How long the fever has lasted
3. Any other symptoms accompanying the fever
4. Any medications given and their effects
5. Recent exposures to illnesses or travel history
6. The child’s vaccination status
7. Any underlying health conditions

By providing this information, you can help your healthcare provider make a more accurate assessment and provide appropriate guidance.

Top 5 fever myths and facts

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For many parents, fever is one of the most concerning and alarming symptoms a child can have. There are many scary fever myths out there – and it’s time to set the record straight! To many pediatricians, fever is considered a good sign that the body is mounting a response to an infection. Here are my top five fever myths and facts:

Myth #1: Temperatures between 98.7°F and 100°F (37.1°C to 37.8°C) are low-grade fevers.

Fact: These temperatures are actually normal variations and are not fevers. The body’s temperature changes throughout the day and is naturally higher in the afternoon and evening. An actual fever is any temperature of 100.4°F or higher.

Myth #2: Fevers are bad, can cause brain damage or seizures and are dangerous to my child.

Fact: Fevers are a protective mechanism and a sign that the body’s immune system is turned on. Most fevers are good for sick children and help the body fight infection. Fevers do not cause brain damage. As for seizures, the vast majority (96 percent) of children do not have seizures with a fever. About 4 percent of children can have a seizure with a fever – this is called a febrile seizure. Febrile seizures are scary to watch, but they usually stop within five minutes. They do not cause brain damage or have long-term side effects. Children who have had febrile seizures are not at greater risk for developmental delays or learning disabilities.

Myth #3: All fevers need to be treated with fever medicine (such as acetaminophen or ibuprofen). After treatment, the fever should go away completely.

Fact: Fevers need to be treated only if the child is uncomfortable. For young children, that usually means fevers over 102°F or 103°F (39°C or 39.4°C). With treatment, fevers usually come down 2°F or 3°F (1.1°C or 1.7°C) but may not go away completely. There is no harm in not treating a fever.

Myth #4: The exact number of the temperature is very important. If the fever is high, the cause is serious.

Fact: How your child looks is what’s important, not the exact temperature. If the fever is high, the cause may or may not be serious. If your child looks very well, the cause is likely to be less serious. One exception is in babies who are less than 3 months of age. They should always be seen by a health care provider right away if they have a fever because their immune systems are not fully developed. If it’s the weekend and your baby spikes a fever, it’s best to call your doctor’s office and take them to an urgent care.

Myth #5: If the fever doesn’t come down (if you can’t “break the fever”), the cause is serious.

Fact: Whether a fever comes down or not, is not related to the seriousness of the infection. The height of the fever and how long it lasts does not tell us whether it is caused by a virus or bacteria. What matters most is how your child looks.

Author

Dr. Erica Wang, Texas Children’s Pediatrics – Grand Parkway

Departments

Texas Children’s Pediatrics

Fever: MedlinePlus Medical Encyclopedia

Fever is the temporary increase in the body’s temperature in response to a disease or illness.

A child has a fever when the temperature is at or above one of these levels:

• 100.4°F (38°C) measured in the bottom (rectally)
• 99.5°F (37.5°C) measured in the mouth (orally)
• 99°F (37.2°C) measured under the arm (axillary)

An adult probably has a fever when the temperature is above 99°F to 99.5°F (37.2°C to 37.5°C), depending on the time of day.

Normal body temperature may change during any given day. It is usually highest in the evening. Other factors that may affect body temperature are:

• A woman’s menstrual cycle. In the second part of this cycle, her temperature may go up by 1 degree Fahrenheit or more.
• Physical activity, strong emotion, eating, heavy clothing, medicines, high room temperature, and high humidity can all increase body temperature.

Fever is an important part of the body’s defense against infection. Most bacteria and viruses that cause infections in people thrive best at 98.6°F (37°C). Many infants and children develop high fevers with mild viral illnesses. Although a fever signals that a battle might be going on in the body, the fever is fighting for, not against the person.

Brain damage from a fever generally will not occur unless the fever is over 107.6°F (42°C). Untreated fevers caused by infection will seldom go over 105°F (40.6°C) unless the child is overdressed or in a hot place.

Febrile seizures do occur in some children. Most febrile seizures are over quickly and do not mean your child has epilepsy. These seizures also do not cause any permanent harm.

Unexplained fevers that continue for days or weeks are called fevers of undetermined origin (FUO).

Almost any infection can cause a fever, including:

• Bone infections (osteomyelitis), appendicitis, skin infections or cellulitis, and meningitis
• Respiratory infections such as colds or flu-like illnesses, sore throats, ear infections, sinus infections, mononucleosis, bronchitis, pneumonia, and tuberculosis
• Urinary tract infections
• Viral gastroenteritis and bacterial gastroenteritis

Children and adults may have a low-grade fever for 1 or 2 days after some immunizations.

Teething may cause a slight increase in a child’s temperature, but not higher than 100°F (37.8°C).

Autoimmune or inflammatory disorders may also cause fevers. Some examples are:

• Arthritis or connective tissue illnesses such as rheumatoid arthritis and systemic lupus erythematosus
• Ulcerative colitis and Crohn disease
• Vasculitis or periarteritis nodosa

The first symptom of a cancer may be a fever. This is particularly true of Hodgkin disease, non-Hodgkin lymphoma, and leukemia.

Other possible causes of fever include:

• Blood clots or thrombophlebitis
• Medicines, such as some antibiotics, antihistamines, and seizure medicines

A simple cold or other viral infection can sometimes cause a high fever (102°F to 104°F or 38.9°C to 40°C). This does not mean you or your child has a serious problem. Some serious infections don’t cause a fever or can cause a very low body temperature, most often 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:

• 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:

• Do not bundle up someone who has 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 effective after medicine 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:

• Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) help reduce fever in children and adults. Sometimes health care providers advise you to use both types of medicine.
• Take acetaminophen every 4 to 6 hours. It works by turning down the brain’s thermostat.
• Take ibuprofen every 6 to 8 hours. Do not use ibuprofen in children 6 months or younger.
• Aspirin is very effective for treating fever in adults. Do not give aspirin to a child unless your child’s provider tells you to.
• Know how much you or your child weighs. Then check the instructions on the package to find the correct dose.
• In children 3 months or younger, call your child’s provider first before giving medicines.

Eating and drinking:

• Everyone, particularly children, should drink plenty of fluids. Water, ice pops, soup, and gelatin are all good choices.
• In younger children do not give too much fruit juice or apple juice, and do not give sports drinks.
• Although eating is fine, do not force foods.

Contact a provider right away if your child:

• Is 3 months or younger and has a rectal temperature of 100.4°F (38°C) or higher
• Is 3 to 12 months old and has a fever of 102.2°F (39°C) or higher
• Is 2 years or younger and has a fever that lasts longer than 24 to 48 hours
• Is older and has a fever for longer than 48 to 72 hours
• Has a fever of 105°F (40. 5°C) or higher, 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 had fevers come and go for up to a week or more, even if these fevers 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
• Has pain with urination
• Has a weakened immune system (because of long-term [chronic] steroid therapy, a bone marrow or organ transplant, spleen removal, HIV/AIDS, or cancer treatment)
• Has recently traveled to another country

Contact your provider right away if you are an adult and you:

• Have a fever of 105°F (40.5°C) or higher, unless it comes down readily with treatment and you are comfortable
• Have a fever that stays at or keeps rising above 103°F (39. 4°C)
• Have a fever for longer than 48 to 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 long-term (chronic) lung problems
• Have a new rash or bruises
• Have pain with urination
• Have a weakened immune system (from chronic steroid therapy, a bone marrow or organ transplant, spleen removal, HIV/AIDS, or cancer treatment)
• Have recently traveled to another country

Call 911 or the local emergency number if you or your child has a fever and:

• Is crying and cannot be calmed (children)
• Cannot be awakened easily or at all
• Seems confused
• Cannot walk
• Has difficulty breathing, even after the 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

Your provider will perform a physical exam. This may include a detailed examination of the skin, eyes, ears, nose, throat, neck, chest, and abdomen to look for the cause of the fever.

Treatment depends on the duration and cause of the fever, as well as other symptoms.

The following tests may be performed:

• Blood tests, such as a CBC or white blood cell differential
• Urinalysis
• X-ray of the chest

Elevated temperature; Hyperthermia; Pyrexia; Febrile

• Colds and the flu – what to ask your doctor – adult
• Colds and the flu – what to ask your doctor – child
• Febrile seizures – what to ask your doctor
• When your baby or infant has a fever

• Thermometer temperature
• Temperature measurement

Leggett JE. Approach to fever or suspected infection in the normal host. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 264.

Nield LS, Kamat D. Fever. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 201.

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Fever

The state of the body, characterized by a rise in body temperature above normal, is called fever. Normally, the temperature of the human body is maintained at a level of about 37 ° C, however, in some (often infectious) diseases, a protective and adaptive reaction occurs, which is based on an increase in body temperature with the obligatory preservation of the thermoregulation mechanism. This property is a hallmark of fever from hyperthermia (overheating). Pyrogens cause fever – substances that enter the body during infection (exogenous pyrogens) or are formed by cells of the immune system as a result, for example, of inflammation (endogenous pyrogens).

Fever always passes in three stages:

1. Rise in temperature – blood vessels constrict, skin becomes pale, there is a feeling of chills, muscle tremors, metabolism in muscles increases. At this stage, heat production is much higher than heat transfer.
2. Temperature retention – the mechanisms of heat production and heat transfer are balanced – the temperature can be fixed for hours, days or weeks. Skin vessels dilate, the skin ceases to be pale and becomes hot to the touch, chills and trembling go away. At this time, a person experiences a feeling of heat.
3. Drop in temperature – either a sharp or gradual decrease in body temperature is possible. At this stage, heat transfer significantly exceeds heat production, profuse sweating occurs and diuresis increases. This stage begins in case of exhaustion of exogenous reserves or cessation of production of endogenous pyrogens.

There are several types of fever:

• Remittent (laxative) type is characterized by diurnal changes in temperature, which does not drop to normal;
• Intermittent (intermittent) type characterized by rapid diurnal fluctuations in temperature, which falls to normal and rises again;
• Constant fever – slight fluctuations in elevated temperature during the day;
• Relapsing fever – constantly elevated temperature for one or more days, then its reduction to normal and repeated increase;
• Perverse fever – a rise in temperature in the morning is characteristic;
• Incorrect fever – temperature fluctuation during the day occurs without any dependence.

Most often, fever indicates the presence of an infectious disease, but it can also be a symptom of cancer.

Fever is treated by identifying and eliminating the source of the infection. If necessary, fever is removed with the help of antipyretics: Nurofen, Aspirin . For children, Nurfen suspension , Panadol suppositories are recommended. Also, to reduce the temperature, you can use alcohol compresses or cold lotions, body wraps and immersion in a cold water bath.

Pankratova Evgenia Igorevna

The material is for informational purposes only. Medicinal products, biologically active supplements and other products are indicated as an example of their possible use and / or application, which in no way constitutes a recommendation for their use. Before using drugs, dietary supplements and medical equipment and other products, be sure to consult a specialist.

why fever is not just a high temperature and what is its danger

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VM Exclusives

December 01, 2022 19:16 Society

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Fever is a symptom of those diseases that provoke an increase in body temperature. However, in addition to high temperature, it has a number of features and negative consequences. Vechernyaya Moskva discussed with experts what a fever is and why it can be dangerous.

Fever is

According to Andrey Kondrakhin, a general practitioner, a fever is an increase in body temperature.

— This condition can occur for various reasons, but most often these are infectious diseases that trigger pathological processes in the body and increase body temperature, — the doctor explained.

In turn, physician Viktor Lishin added that fever includes a combination of symptoms:

— This is a whole complex of symptoms that is accompanied by headache, body aches, redness of the skin, changes in vision, sweating, increased heart rate, decreased appetite.

Also, according to the specialist, fever can cause a general intoxication syndrome, which is accompanied by trembling in the body, confusion of thoughts and partial loss of orientation.

Is it possible to replace some antibiotics with others if the required medicine is not in the pharmacy

Is it possible to replace one antibiotic with others if the necessary medicine is not in the pharmacy

Types of fever

Kondrakhin identified three types of fever:

• Sofebrile – up to 38 degrees.