FEVER

Possible Cause

Fever occurs when an area in your brain called the hypothalamus also known as your body's "thermostat" — shifts the set point of your normal body temperature upward. When this happens, you may feel chilled and add layers of clothing or wrap up in a blanket, or you may shiver to generate more body heat, eventually resulting in an elevated body temperature.

Normal body temperature varies throughout the day — it's lower in the morning and higher in the late afternoon and evening. Although most people consider 98.6 F (37 C) normal, your body temperature can vary by a degree or more — from about 97 F (36.1 C) to 99 F (37.2 C) — and still be considered normal. Factors such as your menstrual cycle or heavy exercise can affect your temperature.

Fever or elevated body temperature might be caused by:

• A virus
• A bacterial infection
• Heat exhaustion
• Extreme sunburn
• Certain inflammatory conditions such as rheumatoid arthritis — inflammation of the lining of your joints (synovium)
• A malignant tumor
• Some medications, such as antibiotics and drugs used to treat high blood pressure or seizures
• Some immunizations, such as the diphtheria, tetanus and acellular pertussis (DTaP) or pneumococcal vaccine

Sometimes the cause of a fever can't be identified. If you have a temperature of 101 F (38.3 C) or higher for more than three weeks and your doctor isn't able to find the cause after extensive evaluation, the diagnosis may be fever of unknown origin.

Complications

Complications of a fever may include:

• Severe dehydration
• Hallucinations
• Fever-induced seizure (febrile seizure), in a small number of children ages 6 months to 5 years
• Febrile seizures
• Febrile seizures usually involve loss of consciousness and shaking of limbs on both sides of the body. Although alarming for parents, the vast majority of febrile seizures cause no lasting effects.

If a seizure occurs:

Most seizures stop on their own. Take your child to the doctor as soon as possible after the seizure to determine the cause of the fever.

Call for emergency medical assistance if a seizure lasts longer than 10 minutes.

• Lay your child on his or her side or stomach on the floor or ground
• Remove any sharp objects that are near your child
• Loosen tight clothing
• Hold your child to prevent injury
• Don't place anything in your child's mouth or try to stop the seizure

Care and Treatment

You may be able to prevent fevers by reducing exposure to infectious diseases. Here are some tips that can help:

• Wash your hands often and teach your children to do the same especially before eating, after using the toilet, after spending time in a crowd or around someone who's sick, after petting animals, and during travel on public transportation.
• Show your children how to wash their hands thoroughly, covering both the front and back of each hand with soap and rinsing completely under running water.
• Carry moist towelettes or hand sanitizer with you for times when you don't have access to soap and water.
• Try to avoid touching your nose, mouth or eyes as these are the main ways that viruses and bacteria can enter your body and cause infection.
• Cover your mouth when you cough and your nose when you sneeze and teach your children to do likewise. Whenever possible, turn away from others when coughing or sneezing to avoid passing germs along to them.
• Avoid sharing cups, water bottles and utensils with your child or children.

When to Call the Doctor

Fevers by themselves may not be a cause for alarm — or a reason to call a doctor. Yet there are some circumstances when you should seek medical advice for your child or yourself.

Taking a temperature

To check your or your child's temperature, you can choose from several types of thermometers, including oral, rectal, ear (tympanic) and forehead (temporal artery) thermometers.

Although it's not the most accurate way to take a temperature, you can use an oral thermometer for an armpit (axillary) reading:

• Place the thermometer in the armpit and cross your arms or your child's arms over the chest.
• Wait four to five minutes. The axillary temperature is slightly lower than an oral temperature.
• If you call your doctor, report the actual number on the thermometer and where on the body you took the temperature.

Use a rectal thermometer for infants:

• Place a dab of petroleum jelly on the bulb.
• Lay your baby on his or her tummy.
• Carefully insert the bulb 1/2 to 1 inch into your baby's rectum.
• Hold the bulb and your baby still for three minutes.
• Don't let go of the thermometer while it's inside your baby. If your baby squirms, the thermometer could go deeper and cause an injury.

Infants

An unexplained fever is greater cause for concern in infants and in children than in adults. Call your baby's doctor if your child is:

• Younger than age 3 months :and has a rectal temperature of 100.4 F (38 C) or higher.
• Between ages 3 to 6 month: and has a temperature up to 102 F (38.9 C) and seems unusually irritable, lethargic or uncomfortable or has a temperature higher than 102 F (38.9 C).
• Between ages 6 to 24 months: and has a temperature higher than 102 F (38.9 C) that lasts longer than one day but shows no other symptoms. If your child also has other signs and symptoms, such as a cold, cough or diarrhea, you might call your child's doctor sooner based on severity.
• A newborn and has a lower than normal temperature: less than 97 F (36.1 C). Very young babies may not regulate body temperature well when they're ill and may become cold rather than hot.

When in doubt, go ahead and call your child's doctor, whether you think your baby's temperature is abnormally high or abnormally low.

Children

There's probably no cause for alarm if your child has a fever but is responsive — making eye contact with you and responding to your facial expressions and to your voice — and is drinking fluids and playing.

Call your doctor if your child:

• Is listless or irritable: vomits repeatedly, has a severe headache or stomachache, or has any other symptoms causing significant discomfort.
• Has a fever: after being left in a hot car. Seek medical care immediately.
• Has a fever: that lasts longer than three days (in children age 2 and older).
• Appears listless: and has poor eye contact with you.

Ask your child's doctor for guidance in special circumstances, such as a child with immune system problems or with a pre-existing illness. Your child's doctor may also recommend precautions if your child has just started taking a new prescription medicine.

Adults (Call your doctor if):

• Your temperature is 103 F (39.4 C) or higher
• You've had a fever for more than three days

In addition, seek immediate medical attention if any of these signs or symptoms accompanies a fever:

• Severe headache
• Severe throat swelling
• Unusual skin rash, especially if the rash rapidly worsens
• Unusual sensitivity to bright light
• Stiff neck and pain when you bend your head forward
• Mental confusion
• Persistent vomiting
• Difficulty breathing or chest pain
• Extreme listlessness or irritability
• Abdominal pain or pain when urinating
• Muscle weakness or sensory changes, which might indicate a problem with your nerves, spinal cord or brain function (focal neurologic deficit)
• Seizure
• Any other unexplained signs or symptoms