Fever Treatment

Fever is a common symptom in children and often indicates an underlying infection or illness. In pediatric practice, it’s important to distinguish between mild fevers, which often resolve on their own, and those associated with more serious conditions that require intervention.

Understanding Fever in Children

• Normal Body Temperature: The average normal body temperature for a child is 98.6 degree F (37 degree C) when measured orally.
• Fever: A fever is typically defined as a body temperature of 38°C (100.4°F) or higher. It’s a common response of the body to infection or inflammation.

Common Causes of Fever in Children

Fever in children can be caused by a variety of conditions, from mild viral infections to serious bacterial infections. The cause is often determined by the child’s age, vaccination status, and other symptoms present.

Infectious Causes

Viral Infections:

• Common Cold (Rhinovirus): Mild fever, cough, runny nose, and sore throat.
• Flu (Influenza): Sudden high fever, body aches, chills, fatigue, cough, and sore throat.
• COVID-19: Fever, cough, loss of taste/smell, fatigue, and respiratory symptoms.
• Roseola (Sixth Disease): High fever followed by a rash when the fever subsides.
• Respiratory Syncytial Virus (RSV): Causes bronchiolitis in infants with a fever, wheezing, and respiratory distress.
• Hand, Foot, and Mouth Disease: Fever, sores in the mouth, and a rash on the hands and feet.
• Gastroenteritis: Often caused by rotavirus, resulting in fever, vomiting, and diarrhea.

Bacterial Infections:

• Urinary Tract Infection (UTI): Fever, irritability, and poor feeding in infants or dysuria and abdominal pain in older children.
• Pneumonia: Often caused by bacteria like Streptococcus pneumoniae, resulting in high fever, cough, and respiratory distress.
• Meningitis: Fever, headache, neck stiffness, and altered consciousness; a medical emergency.
• Otitis Media (Ear Infection): Fever, irritability, and ear pain.
• Sepsis: Severe infection with systemic symptoms, including high fever, rapid heart rate, and low blood pressure.
• Strep Throat: Fever, sore throat, and red spots on the throat.

Parasitic Infections:

• Malaria: Fever, chills, fatigue, and sweating, especially in children from endemic areas.
• Toxoplasmosis: Fever and flu-like symptoms, often associated with exposure to cats or undercooked meat.

Fungal Infections: Rare in children but can cause fever, especially in immunocompromised individuals.

Non-Infectious Causes

• Immunization: Fever is a common response to vaccination and typically occurs within 24-48 hours after receiving the vaccine (e.g., MMR, DTP).
• Teething: In infants, mild fever may occur as a result of the discomfort associated with the eruption of teeth.
• Autoimmune Conditions: Conditions like juvenile arthritis or lupus can cause prolonged fevers.
• Heat Exhaustion or Heatstroke: Elevated body temperature due to prolonged exposure to heat, often accompanied by dehydration.
• Drug Fever: Certain medications, including antibiotics or anticonvulsants, can cause a fever as an adverse reaction.

Symptoms Associated with Fever

In addition to an elevated body temperature, fever may be accompanied by the following symptoms, which can provide clues to the underlying cause:

• Behavioral Changes: Irritability, lethargy, and changes in feeding or sleep patterns.
• Respiratory Symptoms: Cough, runny nose, difficulty breathing, or wheezing.
• Gastrointestinal Symptoms: Vomiting, diarrhea, or abdominal pain.
• Rashes: Rash appearance can vary depending on the cause (e.g., roseola, hand-foot-mouth disease).
• Neck Stiffness or Headache: Could indicate meningitis or other serious infections.
• Pain: Localized pain, such as ear pain (otitis media), abdominal pain (UTI, gastroenteritis), or sore throat (strep throat).
• Severe Symptoms: Severe lethargy, poor feeding, inability to wake up, or difficulty breathing—these require immediate medical attention.

Treatment of Pediatric Fever

Treatment of fever in children primarily involves managing the underlying cause and providing symptomatic relief. Most fevers resolve on their own without requiring medication, but it’s essential to monitor the child closely and seek medical care when necessary.

General Measures

• Fluids: Keep the child hydrated, as fever can lead to fluid loss due to sweating. Offer clear fluids like water, electrolyte solutions, or breast milk for infants.
• Comfort Measures: Keep the child in a comfortable environment. Ensure they’re not overdressed or overheated, as this can worsen the fever.
• Rest: Encourage adequate rest, as the body needs energy to fight infections.