Children's Health

When Fever Strikes

Symptoms to Watch For

 Fever, Age 4 and Older

Fever is the body's normal and healthy reaction to infection and other illnesses, both minor and serious. It helps the body fight infection. Fever is a symptom, not a disease. In most cases, having a fever means you have a minor illness. When you have a fever, your other symptoms will help you determine how serious your illness is.

Temperatures in this topic are oral temperatures. Oral temperatures are usually taken in older children and adults.

Normal body temperature

Most people have an average body temperature of about 98.6°F (37°C), measured orally (a thermometer is placed under the tongue). Your temperature may be as low as 97.4°F (36.3°C) in the morning or as high as 99.6°F (37.6°C) in the late afternoon. Your temperature may go up when you exercise, wear too many clothes, take a hot bath, or are exposed to hot weather.

Fever temperatures

A fever is a high body temperature. A temperature of up to 102°F (38.9°C) can be helpful because it helps the body fight infection. Most healthy children and adults can tolerate a fever as high as 103°F (39.4°C) to 104°F (40°C) for short periods of time without problems. Children tend to have higher fevers than adults.

The degree of fever may not indicate how serious the illness is. With a minor illness, such as a cold, you may have a temperature, while a very serious infection may cause little or no fever. It is important to look for and evaluate other symptoms along with the fever.

If you are not able to measure your temperature with a thermometer, it is important to look for other symptoms of illness. A fever without other symptoms that lasts 3 to 4 days, comes and goes, and gradually reduces over time is usually not a cause for concern. When you have a fever, you may feel tired, lack energy, and may not eat as much as usual. High fevers are not comfortable, but they rarely cause serious problems.

Oral temperature taken after smoking or drinking a hot fluid may give you a false high temperature reading. After drinking or eating cold foods or fluids, an oral temperature may be falsely low.

Causes of fever

Viral infections, such as colds and flu, and bacterial infections, such as a urinary tract infection or pneumonia, often cause a fever.

Travel outside your native country can expose you to other diseases. Fevers that begin after traveling in other countries need to be evaluated by your health professional.

Fever and respiratory symptoms are difficult to evaluate during the flu season. A fever of 102°F (38.9°C) or higher for 3 to 4 days is common with the flu. For more information, see the topic Respiratory Problems, Age 12 and Older.

Recurrent fevers are those that occur 3 or more times within 6 months and are at least 7 days apart. Each new viral infection may cause a fever. It may seem that a fever is ongoing, but if 48 hours pass between fevers, then the fever is recurring. If you have frequent or recurrent fevers, it may be a symptom of a more serious problem. Talk to your doctor about your fevers.

Treating a fever
In most cases, the illness that caused the fever will clear up in a few days. You usually can treat the fever at home if you are in good health and do not have any medical problems or significant symptoms with the fever. Make sure that you are taking enough foods and fluids and urinating in normal amounts.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional

Emergencies

Do you have any of the following symptoms that require emergency treatment? Call your doctor or other emergency services immediately.

* Seizure. Note: If a fever seizure has occurred, see the topic Fever Seizures for immediate first aid treatment.

* Changed level of consciousness

* Sweating with any symptoms of a heart attack

* Signs of severe dehydration

* Signs of shock

* Signs of heatstroke

* Signs of moderate to severe difficulty breathing

* Drooling with trouble breathing occurs, or a child is not able to cry or make sounds. This can be caused by epiglottitis.


Home Treatment

 to become dehydrated when you have a fever. Watch for early signs of dehydration and drink extra fluids, especially water. Adults should drink at least 10 glasses of liquid a day to replenish lost fluids. Children between the ages of 4 and 10 should drink at least 6 to 10 glasses. You may feel better if you eat light, easily digested foods, such as soup.

Many people find that taking a lukewarm [80°F (27°C) to 90°F (32°C)] shower or bath makes them feel better when they have a fever. Do not try to take a shower if you are dizzy or unsteady on your feet. Increase the water temperature if you start to shiver. Shivering is a sign that your body is trying to raise its temperature. Do not use rubbing alcohol, ice, or cold water to cool your body.

Dress lightly when you have a fever. This will help your body cool down. Wear light pajamas or a light undershirt. Do not wear very warm clothing or use heavy bed covers. Keep room temperature at 70°F (21°C) or lower.

If you are unable to measure your temperature, you need to look for other symptoms of illness every hour while you have a fever and follow home treatment measures.

Sore Throat

Sore throats can be painful and annoying. Fortunately, most sore throats are caused by a minor illness and go away without medical treatment.

Several conditions can cause a sore throat.

Viral infections


Many sore throats are caused by a viral illness, such as:
The common cold, the most common type of viral infection.

* Infection of the voice box (laryngitis)

* Mononucleosis (mono, "the kissing disease"), a viral infection that tends to cause a persistent sore throat.

* Other viral infections, such as mumps, herpangina, or influenza.

Bacterial infections

A bacterial infection may also cause a sore throat. This can occur from:

* Strep throat, which usually does not occur with congestion or a cough.

* An inflammation or infection of the tonsils (tonsillitis) and sometimes the adenoids (adenoiditis).

* Inflammation of the epiglottis (epiglottitis).

* Inflammation of the uvula (uvulitis).

In rare cases, a sexually transmitted disease (STD), such as gonorrhea or chlamydia. If you have engaged in high-risk sexual behavior, consider whether gonorrhea or chlamydia may be present. For more information, see the topic Exposure to Sexually Transmitted Diseases.

Irritants and injuries


A sore throat that lasts longer than a week is often caused by irritants or an injuries, such as:

* Throat irritation from low humidity, smoking, air pollution, yelling, or nasal drainage down the back of the throat (postnasal drip).

* Breathing through the mouth when you have allergies or a stuffy nose.

* Stomach acid that backs up into the throat, which may be a symptom of gastroesophageal reflux disease (GERD). Although this often occurs with heartburn, an acid taste in the mouth, or a cough, sometimes a sore throat is the only symptom.

* An injury to the back of the throat, such as a cut or puncture from falling with a pointed object in the mouth.

* Chronic fatigue syndrome, a condition that causes extreme tiredness.

Treatment for a sore throat depends on the cause. You may be able to use home treatment to obtain relief.


Because viral illnesses are the most common cause of a sore throat, it is important not to use antibiotics to treat them. Antibiotics do not alter the course of viral infections. Unnecessary use of an antibiotic exposes you to the risks of an allergic reaction and antibiotic side effects, such as nausea, vomiting, diarrhea, rashes, and yeast infections. Antibiotics also may kill beneficial bacteria and encourage the development of dangerous antibiotic-resistant bacteria.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

Emergencies


Do you have any of the following symptoms that require emergency treatment? Call your doctor or other emergency services immediately.

* Moderate to severe difficulty breathing:

* In a child

* In an adult and older child

* Rapid swelling of the throat or tongue

* Drooling develops with difficulty breathing or the inability to cry or make sounds. This can be caused by epiglottitis.

Severe dehydration:

* In a child

* In an adult and older child

Home Treatment


Home treatment is usually all that is needed for a sore throat caused by a virus. These tips may help you feel better.

* Gargle with warm salt water to help reduce swelling and relieve discomfort:

* Gargle at least once each hour with 1 tsp (5 g) of salt dissolved in 8 fl oz (237 mL) of warm water.

* If you have postnasal drip, gargle often to prevent more throat irritation.

* Prevent dehydration. Fluids may help thin secretions and soothe an irritated throat. Hot fluids, such as tea or soup, may help decrease throat irritation.

* Use a vaporizer or humidifier in your bedroom.

* Warm or cool mist may help you feel more comfortable by soothing the swollen air passages. It may also relieve hoarseness. However, don't let your room become uncomfortably cold or very damp.

* Use a shallow pan of water to provide moisture in the air through evaporation if you don't have a humidifier. Place the pan in a safe location where no one will trip on it or fall into it.

* Do not smoke or use other tobacco products and avoid secondhand smoke. For more information, see the topic Quitting Tobacco Use.

* If you suspect that problems with stomach acid may be causing your sore throat, see the topic Heartburn.

* Consider taking nonprescription medicine for your symptoms.

* Use nonprescription throat lozenges.

* Some nonprescription throat lozenges, such as Sucrets Maximum Strength or Spec-T, are safe and effective and have medicine (local anesthetic) that numbs the throat to soothe pain.

* Regular cough drops may also help.

* Use a decongestant.

* Decongestants make breathing easier by shrinking swollen mucous membranes in the nose, allowing air to pass through. They also help relieve a runny nose and postnasal drip, which can cause a sore throat.

* Decongestants can be taken orally or used as decongestant nasal sprays. Oral decongestants (pills) are probably more effective and provide longer relief but may cause more side effects.

* Don't give decongestants to a child younger than 2 unless you've checked with the doctor first. If your child’s doctor tells you to give a medicine, be sure to follow what he or she tells you to do.

Back Pain

Low-Back Pain


Give your low back pain a day or two to work itself out before you call your doctor, unless you have signs of a severe illness, injury, or heart attack, as described below.


Call your doctor or other emergency services immediately if:

* You have back pain with chest pain. Always call 911 anytime you think you might have symptoms of a heart attack. Symptoms of a heart attack can include:

* Pain in the upper back with chest pain or discomfort that is crushing or squeezing or feels like a heavy weight on the chest.

Chest discomfort or pain that occurs with:

* Sweating.

* Shortness of breath.

* Nausea or vomiting.

* Pain that spreads from the chest to the back, neck, or jaw, upper belly, or one or both shoulders or arms. The left shoulder and arm are more commonly affected. See a picture of areas that may be affected by chest pain.

* Dizziness, lightheadedness, or feeling like you are going to faint.

* A fast, slow, or irregular heartbeat.

* You had a severe injury to your back. Signs of spinal injury include:

* New loss of bowel or bladder control.

* New weakness in the legs.

* New numbness or tingling in the buttocks, genital area, or legs.

* Moderate to severe pain following an injury to the back.

Note: If you suspect that someone has a spinal injury, don't move the person except to avoid an immediate threat, such as a fire. If there is immediate danger, keep the head, neck, and back supported and aligned while you move the person to safety.

Watchful Waiting

Most low back pain does not require a visit to a doctor. In general, pain should start to improve after 1 or 2 days of home treatment.

If you have pain that has not improved after 1 or 2 days and you are unable to do your normal daily activities, call your doctor.

If your mild to moderate low back pain has continued through at least 2 weeks of home treatment, talk with your doctor. He or she may want to check for problems that may be causing your back pain.

The following health professionals can diagnose the cause of back pain, evaluate back injuries, and start treatment:

Primary care provider such as:

Family medicine doctor

Internist

Nurse practitioner

Physician assistant

Orthopedic surgeon

Osteopathic doctor (osteopath)

Emergency medicine specialist

Chiropractor