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Fever, Facts and Phobia

We get a lot of questions about fever this time of year so it’s good to review it now. Fever is a response to something and in and of itself almost never going to be harmful. We define fever as 100.5 or greater, as a rectal, ear, temporal artery or under the tongue measure. There are two circumstances where fever can cause problems, first it it gets to 105 or higher and, second if it occurs in a child who gets seizures from fever. Those are really rare events and the vast majority of times the focus should be on identifying the cause of the fever rather than the fever itself.

By far, the most common reason for fever is an infection. The two major types are caused by viruses, which the immune system can usually handle, and bacterial infections where we use antibiotics to assist the immune system in curing the problem. Examples of viral infections include the cold and flu family and illnesses like mono, enterovirus and thousands of others. Examples of bacterial infections would be Strep throat, skin infections like impetigo or abcesses, ear infections and urinary tract infections.

Our job if we can, is to identify the cause and treat it if possible. We know that can be hard and sometimes we have to make judgement calls based on probability rather than certainty. In some circumstances there just isn’t enough evidence to be ¬†absolutely sure about the cause.

Some research suggests that fever should be allowed to occur because it may be part of the immune response. We generally advise you to reduce the fever if your child is really miserable as a result or if they are prone to seizures. There is no urgency in getting the temp down to normal if you have tried with Motrin or Tylenol without complete resolution.

Persistance of fever may warrant a diagnostic evaluation that might include blood tests, urine  samples or X rays to delve deeper into the causative agent.

The bottom line is that you don’t need to fear fever, it is there to alert you to a problem and in a sense a valuable warning sign. It is really important to remember that lack of fever is not always a sign of wellness and if you think your child is ill we need to know about it.