Fever 101

We get a lot of questions about fever this time of year so it’s good to review it now. First, don’t forget that fever is a response to a stimulus and it’s almost never 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, if it gets to 105 or higher, and second if it occurs in a child who gets seizures from fever. Those are rare events. The focus should always 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 and bacteria. Viral infections are handled by the immune system. With bacterial infections, we use antibiotics to assist the immune system in curing the problem. Examples of viral infections include covid, cold and flu, mono, enterovirus, and thousands of others. Examples of bacterial infections would be Strep throat, skin infections like impetigo or abscesses, ear infections, and urinary tract infections.

Our job is to identify the cause and treat it if possible. We know that can be hard and sometimes we have to make judgment 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 Motrin or Tylenol. Remember it’s not harmful.

The persistence of fever may warrant a diagnostic evaluation that might include blood tests, urine samples or X-rays to determine the cause.

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