FEVER IN CHILDREN

What Is Fever? Fever is when the body's temperature is above its normal level of around 37.0^oC (98.6^oF). The body's normal temperature does fluctuate throughout the day between 36.1^oC (97^oF) to 37.4^oC (99.3^oF), being lower in the morning and higher in the evening. A temperature higher than 38^oC (100.4^oF) measured rectally, higher than 37.8^oC (100.0^oF) measured orally or in the ear, and higher than 37.2^oC (99.0^oF) measured under the arm are all values which are considered above normal. A fever is a sign that an infection or illness is present in the body. One natural defense mechanism of the human body to fight against the infection or illness is to raise the body temperature. Because fever signals that there is some underlying physiologic disturbance, it is important to determine the cause of the fever.

What Causes Fever? Fever occurs when the body senses the presence in the blood of small molecules known as "pyrogens". Pyrogens are produced by cells of the immune system in reaction to either bacteria, viruses, toxic substances, etc. Pyrogens disturb the central nervous system's regulation of body temperature, resulting in an elevation of body temperature. The most common causes of fever in children are viral or bacterial infections. Viral illnesses associated with fever include the 'flu (caused by the influenza virus) and the common cold (often caused by rhinoviruses and coronaviruses). Bacterial illnesses associated with fever include bacterial meningitis, pneumonia, local skin infections, ear infections, strep throat, and urinary tract infections.

What Are Some Of The Signs And Symptoms Of Fever? As mentioned before fever is best defined by an elevated body temperature measured by a thermometer. Fever can be associated with dehydration due to excessive sweating and inadequate hydration. If the cause is an infection the child may have a loss of appetite with vomiting and diarrhea. In children between 6 months and 6 years, febrile convulsions may occur.

What Are Other Causes of Fever? While most causes of fever are from an infection, there are other causes that are not infectious. These include sickle cell crises in sickle cell disease, a flare up in ulcerative colitis, autoimmune diseases such as collagen disorders, and a malignancy such as Hodgkin's lymphoma. A recent immunization could also cause fever. Some reports have indicated that teething can also cause fever. However, make sure you rule out other, more serious causes before accepting teething as a cause of your child's fever.

What Can You Do For Fever? Dress your child lightly and do not overheat the room your child is in. Make sure that you prevent dehydration by providing plenty of liquids. Sponge baths using room temperature water might make your child more comfortable. However, avoid alcohol or cold water baths as these are not beneficial. If there is significant discomfort from the fever you might like to give the appropriate dose of acetaminophen (i.e. Tylenol). Aspirin is not recommended because of its association with Reye's syndrome, a rare but often fatal illness. If your child is less than 3 months old, or if the fever persists for more than 24 hours without an obvious cause, or if you have any concerns, call your doctor immediately.