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Fever in Children - Danger Signs

Dr. Parang Mehta, MD.

Fever is a protective mechanism of our body, and helps the defense systems to fight the infections that cause fever.  It is a sign that all is not right with the child, that some disease process is ongoing.  Most episodes of fever in children resolve quickly and completely, with minimal treatment.  However, some episodes of fever are caused by a serious disease.

A serious disease is one that can progress without treament, and may cause death or a permanent harmful effect.  In the context of fever, most such diseases are infections.  Mild infections like a sore throat, a cold, or a viral fever are common, and usually last a few days only.  However, other infections are serious, affect vital organs and systems, and require quick and effective treatment for successful resolution.

Fever Terms

Fever: Rectal temperature of 38 degrees C (100.4 degrees F) or greater.  Temperature measurements in the mouth, armpit, or ear canal are not considered as reliable.

Serious bacterial infection: Meningitis, sepsis, bone and joint infections, urinary tract infections, pneumonia, enteritis

Toxic appearance: A term generally taken to indicate a seriously ill child.  A somewhat vague concept, but now taken to mean a child with some or all of the following -- lethargy, poor blood flow, blueness of lips or fingers, and slow or fast breathing.

Lethargy: Poor or absent eye contact, poor recognition or response to parents, no interest in people or objects around the child.

Dangerous Situations for Fever

Fever in children should never be taken lightly, because a small percentage of children have a serious infection.  The danger is higher under certain situations.  Children in these situations are in danger of serious or progressive diseases, and need aggressive laboratory testing and treatment.

• High fever.  In general, children with higher fever are more likely to have a serious bacterial infection.
• Very young children with fever are more likely to have serious disease.  Children under three months, for example, are considered a high risk group.  Fever in these babies should be managed with urgency.
• Long term diseases that reduce the child's ability to resist infections.  Cancers, especially leukemia, AIDS, sickle cell disease, cystic fibrosis, congenital heart disease, and diabetes are some of these situations.  
• Children who have received antibiotics recently.  Some of these children with fever have meningitis, though they appear relatively well.  Partially treated meningitis should be considered in all children with fever who have received antibiotics for any reason in the past few days.
• Day care centres and creches.  Children who spend time every day at these places are at increased risk for serious infections.

Fever in Children
Treatment of Fever

Last Revision: May 22, 2020

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Dr.  Parang Mehta,
Mehta Childcare,
Opposite Putli, Sagrampura,
Surat.
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