FEVER: TREATMENT

Fever is not an illness. It is a normal reaction of the body's immune system to infection and other conditions. Children often have high temperatures even with minor viral infections. Older adults may have a serious infection and not have a fever. Fever may occur with viral or bacterial infections, such as ear infection, flu, severe cold, sore throat, pneumonia, stomach virus, urinary tract infection, or dehydration and other conditions. Not all fevers mean that a person has a serious illness or needs an antibiotic. Factors such as age and gender, as well as symptoms associated with a fever, determine how serious a fever is.

Use a digital thermometer to take a temperature either orally, rectally, or under the arm. Children under 5 are too young to be able to keep their mouths closed for oral temperature readings. Rectal temperature should not be taken if you have diarrhea or if there is blood in the bowel movement. Devices are available that can monitor the ear temperature. Follow the instructions carefully. Ear thermometers are NOT reliable when used in a child under 12 months of age because of the small size of their ear canal.

The goal of care is to help you feel better while your body is responding to the infection. Low grade fevers do not require more care than getting more rest and drinking more fluids, especially water. Dress in light, comfortable clothing. Cover with a sheet or light blanket when resting or sleeping. Do not bundle in heavy clothes or blankets. Keep the room cool but not uncomfortable. Medications are not needed for a low grade fever unless they are recommended by your provider.

Begin to use fever-reducing medications if the temperature is over 102 degrees Fahrenheit (38.8 degrees Centigrade) and only if feeling uncomfortable. Follow your doctor's recommendations or the label instructions for using acetaminophen or ibuprofen. Ibuprofen should not be given to infants under 6 month of age.

Aspirin or medicines that have aspirin in them should not be given to anyone younger than 18 years of age. Taking aspirin is a risk for a serious illness called Reye's syndrome. Non-steroidal anti-inflammatory drugs (NSAIDs) should be taken with food or milk to prevent stomach upset. NSAIDs should not be taken by anyone who has been diagnosed with asthma, ulcer disease, or a bleeding disorder. Taking NSAIDs increases the risk of bleeding with trauma, dental work, surgery, or if taking blood thinners (anticoagulants).

Acetaminophen should not be taken by anyone with known liver or kidney disease. Do not drink alcohol when taking more than 1 dose of acetaminophen.

These medications should reduce fever 2 to 3 degrees Fahrenheit (1 to 2 degrees Centigrade) within 1 to 2 hours. Recheck the temperature 1 to 2 hours after the medication to see if the fever is reduced. It will be necessary to repeat dosages of the medications at the intervals recommended until the illness runs its course. There is no need to awaken someone to take this medication. It is a good idea to write down the name of the medication and the time each dose is taken, especially if using more than one medication. It is important not to take too much medication.

If fever reducing medication is not making you more comfortable, bathing or sponging in lukewarm water for about 30 minutes may also help reduce a fever. Do not use alcohol in the water. Keep wetting the skin surface while sitting in shallow water. The evaporation of water on the skin causes cooling. Stop the bath if shivering starts or if feeling too chilled. Pat dry with a towel.

Fever that should be reported to your provider includes:

For children --

An infant younger than 3 months with any fever
An infant between 3 months and 1 year with a fever that has lasted more than 24 hours
A fever that remains above 103 degrees Fahrenheit (39.4 degrees Centigrade) after an hour or two of home treatment
A fever that continues for more than 2 days
A fever along with unexplained crying, sleeping more than usual or not as alert as usual

Other symptoms of concern with a fever are: repeated vomiting, being too ill to drink or refusing to drink, stomachache, severe headache, a rash, or behavior that is different than usual.

For adults --

A fever of 103 degrees Fahrenheit (39.4 Centigrade) or higher
A fever of 101 degrees Fahrenheit (38.3 Centigrade) or higher that lasts longer than 3 days
A fever associated with any of the following new or worsening symptoms:

shortness of breath
severe or persistent headache
significant stiff neck and pain when bending the head forward
sensitivity to bright lights
mental confusion or drowsiness
seizure or convulsion
moderate to severe pain
redness, swelling, tenderness or other signs of local infection

A fever of 100.5 degrees Fahrenheit (39.1 degrees Centigrade) or greater OR a temperature of 100 degrees Fahrenheit (37.7 Centigrade) for 3 days when pregnant

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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