Pediatrician Questions Fever

When is a fever a cause of concern?

My daughter often gets fever and I often believe it to be her body's immune response to an infection. When is fever a cause of concern?

7 Answers

You should be concerned if the fever is persistent and she is listless, vomiting, has a rash or cough. Mild fevers with viral illnesses are common and do not need treatment. They can cause the body to fight off the infection.
I think you are right. Fever is a design feature and not a problem in children. Attempt to correlate height of fever to severity of disease have been unfruitful. If you treat the fever of influenza you will prolong the course of the illness (double!)

Fever is a cause of concern if it lasts more than 3 days at a time and has other signs of infection or fatigue or loss of appetite. It is also of concern if it is recurrent and follows a certain pattern with any other associated symptoms. Fever is also a concern if it causes seizures with a sick looking child. Fever itself does not kill anyone, but could cause dehydration or poor oral intake due to fatigue. Fever is a cause of concern in any sick looking child.

Hope this helps.
You are completely right, fever is an immune response. Fever is a sign of an infection, most commonly caused by a virus, and it is our body's mechanism to make the environment (our body) uninhabitable to the virus or bacteria. Viruses and bacteria have adapted to infect us at our normal body temperature (one of the reasons why humans are not susceptible to ALL viruses and bacteria) so our body raises the temperature as a way to kill the invader.

Most often I tell people that if the fever is not preventing the patient (adult or child) from functioning - eating, drinking, sleeping - and is not causing significant distress - in the case of children this would manifest by being cranky, inconsolable - then do no suppress the temperature until it reaches closer to 103.5F.

An exception to this would be in a child with KNOWN febrile seizures, generally treating the seizure if important until they outgrow this condition which is something you should discuss with your personal physician as far as at what age you can stop avid fever suppression.
You are quite right about fever being caused by the immune system's response to an infection. However the child's fever may be the result of a rare syndrome, like Familial Mediterranean fever, which causes fever and other symptoms every 2-4 weeks. Some children also may have Hereditary hypohydrotic ectodermal dysplasia because of the lack of sweat glands. Need to have the child evaluated by a competent pediatrician.
When the temperature is over 101 degreeF & persists causing discomfort to her.
When the fever lasts more than 7 to 8 days, then it is a cause of concern. Also, if fever is high in a child from 6 months to 6 years, it can cause febrile convulsions.