Fever in children Home A-Z Health Information Health Library A-Z Fever In Children Overview Fever in children is a frequent cause for medical consultation, prompting concern among parents. It is defined as an increase in the body temperature above the normal temperature of 98.6°F (37°C). While fever itself is not a disease, it is a sign of an underlying condition, typically an infection. In a tertiary care hospital setting, proper evaluation and management of paediatric fever are critical due to the potential severity of underlying causes. Causes and Risk factors Fever in children can be triggered by various conditions, most commonly infections.Viral infections: Influenza, respiratory syncytial virus (RSV), and enteroviruses are the leading viral causes of fever in children.Bacterial infections: Conditions, such as urinary tract infections (UTIs), streptococcal pharyngitis, bacterial meningitis, and sepsis can cause high fever.Non-infectious disease: Autoimmune diseases, malignancies, and inflammatory conditions can also present with fever but are less common in the paediatric population.Immature immune system: The epidemiology of paediatric fever varies with age, geographic location, and season. Young children, particularly those aged under 5 years, are susceptible to febrile illnesses due to their underdeveloped immune systems.Exposure to pathogens: Communal settings like daycare centres and schools increase the risk of infection. Symptoms Symptoms accompanying fever in children can vary depending on the underlying cause.General symptoms: Irritability, lethargy, poor feeding, vomiting, cough, diarrhoea, and rash.Localised symptoms: In older children, localised symptoms, such as sore throat, ear pain, or abdominal pain can help identify the source of infection.Severe symptoms: Signs of serious illness, such as high fever, difficulty breathing, or persistent vomiting may indicate more severe underlying conditions. Diagnosis The diagnostic of fever in children involves systematically evaluating the cause and severity.Medical history: Recording details, such as fever duration, pattern of fever, associated symptoms, recent exposures, and vaccination status is crucial.Physical examination: This helps detect any localised signs of infection or other abnormalities.Laboratory tests: Blood tests, urine analysis and cultures, and inflammatory markers, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) can guide diagnosis.Imaging: Chest X-rays, abdominal ultrasounds, or other radiological studies are useful for identifying infection or inflammation.Specialised tests: These include lumbar puncture for cerebrospinal fluid analysis in suspected meningitis cases or viral panels to detect specific viral pathogens. Treatment Managing fever in children focuses on treating the underlying cause, alleviating discomfort, and preventing complications.Severe illness: Supportive care for severe illnesses includes adequate hydration, administering antipyretics, such as paracetamol or ibuprofen for fever and discomfort, and monitoring for severe illness.Viral infections: Viral infections usually require supportive care as most viral infections are self-limiting.Bacterial infections: Antibiotics are prescribed based on the suspected pathogen, especially for serious conditions like sepsis or meningitis.Non-infectious causes: Management may involve specific therapies, such as immunosuppressive agents for autoimmune diseases or chemotherapy for malignancies.Hospital monitoring: Children with fever and signs of severe illness or underlying chronic conditions need to be closely monitored in a hospital setting. Advanced supportive care, including intravenous fluids, oxygen therapy, and intensive care, may be necessary for critically ill patients. Prevention and public health measures Preventing fever in children largely involves preventing the infections that cause it.Vaccination: It is the most effective measure for many common pathogens, such as influenza, measles, mumps, rubella, varicella, and pneumococcus, and decreases the incidence of fever-causing infections.Hygiene practices: Good hygiene practices, including regular hand washing, respiratory etiquette, and avoiding close contact with sick individuals, can also reduce the spread of infectious diseases.Public health education: Education must be provided for parents and caregivers on recognising warning signs of serious illness, appropriate use of antipyretics, and the importance of vaccinations.Child health initiatives: Promoting breastfeeding, proper nutrition, and overall health reduces the incidence and severity of febrile illnesses.