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Childhood Fevers

November 23, 2007

Childhood Fevers

People often think that a high fever is bad, that it can cause brain damage. This is not true. The truth is that fever is one of the ways the body helps fight against infections. When we have an infection in any part of the body, we produce more heat (fever). With more heat, the body can better mobilize the white blood cells and other defenses to kill germs better. So the fever is not our enemy but our friend, and it is helping the body fight the germs.

Therefore, the question is, “What is causing the fever?”

One must determine if the cause is serious or not serious. Most of the time, the cause of fever in children is something that is not serious. Some examples are viral infections like sore throats or the flu. Occasionally there may be a more serious infection, such as a urinary-tract infection or pneumonia. Another example of a serious infection is meningitis, an infection that is caused by germs around the brain. This disease is rare, and children are now immunized against the most common causes of meningitis.

To tell the difference between a serious infection (like meningitis) and common infections, look at the whole picture, not just the temperature. Ask these questions:

  • Does the child look focused and track with his eyes?
  • Does he move his head easily from side to side, or does he act as if it hurts and he does not want to move his head?
  • Does he follow what is going on around him?
  • When the fever breaks, after several hours, does he perk up, play and smile more, or does he look worse?

If the answers to these questions are good, then the child most likely does not have meningitis or another serious infection. If the answers to these questions are bad, then the child should be seen by a doctor right away. Meningitis is a rare disease, and most children will not have it.

Now that you know that the fever is not harmful, do you need to bring it down? The more you try to do this, the more you are doing exactly the opposite of what the body is trying to do.

Acetaminophen and ibuprofen are used not so much to bring the fever down (which they do most of the time), but to make the patient more comfortable, as children feel miserable with a high fever. Give acetaminophen or ibuprofen every six hours for a high fever.

If the child does not have a specific symptom along with the fever, such as an earache or sore throat, then he may have the flu. The flu is a common illness caused by a virus. Infections can be caused by viruses or bacteria. Bacteria, not viruses, can be killed by antibiotics like penicillin and amoxicillin. Antibiotics do not work against viruses.

If a disease is caused by a virus such as flu, cold or chickenpox, nothing can be done but wait until it runs its course. With flu, the fever goes up and down for two to four days, then the child will get better.

Some parents have heard about seizures caused by fever. These are called “febrile seizures” and only happen in three or four children out of a hundred. These seizures last a few minutes, but are frightening to watch. However, they are totally harmless. They do not cause brain damage.

Fever is our friend in helping fight infections. We need to be concerned about its causes, but not about the fever. If the child perks up and the whole picture looks good, watch and wait for about three days. If the picture looks worse, or the fever lasts longer than three days, the child should be seen.

Fever in the presence of an infection is different from fever in the presence of excessive heat in the summer. Heat stroke is different in that there is no infection, the person is usually dehydrated, and the fever is not aiding the body in fighting off infection. In this case, the fever can reach excessive degrees and cause serious damage. However, the situation is completely different and not usually confused.

(Information provided by the emergency room staff, Evans Army Community Hospital, Fort Carson, Colo.)

(Reprinted from the Fort Carson, Colo., Mountaineer)

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