From the Guidelines
Fever is primarily caused by the body's immune response to an infectious pathogen, and it plays a crucial role in fighting and overcoming infections. The most recent and highest quality study, 1, published in 2016, highlights that fever is a normal physiologic response that may result from the introduction of an infectious pathogen into the body. According to this study, the majority of febrile children will have a benign, self-limited viral infection, but a small number of pediatric patients, especially those younger than 3 months, will have a serious infection.
Key Points to Consider
- Fever is defined as a rectal temperature greater than 38°C (>100.4°F) 1
- The risk of serious bacterial infections (SBI) varies by age, with neonates (aged 3 to 28 days) having a higher risk of 13% 1
- The management of febrile pediatric patients involves differentiating between those with serious infections and those with benign, viral infections
- Antipyretic use, immunization status, and the ability of parents or caregivers to monitor the infant or child are important considerations in management
Management Recommendations
- For adults, take acetaminophen (Tylenol) 325-650mg every 4-6 hours or ibuprofen (Advil, Motrin) 200-400mg every 4-6 hours as needed, not exceeding maximum daily doses (4000mg for acetaminophen, 3200mg for ibuprofen)
- For children, use weight-based dosing and children's formulations
- Stay hydrated by drinking plenty of fluids, rest, and dress in light clothing
- Apply cool compresses if comfortable
- Seek medical attention if fever exceeds 103°F (39.4°C) in adults or 102.2°F (39°C) in children, persists beyond 3 days, or is accompanied by severe headache, stiff neck, confusion, difficulty breathing, rash, or persistent vomiting.
From the Research
Causes of Pyrexia (Fever)
- Pyrexia, or fever, is a physiologic mechanism that has beneficial effects in fighting infection 2
- Fever is not the primary illness, but rather a symptom of an underlying condition 2
- The cause of fever can be due to various conditions, including viral or bacterial infections 3, 4, 5
Types of Infections that Cause Fever
- Bacterial infections, such as bacterial fever, can cause fever 3, 4
- Viral infections, such as the common cold, sore throat, and sinusitis, can also cause fever 3, 4, 5
- Neoplastic or inflammatory fever can also cause fever 4
Treatment of Fever
- Antipyretics, such as acetaminophen and ibuprofen, can be used to treat fever 2, 3, 4, 6
- The choice of antipyretic may depend on the underlying cause of the fever, with some studies suggesting that paracetamol/ibuprofen combination may be more effective in patients with bacterial fever 4
- The primary goal of treating fever should be to improve the patient's overall comfort, rather than focusing solely on normalizing body temperature 2