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Compliments of American Academy Of Family Physicians

Fever in Infants and Children

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Checking temperatures rectally or axillary (under the arm) is necessary in small children because they're not able to hold a thermometer in their mouths. Axillary temperatures are generally 1^o lower than rectal temperatures. Temperatures above 105^o (oral) can be dangerous, and immediate action must be taken.

SYMPTOMS	DIAGNOSIS	SELF-CARE

1. Is your child three months of age or younger with a fever of 101° or above?		Contact your doctor.

2. Does your child have a temperature of 102° or above that is unresponsive to fever-reducing medicine?	Go to Question 10.*.

3. Does your child appear tired or irritable and have a low-grade fever (up to 101°) and a runny nose?	The child may have a simple VIRAL INFECTION, a COLD or FLU.	Treat with nonaspirin fever-reducing and cold medicine. If there is no improvement in two to three days, if the child is complaining of ear or throat pain, or if the temperature continues to climb, see your doctor.

4. Does your child have a fever up to 101° and a barking cough?	These are symptoms of CROUP or EPIGLOTTITIS (swelling of the airway).	Call your doctor right away. Both of these conditions can be life-threatening.

5. Does your child have low-grade fevers with diarrhea, nausea or vomiting?	The likely source of these symptoms is VIRAL GASTROENTERITIS.	High fevers, diarrhea and vomiting can quickly lead to dehydration. If the illness is mild, use nonaspirin fever-reducing medicines. You may also need to give oral rehydration therapy to prevent dehydration. If it is severe, contact your doctor.

6. Is your child pulling at his or her ear, and is he or she irritable?	Ear pain may be from a middle ear infection or OTITIS MEDIA. In younger children, it may be from TEETHING PAIN radiating to the ear.	Have your child seen promptly by your doctor for an exam, testing and treatment.

7. Is your child complaining of stomach pain or nausea, or has he or she vomited?	Pain in the mid-abdomen that moves to the right lower area, along with fever and vomiting, are the signs of APPENDICITIS.	Contact your doctor immediately.

8. Does your child have a cut or wound that appears red, swollen and tender?	He or she may have an infection of the skin called CELLULITIS.	See your doctor promptly.

9. Is your child older than age three and does he or she have a fever up to 101° and sore throat?	The child may have STREP THROAT or PHARYNGITIS.	Treat with nonaspirin fever-reducing medicine. Contact your doctor.

*10. Does your child have a moist, productive cough with breathing that is rapid and sounds tight?	Your child may ahve PNEUMONIA or BRONCHIOLITIS. Occasionally a higher fever will accompany BRONCHITIS.	Your child should be seen right away by your doctor.

11. Is the child feeling very ill, complaining of headaches and vomiting, with a stiff neck?	This may represent MENINGITIS, a serious infection of the spinal canal and the brain.	See your doctor right away.

12. Does your child have blisters scattered over the face, back, chest and stomach?	This may be from CHICKENPOX, an extremely contagious viral illness.	See your doctor.

13. Did your child start with a high fever but still look active, then develop a red rash on the face four or five days later?	This may be from a viral illness known as FIFTH DISEASE.	Call your doctor. Treat with nonaspirin fever-reducing and cold medicine, if needed.

14. Did your child start with a sore throat and fever, then have a red rash with small bumps that spread from the face downward?	Slightly larger bumps may be from MEASLES. Small "sandpaper" bumps may be from SCARLET FEVER, a strep infection in the blood.	See your doctor.

15. Does your child have swelling under the jaws on one or both sides?	This fever and swelling may be from the MUMPS.	Call your doctor.

16. Does your child have either a runny nose or diarrhea with a high fever?	These may be from a simple VIRAL INFECTION, even with the high fever.	Call your doctor, who can rule out other, more serious infections.

17. Does your child have pain or burning with urination, or have back pain?	This may be a kidney infection, PYELONEPHRITIS.	Call your doctor.

18. Does your child have a fever following a recent immunization?	This may be a REACTION TO THE IMMUNIZATION.	Treat the fever with acetaminophen. If the fever is above 105° F contact your doctor immediately

For more information, please consult your doctor. If you think the problem is serious, call right away.

This tool has been reviewed by doctors and is for general educational purposes only. It is not a substitute for medical advice. The information in this tool should not be relied upon to make decisions about your health. Always consult your family doctor with questions about your individual condition(s) and/or circumstances. Source: American Academy of Family Physicians. Family Health & Medical Guide. Dallas: Word Publishing; 1996.