Fever

Elevated body temperature is usually a symptom of an infection and is generally not a cause for concern. It can cause unpleasant symptoms such as headache, chills, and sweating, which require rest. In most cases, fever subsides within a few days. Over-the-counter medications available at pharmacies can help lower a high temperature. Temperature can also decrease without the use of medication through rest and fluid intake.

However, if a child or older adult has a high temperature along with other symptoms or has a weakened immune system, they should seek medical assistance. Any temperature above 40 degrees Celsius is a reason to urgently consult a doctor.

What is a high temperature?

An elevated temperature is a body temperature that is higher than normal, ranging from 36.6 to 37 degrees Celsius. Normal body temperature is not the same for everyone and can vary depending on several factors such as:

  • time of day (usually lower in the morning and higher in the late afternoon and evening)
  • menstrual cycle or intense exercise
  • some disease

Babies typically have a higher body temperature than older children and adults. Their average body temperature is around 37.5°C.

A fever is usually a sign that the body is trying to fight off an illness or infection, and all body systems are working to maintain the health of vital organs. Increasing body temperature can slow the growth of bacteria and improve the defense capabilities of white blood cells.

4 types of elevated temperature by severity

  • Mildly elevated temperature up to 38 °C
  • Moderate temperature 38.1 to 39 °C
  • High temperature 39.1 – 40 °C
  • Extremely high temperature above 40.1 °C or more than 41 °C (hyperpyrexia).

The duration of elevated temperature

In terms of duration, the fever can be classified as:

-Acute if it lasts less than 7 days
-Subacute if it lasts up to 14 days
-Chronic or persistent if it lasts longer than 14 days

Temperature measurement

Temperature can be measured in different ways: Axillary (under the armpit). The thermometer is placed in the armpit for about 5 minutes. Oral: The thermometer is placed under the tongue for three minutes. Rectal (for babies): The thermometer is inserted into the rectum.

There are also thermometers that measure temperature by touching the forehead or placing them in the ear, but they are less precise than other temperature measurement methods.

Who can get a fever?

-Individuals with infections (bacterial, viral, or fungal)
-Individuals with inflammatory conditions or autoimmune diseases
-Children and older adults with weakened immune systems
-Individuals with cancerous conditions

The most common causes of elevated temperature

Fever can be a sign of many health conditions, which may or may not require medical treatment. The most common causes of fever are infections such as colds and stomach viruses (gastroenteritis).

The triggers of elevated temperature are:

  • Viruses
  • Bacteria
  • Malaria

Other causes include:

  • Ear, lung, skin, throat, bladder, or kidney infections;
  • Heat stroke;
  • Sunburn;
  • Inflammatory conditions such as rheumatoid arthritis;
  • Side effects of medications and medical treatments;
  • Blood clots;
  • Autoimmune diseases such as lupus and inflammatory bowel disease;
  • Cancer;
  • Hormonal disorders;
  • Teething in babies can cause a slightly elevated temperature.

Symptoms of fever

Depending on the underlying cause of elevated temperature, the symptoms can include:

  • Sweating, chills, and tremors
  • Headache
  • Muscle aches
  • Loss of appetite
  • Irritability
  • Dehydration
  • General weakness and fatigue

Diagnosis of elevated temperature and tests

Fever is a symptom, not a disease. The doctor can diagnose fever, but will also need to find out its cause. Therefore, the doctor will take a detailed anamnesis of the patient and ask him about all other symptoms and medical history. For example, if the person has recently experienced another infection, undergone surgery, or if there is pain or swelling in a specific area, it may indicate a present infection.

To confirm the diagnosis, the doctor may recommend laboratory blood and urine tests, throat, and nasal swabs, and, if necessary, imaging such as X-rays or scanner (depending on the cause of the elevated temperature).

Sometimes, the underlying cause of elevated temperature cannot be determined during the initial examination. When it persists for more than three weeks continuously or occurs intermittently without a clear cause, it is usually referred to as fever of unknown origin. In such cases, the doctor will refer the patient for further diagnostic tests (the causes are usually chronic infection, autoimmune disease, or cancer).

Since elevated temperature in infants, especially those under two months old, can indicate a serious illness, it is necessary to keep the child in the hospital for observation, further diagnosis, and treatment.

Treatment of fever

Medications: In the case of high temperature causing discomfort, the doctor may recommend over-the-counter medications to reduce the temperature (such as paracetamol, ibuprofen). However, these medications should be used only as directed by a doctor. Aspirin should not be given to children as it can cause a rare but potentially fatal condition called Reye’s syndrome.

The doctor may also prescribe other medications based on the underlying cause of the illness. Treating the underlying cause can alleviate symptoms, including elevated temperature.

Fluid intake and rest: It is important to consume plenty of clear fluids such as water, juice, soup, and tea.

Home remedies: Effective measures to reduce high temperatures, especially above 39 degrees Celsius, include lukewarm baths or showers. After bathing, it is important to measure the temperature and repeat the process until the temperature subsides. Cold compresses can also help lower the temperature. A cotton towel or cloth can be placed on the forehead and legs and should be changed when it dries.

Treatment for infants: Babies, especially those under two months old, may need to be hospitalized for testing and treatment. In such young infants, elevated temperature can indicate a serious infection that requires intravenous (IV) medication and continuous monitoring. Therefore, any temperature above 38 °C in such a young baby should be evaluated by a doctor.

For older infants and children, temperature-reducing syrups may be included in the treatment. Avoid overdressing the baby, and if the temperature exceeds 39 °C, you can help cool them down with a lukewarm (not cold) bath. Instead of showering, you can gently pat the baby with a wet diaper so that a few drops of lukewarm water remain on their skin. Let the baby air dry and then dress them.

Monitor how the baby responds, and if there are no signs of improvement, the child should be taken to the doctor.

When an elevated temperature is a reason to visit doctor

A fever itself is not a cause for immediate concern. However, there are some circumstances in which you should see a doctor: 

Infants and young children – Elevated temperature is a particular cause for concern in infants and young children. You should immediately take your baby to the doctor if:

The baby is younger than 3 months and has a temperature of 38 °C or higher (measured rectally).

The baby is between 3 and 6 months and has a temperature higher than 39 °C or lower but appears unusually irritable, confused, or lethargic.

The baby is between 7 and 24 months and has a temperature higher than 38.9 °C that lasts longer than one day but does not exhibit other symptoms.

If the child also has other symptoms such as a runny nose, cough, or diarrhea, they should be taken to the doctor earlier.

Older children 

Consult a doctor if the child:

-Is listless, confused, or unable to make eye contact.

-Is irritable, vomiting, experiencing severe headache, sore throat, stomach pain, or other symptoms causing significant discomfort.

-Has an elevated temperature that lasts longer than three days.

-Has a pre-existing immune system disorder or another underlying illness.

Adults 

It is advisable for all individuals to see a doctor if:

-The temperature is higher than 39.4 °C.

-Symptoms such as severe headache, rash, unusual sensitivity to bright light, stiff neck, confusion, vomiting, difficulty breathing, chest or abdominal pain, painful urination, or seizures occur.

Prevention

Limiting exposure to viruses and bacteria is one of the best ways to prevent the occurrence of elevated temperature. Here are a few tips that can help reduce exposure to pathogens:

-Wash your hands frequently, especially before eating, after using the restroom, and being around people. Regular handwashing with soap and water should last for at least 20 seconds. Teach your children how to properly wash their hands.

-Carry hand sanitizer or antibacterial wipes with you. They can be useful when soap and water are not available. Use a hand sanitizer that contains at least 60% alcohol.

-Avoid touching your nose, mouth, or eyes.

-Cover your mouth when coughing and your nose when sneezing. Teach your children to do the same.

-Avoid sharing cups, glasses, and utensils with others.

– Avoid close contact with sick people

– Focus on a diet rich in vitamins and minerals to strengthen your immune system.

Prognosis / Perspective

Older people with fever are at greater risk of developing a serious bacterial infection compared to younger people with fever. As with younger adults, the cause is usually a respiratory or urinary tract infection. Skin and soft tissue infections are also common causes in older people. Older people are more likely to have more serious manifestations of respiratory viral infections such as influenza, COVID-19 and respiratory syncytial virus (RSV). Recovery is also influenced by the underlying cause of the elevated temperature, regardless of age (autoimmune diseases, cancer), as well as the overall health status of the individual.

Expected recovery time for fever

The fever usually disappears in a few hours to several days, usually by 3 to 4, depending on the cause and how long it takes the body to cope with the infection. If the fever persists or recurs, it may be a sign of a more serious condition.

Therefore, it is important to follow the doctor’s advice and take the prescribed treatment in order to normalize body temperature as soon as possible.

Living with fever

To alleviate discomfort caused by elevated temperature, you can:

-Drink plenty of fluids: Fluids will help replenish the ones lost through sweating. Water and clear soups are healthy choices. Infants under 6 months of age should consume only breast milk or formula.
– Get some rest. You need rest to recover, and activities can raise your body temperature.
-Avoid alcohol as this can worsen dehydration.
– Take a temperature-reducing medication such as paracetamol (if prescribed by a doctor).
– Wear lightweight, cotton clothing: Unless you have chills, there is no need to overdress.

When to seek medical help or examination

Seek additional medical help or schedule a follow-up appointment if:

– the temperature does not drop after three days, or still rises and exceeds 39.5 °C;
– the temperature is accompanied by symptoms such as severe headache, vomiting, exhaustion, shortness of breath, chest pain;
– you have an autoimmune disease or other disease or compromised immune system
– the child’s temperature is above 39 °C or does not drop for three days, and has significant accompanying symptoms;
-an infant develops a temperature higher than 38 °C;

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