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Fever in children

Children Fever | Ks pediatrics

Definition:

Fever in a child is the one of most common clinical symptoms managed by pediatricians and frequently causes parental concern. Many parents give fever-reducing medications (antipyretics) to keep the temperature normal. Fever is a physiologic mechanism by which the body fights infection. Against the common misconception, fever does not predict the severity of illness.

How to treat:

High parental concern causes frequent usage of antipyretics to control the temperature. Acetaminophen and ibuprofen are the most commonly used drugs to treat fever in United States. Current evidence suggests that there is no substantial difference between both of those medications in terms of efficacy and safety. When medications are given by mouth, the fever will start responding within about 30-60 minutes. Dosing of acetaminophen and ibuprofen is based on the weight of the child, not on the age of the child.

When to treat:

Antipyretics do not need to be given to bring down the temperature in all situations. It is recommended to give medication in order to make the child feel comfortable. The idea that fever is harmful to the brain and increases the incidences of febrile seizures is not found to be true. Having fever-phobia increases the chance of giving antipyretics without any indication, resulting in inappropriate dosing and frequent usage of those medications.

When to worry about a fever:

1.When the temperature is more than 105.8 degrees (called Hyperpyrexia)
2. When the child is drowsy
3. When the child is not eating well
4. When it is associated with vomiting and headache
5. When it is associated with significant neck pain
6. When the child seems very ill and has a rash
7. Fever persisting more than 5 days
8. Fever with low neutrophil count (neutropenic fever)
9. Significant parental concern

When in doubt, please seek medical advice from your provider or kspediatrics.com

References:

1. https://doi.org/10.1542/peds.2010-3852 – Fever and antipyretics use in children
2. BMJ Open 2017;7:e015404. doi:10.1136/ bmjopen-2016-015404
3. https://doi.org/10.1016/j.paed.2019.12.002 – Febrile neutropenia in paediatric oncology