Monday Medical: Feeling hot? Fever 101
Fever is a common reaction to an infection. But how hot is too hot? And how do you know whether to head to the doctor’s or back to bed?
Below, Dr. David Niedermeier, a family medicine physician in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center, outlines must-knows when treating fever in children and adults.
Causes of fever
In most cases, fever is a result of the immune system’s reaction to a viral or bacterial infection.
“The immune system will recognize a virus or bacteria, and that starts a whole cascade of chemical reactions,” Niedermeier said. “Those reactions are recognized by the part of the brain that regulates temperature.”
According to some studies, fever may be helpful in preventing viruses and bacteria from dividing or spreading.
Viral infections often primarily affect the respiratory system and involve multiple symptoms such as a runny nose, sore throat, cough, red eyes or diarrhea. Viral infections usually resolve on their own, but some, such as influenza and RSV, can be severe, especially in younger children.
Bacterial causes of fever often involve one infected organ, such as an ear, a sinus, the tonsils or the bladder, and include illnesses, such as strep throat and pneumonia. Sometimes, after a viral infection, a separate bacterial infection can set in.
“Some of those bacterial infections can become aggressive,” Niedermeier said. “The goal is to kill those infections and prevent them from spreading to other systems.”
When to see a doctor
The biggest clue that it’s time to seek medical attention for fever is how poorly you or your child feels.
“Maybe the most important feature that should prompt evaluation is a kid who looks acutely sick,” Niedermeier said. “It’s challenging because you don’t want to run in for every low grade fever or sniffle, but you also don’t want to let things go too long.”
Fevers that should receive prompt medical attention include those in very young children, patients who are immunocompromised or unimmunized, people with underlying medical conditions such as asthma, and people who recently had surgery.
Head to the doctor if your fever comes with concerning symptoms, such as urinary issues, abdominal pain, joint pain, shortness of breath, a severe cough or a skin rash. Children age 3 or younger should be evaluated when they have a fever of more than 102.2 degrees Fahrenheit to make sure there isn’t a significant bacterial infection.
“The goal of most clinic visits for fever is to differentiate a bacterial infection that can be treated with antibiotics from a viral infection that is often treated by focusing on symptoms, such as runny nose or sore throat,” Niedermeier said.
How to treat a fever
There’s no need to heed the old adage, “Feed a cold, starve a fever.” Rather, it’s best to rest, stay hydrated and treat symptoms of fever as needed.
“Once the cause of a fever is determined, treating a fever with acetaminophen or ibuprofen is reasonable but not necessary,” Niedermeier said. “With low or moderate fever, the fever itself is not dangerous and treatment should focus on the patient’s comfort, not their temperature.”
Some experts recommend using either acetaminophen or ibuprofen instead of alternating the two, as has been traditionally recommended. Avoid ibuprofen in children younger than 6 months old.
While in many cases, fever is best treated with rest and hydration, don’t hesitate to seek medical help if symptoms worsen.
“Some infections can progress rapidly, so we would certainly prefer to see people and rule out a serious infection than to have them come in for care once an infection has become more advanced,” Niedermeier said. “There are no dumb questions or concerns when it comes to your child’s health or your own health.”
Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at email@example.com.
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