Fever in Infants and Children

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Because young children are not able to hold a thermometer in their mouths, their temperature may be checked rectally or axillary (under the arm). Axillary temperatures are usually 1o lower than rectal temperatures, and rectal temperatures are the most accurate. All temperature guidelines listed in this chart are rectal. Temperatures above 105o (oral) can be dangerous, and need immediate medical attention.

SYMPTOMS DIAGNOSIS SELF-CARE
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1. Is your child two months of age or younger with a fever of 100.4° or higher?


Yes

This may be a sign of a serious INFECTION.

Call your child's doctor.

No

2. Is your child older than 2 months of age with a fever of 102° or higher that is unresponsive to fever-reducing medicine?


Yes

Go to Question 14.*

No

3. Does your child have a low-grade fever (up to 101°) and a runny nose, and is he or she tired and cranky?


Yes

Your child's symptoms may be from a simple VIRAL INFECTION, such as a COLD or FLU.

Treat your child with nonaspirin fever-reducing and cold medicine. Make sure your child drinks plenty of fluids and gets enough rest. Chicken soup may also help relieve cold and flu symptoms by breaking up congestion. See your child's doctor if your child's symptoms persist or worsen, or if your child is complaining of ear or throat pain. Also, be sure to contact your child's doctor if your child's temperature continues to climb.

No

4. Does your child have a low-grade fever (up to 101°) and a harsh, barking cough?


Yes

These may be symptoms of CROUP.

Mild cases of croup can be treated at home. Make sure your child gets plenty of rest and lots of fluids. See your child's doctor right away if your child is having problems breathing or swallowing, or if your child develops a blue or grayish color around the nose, mouth or fingernails.

No

5. Does your child have a low-grade fever with nausea or vomiting?


No

Go to Question 8**.

Yes

6. Is your child also complaining of stomach pain?


Yes

Pain in the mid-abdomen that moves to the right lower area, along with fever and vomiting, may be signs of APPENDICITIS.

URGENT
Contact your child's doctor immediately.

No

7. Does your child have watery diarrhea and a low-grade fever?


Yes

Your child may have VIRAL GASTROENTERITIS, an intestinal infection.

Diarrhea and vomiting can quickly lead to dehydration. Give your child an oral rehydration solution to prevent it. For the fever, give your child a nonaspirin fever-reducing medicine. Call your child's doctor after 24 hours if the fever continues to climb or if your child cannot keep down any fluids.

No

**8. Is your child pulling at his or her ear, and is he or she irritable?


Yes

Ear pain may be from a middle ear infection or OTITIS MEDIA. In younger children, TEETHING PAIN may radiate to the ear.

A warm, moist cloth placed over your child's ear may help relieve the pain. If your child's symptoms last longer than 24 hours, see your child's doctor.

No

9. Does your child have a rash, cut or wound that is red, swollen and tender?


Yes

Your child may have an infection of the skin called CELLULITIS.

See your child's doctor right away. This condition needs to be treated with antibiotics.

No

10. Does your child have a low-grade fever and sore throat?


Yes

Your child may have STREP THROAT or PHARYNGITIS.

See your child's doctor right away. Strep throat is usually treated with antibiotics. If your child has a viral infection, antibiotics won't help. Give your child lots of fluids. A warm salt water gargle may also help soothe your child's throat.

No

11. Is your child experiencing shortness of breath?


No

Go to Question 15***.

Yes

12. Does your child also have a severe sore throat, problems swallowing, and are his or her skin or lips turning blueish?


Yes

You child may have EPIGLOTTITIS, the swelling of the airways.

EMERGENCY
See your child's doctor or take your child to the emergency room right away.

No

13. Does your child have a slight fever, along with rapid breathing and wheezing?


Yes

These may be symptoms of BRONCHIOLITIS or BRONCHITIS. While bronchiolitis produces a dry cough, bronchitis cough usually produces a yellow-green mucus.

Give your child a nonspirin fever-reducing medicine and be sure he or she drinks plenty of fluids. A cool-mist vaporizer may help ease congestion. See your child's doctor if your child can't keep liquids down or is breathing very fast. Also be sure to seek medical attention if your child's skin is turning blue, especially around the lips, nose or fingernails.

No

*14. Does your child have a high fever with shaking chills, along with chest pain, and is he or she coughing up greenish or yellow mucus?


Yes

Your child may have PNEUMONIA.

See your child's doctor right away.

No

***15. Is your child feeling very ill, complaining of headaches and vomiting, and does he or she have a stiff neck?


Yes

Your child may have MENINGITIS, a serious infection of the membranes and fluid around the spinal canal and the brain.

EMERGENCY
See your child's doctor or go to the emergency room right away.

No

16. Does your child have blisters scattered over his or her face, back, chest and stomach?


Yes

Your child may have CHICKENPOX, an extremely contagious viral illness.

See your child's doctor right away.

No

17. Did your child's illness start with a high fever and cold-like symptoms, with a red rash appearing on his or her face 4 or 5 days later?


Yes

Your child may have PARVOVIRUS INFECTION, also called FIFTH DISEASE.

See your child's doctor right away. Treat your child with nonaspirin fever-reducing and cold medicine, if needed.

No

18. Did your child's illness start with a sore throat and fever, with a red rash with small bumps that spread from the face downward appearing 3 to 5 days later?


Yes

Slightly larger bumps may be from MEASLES. Small "sandpaper" bumps may be from SCARLET FEVER, a strep infection in the blood. Other symptoms of scarlet fever may include vomiting, abdominal pain and muscle aches.

See your child's doctor right away. Scarlet fever is usually treated with antibiotics. However, antibiotics are not effective in the treatment of viral infections such as measles. If your child has measles, make sure he or she gets plenty of rest. For the fever, use a nonaspirin fever-reducing medicine.

No

19. Does your child have swelling under the jaws on one or both sides?


Yes

Your child's fever and swelling may be from the MUMPS.

Call your child's doctor right away. Mumps is a viral infection, so antibiotics aren't effective in treating it. Apply ice or heat to the swollen area to help relieve the pain. A warm salt water gargle, soft foods and lots of fluids may also help.

No

20. Does your child have either a runny nose or diarrhea with a high fever?


Yes

Your child may have a simple VIRAL INFECTION, even with the high fever.

Call your child's doctor. He or she can rule out other causes for your child's symptoms.

No

21. Does it hurt or burn when your child urinates and does he or she or have back pain?


Yes

Your child may have PYELONEPHRITIS, a kidney infection.

See your child's doctor.

No

22. Does your child have a fever following a recent immunization?


Yes

This may be a REACTION TO THE IMMUNIZATION.

Treat the fever with acetaminophen. If the fever is higher than 105° F, see your doctor right away.
WARNING:
Don't give children aspirin without your child's doctor's approval due to the risk of Reye's syndrome.

No

For more information, please talk to your doctor. If you think the problem is serious, call your doctor 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.

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