Fever in children and babies is critical. It is different from adults as most of the fever in adults is self-limiting and will heal with the action by the body’s immune system. Babies from three to 36 months are prone to develop fevers. Fevers that they are having should be taken seriously and immediate action should be taken by caretakers or parents. Rectal temperature of 39-degree celsius or more taken with a medical-grade thermometer require investigations to detect any active infections although there is no evidence obtained from a physical examination by a doctor. Ask questions to child specialists to have a better understanding of how to maintain your children’s health.
Always keep in mind that temperatures below 39 degrees Celcius can also be caused by a serious infection, hence, the safest thing to do if your baby is having a fever is to bring them to the hospital for further evaluation and intervention if required. Prolonged fever of more than 5 days needs extra investigations to rule out Kawasaki disease and fever of more than 7 days requires more investigations to identify the exact cause for the fever of unknown origin.
Sometimes, temperatures are recorded from different locations like the ear and armpit. You must know that the reference used by doctors to investigate or treat your babies is based on rectal temperatures. Do not panic or angry if healthcare workers wanted to measure your child’s rectal temperature as the rectal temperature is the most accurate.
The common causes of fever in babies are:
- Urinary tract infection (UTI)
- Kawasaki disease
- Fever of unknown origin
Urinary tract infection is the most common cause of fever in babies. Eight out of ten babies who are having fevers are caused by urinary tract infections. The risk for babies to get urinary tract infection varies depending on their gender, race, age, and circumcision status. Uncircumcised male babies are at higher risk to develop urinary tract infections compared to circumcised babies. First six months of life, female babies are at the highest risk to have urinary tract infection.
Bacteremia is defined as well-appearing febrile babies with evidence of bacteria invasion following a blood test. The risk for a baby to develop bacteremia is highly depending on the immunization status. The incidence of bacteremia in immunized babies is less than one per cent. Most children with pneumonia are usually presented with other symptoms and upon physical examination, there will be certain findings suggestive of pneumonia.
After history taking and physical examination, investigations are needed before a diagnosis can be formulated. The investigations are:
- Full blood count
- Other blood studies
- Rapid urine test
- Chest radiograph
- Blood culture
- Urine culture
- Cerebrospinal fluid analysis, culture, and sensitivity
- Polymerase chain reaction
Common cold or mild version fever has potential benefits and harms. The potential benefits are:
- Retardation of growth and reproduction of bacteria
- Retardation of growth and reproduction of viruses
- Enhancement of immunologic functions
The potential harms are:
- Increase metabolic rates
- Increase oxygen consumption
- Increase carbon dioxide production
- Increase workload on cardiovascular and respiratory systems
- Immunologic system failure
- Brain injury
The treatments are depending on the underlying causes. Ask the child specialists to have a better understanding of how to maintain your children’s health and how to handle fever in children.