Parents and doctors often have very different views about fever. For something as ubiquitous as fever, this dichotomy often leads to all sorts of misunderstandings and anxieties. This section is intended to narrow the gap between these drastically different views and allow parents to understand their pediatrician's way of thinking.

The Origin of Fever Fear

There must be a historical explanation of why this fear of fever evolved in the first place. Many decades ago, before the advent of antibiotics, a high fever usually indicated the presence of an infection. Occasionally, those were bacterial infections that led to serious consequences, including fatality. With most viral infections, such as a cold, there usually isn't a high temperature that exceeds 102°F. This tendency of associating high fevers only with bacterial infections made people conclude that fever itself was the dangerous condition.

With the diagnostic capability of modern medicine and close follow-up with the doctor, it is generally not difficult to distinguish a bacterial infection from a viral one (with a few exceptions that will be specifically addressed later). As long as they are able to assure the absence of a serious bacterial infection, physicians are generally comfortable observing the patient closely without resorting to diagnostic tests.

The Physician's Take on Fever

On the other hand, this fear about fever isn't entirely unfounded. When body temperature gets very high (that is, more than 104°F), most physicians would be concerned. However, the doctor's concern is usually focused on what might be causing the fever rather than on the fever itself. Parents, on the other hand, tend to be more concerned about the direct effect of the fever rather than curious about what might be triggering it. This distinction cannot be repeated enough.

The duration of a fever has much more clinical relevance than the fever's degree, as a temperature that lasts over many days may indicate that something more serious is evolving from the initial infection. A simple viral infection can sometimes weaken the body enough to allow bacteria to invade. When this happens, the initial fever might be prolonged, or the fever might abate and then return. Physicians are much more concerned with this fever pattern because the secondary bacterial infection could be much more serious than the initial viral one.

Many years of clinical observation have revealed that there is a genetic tendency to develop either high fevers or low ones, depending on the individual. Similar to the great variations in children's height and weight, there is also a wide distribution of temperatures when a child gets sick. Some individuals tend to run a high fever with virtually any infection, even a minor cold.