When to Worry About a Fever

Even though most of this chapter is devoted to assuaging parents' fear of fevers, there are times when pediatricians are genuinely concerned about a fever. One of those times is when the infant is less than six weeks old.

Fever and Your Baby

The first six weeks for your baby is a special period in a child's life. Infants less than a month old have very weak immune systems. They do not have the same arsenal of defenses against infection as older children. To make matters worse, they often do not manifest infections in the same way as older children.

Not only do they lack the ability to communicate, they cannot generate an effective fever at times. If an infant less than six weeks old has just a low-grade fever (temperature higher than 100.4°F), physicians usually take no chances and go all out to investigate a possible bacterial infection. This usually includes blood tests, urine tests, and a spinal tap to check for infection of the brain.

The reaction may seem drastic, but there is no room for guesswork when it comes to a baby with potential bacterial infection. The consequences of missing a serious infection can be devastating, and there is simply too much at stake.

Special Circumstances

Another group of patients that is the exception to the rule are children with deficient immune systems. This is a fairly large group that consists of patients with sickle cell disease, children with organ transplants who are taking immune-suppressing drugs, children with AIDS, children with immune-altering conditions such as lupus or juvenile arthritis, children with certain liver disorders and kidney diseases, children without spleens, and children with cancer.

Parents of these children are often cautioned by their physicians about their child's fragile state in advance, and they typically know exactly what to do when their children get a fever.

In addition, patients with certain implanted devices should also take fever seriously. Many patients with chronic illnesses who have catheters implanted in their bodies need to worry about fever because these implants make it easier for infections to find their way into the bloodstream, and catheters tend to trap bacteria.

Prolonged Fever

If your child has a fever that has lasted for more than four days, you should go to the pediatrician. It is unusual for a fever to last this long if it is caused by a virus. Physicians in general do not worry about how high a fever gets but rather how long the fever lasts. Health professionals feel that a fever that lasts more than three to four days is cause for more concern.

A prolonged fever almost always indicates the presence of a bacterial infection or other more serious conditions. Occasionally, a medication itself can trigger a fever, but this is more likely to happen in the hospital setting.

If your child has a prolonged fever that is associated with a stiff neck and headache, seek medical attention immediately. This combination of symptoms could mean that your child may have an infection in the brain.

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