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Acute fever - Causes, Approach and Treatment

Updated on May 20, 2016

What is Acute Fever

It is defined as the sudden rise in temperature above the normal range. It has to be understood that acute fever is a symptom and not an illness. Development of fever is the way the human system responds to infection. Temperature above the 99th percentile is termed as fever. But this definition of fever has not yet been universally formulated and accepted.

The infection can be either viral or bacterial in nature and the occurrence of fever is the way our body reacts to the presence of the foreign body, inside our body.

Acute fever in children

Acute fever is a cause of concern in children aged 3 to 36 months of age. For children, the body temperature is generally measured rectally. Fever above 102 degree F is indication of underlying illness.

The most common in children is viral infection. Development of acute fever due to bacterial infection occurs in rare cases. It has been estimated that fever is the most common complaint amongst pediatrics and children aged < 3 years are most vulnerable to contract fever.

Causes in children

In children it can occur due to any of the following sources:

  • Upper respiratory tract diseases that comprise of sinusitis, viral respiratory tract disease and otitis media
  • Lower respiratory tract disease that comprises of pneumonia and bronchiolitis
  • Gastrointestinal diseases of both bacterial and viral origin
  • Musculoskeletal infections that comprises of cellulitis, osteomyetlitis and septic arthritis
  • Urinary tract infections
  • Bacteremia and
  • Meningitis

The cause in children however varies with age as there is a vast degree of difference in the immunologic functions of young and older children.

Treatment in children

The treatment mode depends on the underlying cause of infection. Children who are healthy and have fever do not necessarily require much treatment. They are however put on antipyretic drugs to ease discomfort caused due to rise in body temperature. Acetaminophen and ibuprofen are given for treating acute fever.

The doctors however prefer acetaminophen over ibuprofen because the latter decreases the protective effect of prostaglandins in the stomach, which in the long run may lead to development of gastritis.

In adults

Development in adults is an indication of illness. High fever that is defined as more than 104 degrees F should be treated promptly. The most common causes in adults include:

  • Upper respiratory tract infection
  • Gastrointestinal disorders
  • Skin infections
  • Urinary tract infections

It is characterized by high temperature with duration of 4 days or less is most likely to be of infectious origin. Non - infectious diseases causes either chronic or recurrent fever. Very rarely it stems from non - infectious diseases.

Symptoms

It itself is a symptom, but at times other signs and symptoms may also be present. These include:

  • Headache
  • Vomiting
  • Malaise
  • Nausea
  • Lethargy
  • Diarrhea
  • Stiffness in the neck
  • Pain in extremities
  • Pain in abdomen
  • Chest pain

Development of acute fever with any of the above mentioned symptoms may indicate a different kind of illness.

Approach

A preliminary physical examination is done to confirm the fever. Measuring the rectal temperature is the most accurate way of estimating the right body temperature. Mouth temperature does not always give the correct readings.

Physical examination also includes the presence of skin rashes. The presence of petechial or hemorrhagic rash and any lesions in the area of erythema confirms skin infection as the source.

In addition to this, acute fever should also be assessed with other presenting signs and symptoms. The presence of other symptoms helps to narrow down the possibility of various diseases. For understanding the cause of acute fever, past medical history of the patient also proves helpful.

Treatment in adults

Treatment is cause dependent. Anti – infective therapy is required in cases when it occurs due to infection. Use of antipyretics drugs for treating infection based acute fever is controversial. Whether or not these should be given in cases of infectious diseases is not yet clear. However, 3 drugs of choice are prescribed for treating this condition. These are

  1. Acetaminophen
  2. Ibuprofen
  3. Aspirin is also prescribed for treating fever

It needs special mention here that high doses of any of the above medication may prove to be harmful for liver and kidney and hence overdose should be avoided. A medical practitioner should always be contacted before popping in pills.

In cases, when the fever shoots up and exceeds 41 degree C, then in addition to drug therapy other treatment measures should be followed. These consist of:

  • Cooling blankets
  • Evaporative cooling with tepid water mist

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