Danger Signs in Fever

 

Most of the commonly occurring fevers are not harmful and are commonly  caused by seasonal virus.  These fevers are self-limiting . Parents and other family members are really worried and the only thing they want is to decrease the temperature somehow .

Latest guidelines from American Academy of Pediatrics(AAP)  and also National Institute for Health and Care Excellence (NICE guidelines from UK) de-emphasize the excessive and routine use of  fever reducing medicines like Paracetamol, Ibuprufen & Mefenemic acid. All these medicines have side effects and Paracetamol is one of the most common  cause of poisoning in children in many countries .

AAP states that " Fever is a physiological mechanism that has beneficial effects in fighting infection.Parents should focus on the general well-being of the child, his/her activity, observing the child for signs of serious illness and maintaining appropriate fluid intake." Therefore always stay calm and take appropriate action .

High grade fever in an otherwise healthy child and fever  not coming down even after using paracetamol are not  danger signs per se .

The danger signs(requiring urgent medical attention ) in a child with fever( either low grade or high grade fever )  are:

    Altered consciousness - speaking abnormally or not responding to call at all or difficult to arouse from sleep or head rolling from side to side or a child having fits or inconsolable crying or child is not interacting ( may indicate Brain infection- Meningitis/Encephalitis )
    Fast breathing with or without chest in drawing or skin bluish/pale in color ( may indicate Lung infection - Pneumonia)
    Poor feeding, not able to suck at breast,  and poor activity in infants( may indicate Blood infection - Septicemia)  .  Most of the children with fever have a decreased appetite. This is not a danger sign .
    Fever in babies less than 3 months of age even without any other symptoms( may indicate Blood infection - Septicemia)
    Any rash during fever ( may indicate Dengue )
    Persistent vomiting ( child may become dehydrated )
    Repeated loose motions ( child may become dehydrated )



Do see a doctor anytime you just feel that the child is not doing well even though you may not definitely identify any of the above symptoms.