Fever of 38

Fever in adults - HSE.ie

This page provides general information about fever. If you have a child with a fever, see fever in children.

Your body’s normal temperature is between 36 and 36.8 degrees Celsius.

A high temperature or fever, for most people, is when your body temperature is 38 degrees Celsius or higher. This can be a sign that you are unwell. It usually means you have an infection such as a cold. But it can also be due to more serious infections, such as COVID-19 (coronavirus).

Read about the symptoms of COVID-19

Even if you don’t have a high temperature you may still be seriously ill. So it's important to look at all your symptoms.

A fever is usually caused by your body fighting a viral or bacterial infection.

A fever usually lasts 3 to 5 days and most people will recover from a mild fever with self-care at home.

Symptoms

Mild fever (38 to 38.9 degrees Celsius)

With a mild fever you might have flushed cheeks, feel tired and be warm to touch. You will generally be able to carry out normal daily activities.

High fever (39 to 39.9 degrees Celsius)

With a high fever, you’ll feel hot to touch. You may not feel well enough to go to work and you may have aches and pains.

Very high fever (40 degrees Celsius or higher)

With a very high fever, you will usually want to stay in bed or be inactive – you won’t feel well enough to carry out normal activities. You’ll feel hot to touch and you may have lost your appetite.

When to see a GP

Young babies and pregnant women

Babies under 3 months old with fever must be checked by your GP. Contact your GP if your baby is between 3 and 6 months and has a high or very high fever. Read more about fever in children.

If you’re pregnant and have a temperature of 38.5 degrees Celsius, or any fever lasting for 3 days or more, see your GP. They need to monitor the effects of the fever on your baby.

Other ages

Older infants, children and adults will not usually need any medical treatment for mild fever, especially if you are otherwise well.

You should contact your doctor if you:

• have a very high fever (over 40 degrees Celsius)
• are still feverish after 3 days of home treatment or seem to be getting sicker
• are shivering or shaking uncontrollably, or have chattering teeth, and it doesn’t stop within an hour or so
• have a severe headache that doesn’t get better after taking painkillers
• are having trouble breathing
• are getting confused or are unusually drowsy
• have recently travelled overseas

Urgent advice: Contact your GP immediately if

you notice the following symptoms (along with a fever):

• severe headache
• stiff neck
• sensitivity to light

These symptoms may be a sign of meningitis. This needs urgent medical attention.

Causes of fever

Fever is usually caused by a viral or bacterial infection. Fever is your body's way of fighting infection. Raising the temperature inside your body helps to kill the virus or bacteria causing the infection.

Common conditions that can cause fevers include:

• respiratory tract infections
• flu (influenza) and flu-like conditions
• colds
• tummy bugs (gastroenteritis)
• ear infections
• infection of your tonsils (tonsillitis)
• kidney or urinary tract infections
• common childhood illnesses, such as chickenpox, scarlet fever, rubella (German-measles), whooping cough and rheumatic fever

You might have a mild fever after getting a vaccine.

Adults should not take paracetamol before or after getting a vaccine. It may make the vaccine less effective.

Treatment

Medication for fever

Fever is your body’s way of fighting infection. Medication is not needed for mild fever, but you can use paracetamol if you also have a headache, pain or distress.

Self management

• Drink plenty of fluids, especially water (little and often is best). Aim for 2 to 3 litres in 24 hours while you have a fever. This will reduce the risks of dehydration.
• Get plenty of rest. Sleeping for 2 to 3 hours at a time is slightly better than just resting.
• Make sure the room temperature is comfortable - not too hot or too cold.
• If possible, open a window for ventilation but avoid draughts.
• Wear lightweight clothing and use lighter bedding.
• Do not use hot water bottles or electric blankets.
• Use a cool cloth to wash face, hands and neck.
• Change bed linen and clothing regularly.

Content supplied by the NHS and adapted for Ireland by the HSE

Page last reviewed: 18 March 2020
Next review due: 18 March 2023

Fever | Johns Hopkins Medicine

What is a fever?

A fever is a body temperature that is higher than normal. It usually means there is an abnormal process occurring in the body. Exercise, hot weather, and common childhood immunizations can also make body temperature rise.

What causes a fever?

A fever is not an illness by itself. Rather it is a symptom that something is not right within the body. A fever does not tell you what is causing it, or even that a disease is present. It may be a bacterial or viral infection. Or, it could be a reaction from an allergy to food or medicine. Becoming overheated at play or in the sun can also result in fever.

What are the symptoms of a fever?

Normal body temperature ranges from 97.5°F to 98.9°F (36.4°C to 37.2°C). It tends to be lower in the morning and higher in the evening. Most healthcare providers consider a fever to be 100.4°F (38°C) or higher. High fevers may bring on seizures or confusion in children. It's not how high the temperature is, but how fast the temperature goes up that causes a seizure.

A fever has other symptoms besides a higher-than-normal temperature. These are especially important when caring for babies, young children, and disabled people. These groups may not be able to express how they feel. Signs that mean fever include:

• Flushed face
• Hot, dry skin
• Low output of urine, or dark urine
• Not interested in eating
• Constipation or diarrhea
• Vomiting
• Headache
• Aching all over
• Nausea

How is a fever diagnosed?

The best way to diagnose a fever is to take a temperature with a thermometer. There are several types of thermometers, including the following:

• Digital thermometer (oral, rectal, or under the armpit)
• Tympanic (ear) thermometer (not recommended in babies younger than 6 months of age)
• Temporal artery (temperature taken across the forehead area)

Taking a temperature rectally is the most accurate method in children under 3 years of age. In older children and adults, take the temperature under the armpit or in the mouth. Talk with your healthcare provider about the best way to take your temperature.

Most thermometers today are digital, but there are some glass thermometers containing mercury still in use. Mercury is toxic substance and is dangerous to humans and the environment. Because glass thermometers can break, they should be disposed of properly in accordance with local, state, and federal laws. For information on how to safely dispose of a mercury thermometer, contact your local health department, waste disposal authority, or fire department.

How is a fever treated?

You can treat a fever with acetaminophen or ibuprofen in dosages advised by your healthcare provider. Switching between giving acetaminophen and ibuprofen can cause medicine errors and may lead to side effects. Never give aspirin to a child or young adult who has a fever.

A lukewarm bath may reduce the fever. Alcohol rubdowns are no longer recommended.

Call your healthcare provider for guidance anytime you are uncomfortable with the conditions of the fever, and remember to contact your healthcare provider any time a temperature spikes quickly or persists despite treatment.

When should I call my healthcare provider?

Call your healthcare provider right away for a fever in a baby younger than 3 months old.

Call right away or seek immediate medical attention if any of the following occur with a fever:

• Seizure
• Feeling dull or sleepy
• Irregular breathing
• Stiff neck
• Confusion
• Purple spotted rash
• Ear pain (a child tugging on his or her ear)
• Sore throat that persists
• Vomiting
• Diarrhea
• Painful, burning, or frequent urination

Key points about fevers

• A fever is not an illness by itself, but, rather, a sign that something is not right within the body.
• Illness, exercise, hot weather, and common childhood immunizations can make body temperature rise.
• In addition to an elevated temperature, look for other signs, such as: flushed face, hot skin, low urine output, loss of appetite, headache, or other symptoms of an infection or illness.
• Once you have determined that the person has a fever, you may treat it by giving acetaminophen or ibuprofen in dosages advised by your healthcare provider.
• Call your healthcare provider if a baby under 3 months has a fever, or seek immediate medical attention if a fever is accompanied by a seizure, lethargy, irregular breathing, stiff neck, confusion, or other signs of a serious illness.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Fever

Fever and its features in children.

Promotion temperature is the most common symptom of the disease in children, each child has at least 1 time per year fever is noted. Temperature rise is also very common forces the use of medicines, all feverish children receive antipyretic means. This is facilitated by both the idea of ​​many parents about the dangers of high temperature, and the desire of the doctor to alleviate the discomfort associated with febrile reaction or at least make appointment, the effect of which will be obvious. nine0003

Wrestling with fever is an important element of treatment, but not an end in itself, since lowering the temperature in most cases does not affect the course of the disease. therefore the desire to reduce the temperature by all means and keep it at normal level indicates only about a weak acquaintance with the causes and significance of fever.

Fever- an increase in body temperature that accompanies most infectious and some non-infectious (injuries, inflammatory, autoimmune and oncological) diseases. nine0003

Normal the child's body temperature fluctuates during the day from 360C to 370C.

Fever - a defensive reaction directed against the causative agent of infection. At t 38.50C and above, the synthesis of interferons is enhanced, protein synthesis, leukocytosis is stimulated. All these factors reduce the ability to reproduction of many microorganisms. Fever suppression reduces intensity immune response. Fever is dangerous at temperatures closer to 410 C - mainly in children from risk groups. With a high fever, metabolism increases sharply, oxygen consumption and the release of carbon dioxide, fluid losses increase, there is extra stress on the heart and lungs. Initially healthy child tolerates these changes easily, although experiencing discomfort, but in children with pathology (often the central nervous system and congenital heart defects) can worsen the condition significantly. nine0003

There are "pink" and "white" (pale) fevers. "Pink" fever signals the correspondence of heat production to heat transfer, with it, the skin is pink, hot, moist to the touch, the child behaves normally. With "white" fever, the skin is cyanotic or marbled, often appearing "goose bumps" skin", acrocyanosis, cold extremities.

HAZARDS FEVER

Adverse phenomena caused directly by fever are extremely rare. The danger may be a disease that caused a fever that plays protective role. The main danger of fever is dehydration, which is easily prevented or corrected by the introduction of an additional amount liquids. Violation of microcirculation, the signs of which are a marble pattern skin, "goosebumps", cold extremities, are observed with "white" fever and require restoration of microcirculation. Fever is not harmful actions on the CNS. nine0003

K dangers of fever include the possibility of developing febrile seizures, which observed in 2-4% of those predisposed to children, more often at the age of 12-18 months and do not have an unfavorable influence on the central nervous system and its development.

In general, the hazards associated with fever, are largely exaggerated, with most infections the maximum temperature is set within 39. 5-40.00 C, which does not threaten persistent health problems. nine0003

Fever in a child always indicates a disease, but its severity, as usually does not correlate with its severity. Many common viral (eg, rhinitis, sinusitis, pharyngitis, pneumonia) and bacterial (otitis media, urinary tract infection, impetigo) infections in immunocompetent individuals do not have a severe course, against the background of antibiotic therapy or symptomatic treatment, recovery is fast. Other infections (sepsis, meningitis, pneumonia, purulent infections of bones and joints, pyelonephritis) without treatment often lead to complications and sometimes even death. Most febrile diseases in children is associated with viral infections and those bacterial, which only briefly violate the health and do not pose a threat to the life of the child. nine0003

. Fever in a child under the age of 3 months of life requires close monitoring due to high risk of developing a serious bacterial infection.

"White (pale)" fever requires restoration of microcirculation.

Fever without catarrhal phenomena, rash and other visible local symptoms of infection common with urinary tract infection, in children 0-3 years of age may indicate the development bacteremia.

Hemorrhagic a rash (not blanching on pressure) with fever may indicate meningococcemia - in this case, emergency therapy is required.

Rigidity occipital muscles or their soreness, bulging of the fontanel on the background of fever indicates a CNS infection (meningitis). nine0003

Fever associated with abdominal pain and vomiting requires exclusion of appendicitis.

Fever with joint pain may be associated with bacterial arthritis, osteomyelitis.

Resistant fever with rash, changes in the oral mucosa, scleritis, an increase in lymph nodes requires the exclusion of Kawasaki disease.

Continuous (more than 2 weeks) fever requires examination to detect long-term ongoing infections, connective tissue diseases, immunodeficiency, oncological pathology. nine0003

TREATMENT FEVER

Fever is not an absolute indication for temperature reduction.

In cases where the reduction temperature is necessary, there is no need to strive to bring it to normal - enough decrease by 1-1. 50С.

Indications to lower temperature:

In previously healthy children older than 3 months:

- at body temperature above 39.00C -39.50C; and/or

- in the presence of a muscular or head pain;

- in shock.

In children under 3 months of age:

- at body temperature above 380C.

In children with heart, lung, CNS:

- at body temperature above 38.50C.

Uncontrolled the use of antipyretics, especially "course", creates the illusion well-being and causes a belated appointment of etiotropic drugs. nine0003

Selection antipyretics should be founded, first of all, on their safety, and not on the strength of the effect. Ideally, an antipyretic drug for children should have the ability to quickly and effectively reduce the temperature by at least 10C, available in liquid form and as suppositories, rarely cause side effects effects at therapeutic doses and have as wide a gap as possible between therapeutic and toxic dose.

B pediatric practice prohibited the use of acetylsalicylic acid and nimesulide.

REMINDER FOR PARENTS

*temperature - protective reaction; her should be reduced only according to the indications given above;

*adequate fluid administration a feverish child is more important than a decrease in his temperature; nine0003

*not important in antipyretics "strength", but safety, to improve the patient's condition, it is enough to reduce temperature by 1-1. 50C;

* paracetamol and ibuprofen are the most safe drugs, it is important to adhere to the recommended one-time and daily their dosages;

*do not prescribe antipyretic "course" to prevent a rise in temperature, because you can see the progress bacterial infection; nine0003

* should not be used for the same reason antipyretic drugs for longer than 3 days without consulting a doctor;

*with the development of "pale" fever with spasm of the skin vessels, the introduction of an antipyretic agent should be combined with vigorously rubbing the baby's skin until redness and immediately call a doctor.

High temperature - causes, in which diseases it occurs, diagnosis and methods of treatment

High temperature - the causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment.

An increase in temperature serves as a protective reaction of the body and can occur under the influence of various factors. Be sure to separate such conditions as hyperthermia (overheating) and fever, which is also accompanied by an increase in body temperature, but its mechanism differs from overheating and requires other measures to influence the body.

Possible causes

Fever is triggered by external (or exogenous) pyrogens - substances foreign to the body that have entered the bloodstream. These include infectious pyrogens: toxins of viruses and metabolic products of microorganisms. The primary group also includes non-infectious pyrogens: certain lipids, proteins and protein-containing substances that enter the body from the external environment or occur in the body during inflammatory processes, allergic reactions, or the decay of tumor tissues. Primary pyrogens, interacting with the cells of the immune system, initiate the production of internal, or endogenous (secondary) pyrogens - cytokines. They, acting on the center of thermoregulation in the brain, cause an increase in body temperature. nine0003

The feverish state has its own dynamics and includes several stages.

If body temperature is taken as the criterion for the course of fever, then three stages can be distinguished:

stage 1 - the period of temperature rise;

Stage 2 - the period of preservation, or standing temperature;

Stage 3 - the period of temperature decrease to normal values ​​..

Temperature rise stage

The rate of temperature rise depends on the concentration of pyrogens in the blood and can serve as a diagnostic sign.

A rapid increase in temperature to high values ​​​​is observed with influenza, lobar pneumonia,

and also possible when a foreign protein enters the blood (for example, when transfusing blood components). In this case, there is a strong chill, there is a cooling of the skin, which is due to a spasm of the superficial blood vessels. nine0003

A slow rise in temperature is characteristic of adenovirus infection, typhoid fever, brucellosis. In these cases, there may be no pronounced chills, and the first sensations of the disease will be fever, dry eyes, headache, and malaise. Possible blanching of the skin, coldness of the feet and hands.

What should be done?

First of all, it is necessary to warm the patient by wrapping him in a blanket. A heating pad applied to the legs and arms gives a good effect. nine0003

Temperature standing stage

After reaching the upper value, the temperature remains at this level for some time. This period is called the stage of standing temperature, when a balance is established between heat production and heat transfer. At this stage of the disease, the patient feels fever, drowsiness. Perhaps lack of appetite, thirst. Depending on the level of temperature rise, a weak or subfebrile temperature is distinguished - 37-38 ° C; moderate, or febrile - 38-39°C; high - 39-41 ° C and excessive - above 41 ° C.

Knocking down the temperature is not always appropriate.

Fever is a protective and adaptive reaction of the body that occurs in response to the action of pyrogens.

At a temperature of 37.5-38 ° C, the body actively fights infection. However, each person reacts differently to elevated temperatures. Therefore, when deciding on a drug-induced decrease in temperature, one should focus on well-being and associated symptoms. This is especially true for children. Conditionally, the threshold temperature at which it is necessary to strengthen the monitoring of the state of health and external manifestations is a temperature of 38 ° C and above. nine0003

The period of maintaining the temperature at a high level depends on the infectious agent, the state of immunity and the treatment being carried out.

In normal cases, this time can vary from one to five days, but in severe cases of the disease, it can be extended for several weeks.

Temperature fluctuations in a febrile patient have a certain rhythm: the maximum values ​​are noted at 5-6 pm, the minimum - about 4-5 am and variability. With inflammation of the lungs, for example, the temperature can stay at a high level for a long time. For bronchitis, pulmonary tuberculosis are characterized by significant daily temperature fluctuations (1-2 ° C). The so-called debilitating fever is very dangerous, which is characterized by sharp temperature fluctuations (with a rapid rise and fall), sometimes repeated two or three times during the day. There is such a fever with sepsis, the presence of cavities in pulmonary tuberculosis and the decay of lung tissue. nine0003

What should be done?

At high temperatures, it is necessary, if possible, to free the patient from excess clothing and provide access to fresh air, eliminating drafts. A cold compress can be applied to the forehead and areas of large vessels (elbows and knees). You can wipe the body with a towel moistened with cool water.

The issue of drug temperature reduction is decided in each case individually. nine0003

It is more difficult for a person to endure not high temperature, but intoxication of the body. Therefore, the main measures should be aimed at removing toxic metabolic products from the body. This is achieved by drinking plenty of water, if necessary - cleansing enemas.

When prescribing antipyretic drugs for children, the following nuances are taken into account:

- the age of the child is less than three months, and the temperature has risen above 38 ° C;

- a previously healthy child aged three months to six years has a temperature above 39°C;

- in a child with heart or lung disease, the temperature exceeds 38 ° C;

- a child of any age (up to 18 years old) with a convulsive syndrome, diseases of the central nervous system, in the presence of such external signs as pallor, cyanosis of the skin and cold extremities, general lethargy and lethargy, it is necessary to reduce the temperature if it reaches 38 ° C Otherwise, a convulsive syndrome may occur, which is extremely dangerous and can lead to suffocation. nine0003

At high temperatures, the functioning of all organ systems changes.

The heart rate increases by 8-10 beats per minute for every degree of temperature increase. Often there are arrhythmias, more often extrasystole (extraordinary contractions), spasm of blood vessels and increased blood pressure.

The secretory and motor functions of the gastrointestinal tract are reduced, which leads to food retention in the intestines, and the lack of fluid causes constipation. Given these factors, it is necessary to adjust the nutrition of a febrile patient. Preference should be given to liquid easily digestible food, reducing the portion size, but increasing the number of meals. nine0003

There is a feature that should be taken into account for patients with diabetes. It must be remembered that fever is accompanied by an increase in blood glucose levels, which requires appropriate measures.

Treatment

The main antipyretic drugs include non-steroidal anti-inflammatory drugs - paracetamol, ibuprofen, diclofenac. These drugs act quickly and are quickly eliminated from the body.

Although the practice of taking antipyretic pills is widespread, experience shows that side effects are more pronounced in this case. nine0003

It is preferable to use rectal suppositories.

With this method of drug administration, the active substance enters directly into the blood through the blood vessels of the rectum. There is no irritating effect of drugs on the gastric mucosa. It becomes possible to administer the drug regardless of food intake.

Temperature reduction stage

The decrease in temperature in infectious diseases occurs either quickly and is accompanied by profuse sweating, and sometimes a drop in blood pressure, or slowly, within one to two days. nine0003

What should be done?

You can help the patient with a sharp drop in temperature by quickly changing wet clothes to dry ones and drinking hot tea.

It is important to remember that a decrease in temperature is not an indicator of recovery.

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