Most febrile illnesses in children are viral infections, which do not require treatment. Mild infections, such as otitis media or pharyngitis, are diagnosed on the basis of a careful history and clinical symptoms. The problem becomes identifying children with serious infections that require prompt treatment.
To determine whether a child has a fever, body temperature must be measured. Depending on his or her age, methods may vary:
- in newborns: with an electronic thermometer under the armpit,
- from 4 weeks to 5 years of age: with an electronic or chemical thermometer under the armpit or with an infrared thermometer in the ear.
A fever in a child is defined as a body temperature of 37.5°C. Please note that the temperature measured under the armpit is generally 0.5°C lower than the body temperature.
It is also very important to know what the risk factors are that favour the occurrence of infection: illnesses in other family members, lack of vaccination of the child, recent foreign travel, contact with animals or a particular susceptibility to infection due to an immunodeficiency. Not every fever is a condition with which a doctor should be consulted immediately. Symptoms that accompany a fever and should be of concern to parents are pale or marbled skin, reduced level of consciousness, stiffness of the neck, throbbing darkness, an epileptic state, convulsions, respiratory distress, bile-stained vomiting or severe dehydration. Very often the fever is accompanied by rashes. Some are so characteristic that, together with the symptoms, they allow the diagnosis to be established. The appearance of a characteristic haemorrhagic rash should prompt parents to visit the hospital immediately, as it may be indicative of meningococcal septicaemia.
Children who are not in a severe general condition can be left at home, but the doctor's instructions and recommendations regarding observations and symptoms requiring immediate medical consultation should be listened to carefully. Children who are clearly in poor condition and where the focus of infection is not known should stay in the ward and be examined, observed and treated there. Antipyretics are given to children who are feverish, in pain and in poor general condition. Paracetamol or ibuprofen are usually used.
In summary, the most common cause of fever in children is upper respiratory tract infections. It is not always necessary to include antipyretic treatment unless there are additional worrying symptoms. During a fever, it is important to observe the child closely and respond if the condition worsens. It is extremely important to look closely at the child's skin, as a rash can facilitate diagnosis and the implementation of possible treatment.