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Dx Fever Treatments: Read more...


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Observation:
Fever in Infants and Children

The Merck Manual Home Edition
states:
"Normal body temperature varies from person to person and throughout the day (it is typically highest in the afternoon). Normal body temperature is higher in preschool-aged children and highest at about 18 to 24 months of age. However, despite these variations, most doctors define fever as a temperature of 100.4° F (about 38° C) or higher when measured with a rectal thermometer.

Although parents often worry about how high the temperature is, the height of the fever does not necessarily indicate how serious the cause is. Some minor illnesses cause a high fever, and some serious illnesses cause only a mild fever. Other symptoms (such as difficulty breathing, confusion, and not drinking) indicate the severity of illness much better than the temperature does. However, a temperature over 106° F (about 41° C), although quite rare, can itself be dangerous.

Fever can be useful in helping the body fight infection. Some experts think that reducing fever can prolong some disorders or possibly interfere with the immune system's response to infection. Thus, although a fever is uncomfortable, it does not always require treatment in otherwise healthy children. However, in children with a lung, heart, or brain disorder, fever may cause problems because it increases demands on the body (for example, by increasing the heart rate). So lowering the temperature in such children is important.

Infants with a fever are usually irritable and may not sleep or feed well. Older children lose their interest in play. Usually, the higher a fever gets, the more irritable and disinterested children become. However, sometimes children with a high fever look surprisingly well. Children may have seizures when their temperature rises or falls rapidly (febrile seizures). Rarely, a fever gets so high that children become listless, drowsy, and unresponsive.

Medications Used in Treatment:
1. NSAIDs: Advil® Motrin®-IB/ibuprofen, Mapap® extra strength, Aleve®/naproxen, choline magnesiium trisalicylate, Sudafed® Pressure and Pain
2. Acetaminophens (Over-the-Counter): Acephen® Tylenol®/acetaminophen, Dayquil®, Tyleno® Cold Nightime, Nyquil®
3. NSAID Cough and Cold Combinations (Over-the-Counter): Advil Cold and Sinus®ibuprofen/pseudoephedrine, Allergy Sinus®, Advil Allergy and Congestion®,
4. Acetaminophen Combinations (Over-the-Counter): Mapap®/acetamnoophen dextromethorphan-phenylephrine, Tylenol® Cold Severe/acetamnophen-dextromethorphan-guaifenesin-phenylephrine

Acute Fever:
"Acute fevers in infants and children are usually caused by an infection. Teething does not typically cause fever over 101° F.

The most common causes are
*Respiratory infections due to a virus, such as colds or flu
*Gastroenteritis (infection of the digestive tract) due to a virus
*Certain bacterial infections, particularly ear infections (otitis media), sinus infections, pneumonia, and urinary tract infections
*Newborns and young infants are at higher risk of certain serious infections because their immune system is not fully developed. Such infections may be acquired before birth or during birth and include sepsis (a serious bodywide infection), pneumonia, and meningitis.

Children under 3 years old who develop a fever (particularly if their temperature is 102.2° F [39° C] or higher) sometimes have bacteria in their bloodstream (bacteremia). Unlike older children, they sometimes have bacteremia with no symptoms besides fever (called occult bacteremia). Vaccines against the bacteria that usually cause occult bacteremia (Streptococcus pneumoniae and Haemophilus influenzae type B [HiB]) are now widely used in the United States and Europe. As a result, occult bacteremia is less common. However, pneumococcal strains that are not a part of the current pneumococcal vaccine or other bacteria can sometimes cause it.

Less common causes of acute fevers include side effects of vaccinations and of certain drugs, bacterial infections of the skin (cellulitis) or joints (septic arthritis), and viral or bacterial infections of the brain (encephalitis), the tissues covering the brain (meningitis), or both. Heatstroke causes a very high body temperature.

Typically, a fever due to vaccination lasts a few hours to a day after the vaccine is given. However, some vaccinations can cause a fever even 1 or 2 weeks after the vaccine is given (as with measles vaccination). Children who have a fever when they are scheduled to receive a vaccine can still receive the vaccine.

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