One of the most common worries of every parent seems to be unexplained fever in children. They are a common part of the body’s defense against infections. The average child may have several viral infections a year, any one of which can provoke a fever. Most of these fevers will be of short duration.
It’s nightmare for parents to see their children suffering from fever, especially when it continues for prolonged times and doesn’t respond to routine treatment. Fevers may present as forerunners of serious health problems, and usually, it is quite a difficult task to assess whether the fever is going to lead to something serious.
What Is Unexplained Fever?
Unexplained fevers in children are defined as a body temperature greater than 100.4°F for at least seven consecutive days without an identifiable cause, even after thorough medical checkups and laboratory tests.
Evaluation includes thorough history followed by comprehensive physical assessment, monitoring your child’s weight and growth while searching for any physical anomalies.
Testing: Testing may involve blood or urine tests and would be based on your child’s physical examination and symptoms, or medical imaging like MRIs and x-rays.
What are red flag symptoms to identify an underlying serious condition?
- Fever: persistent, recurrent, prolonged
- Joint pain and swelling
- Pain or weakness in the muscles
- Unexplained rash
- Oral or genital Ulcers
- Unexplained Hair loss
- Redness of eyes, oral cavity
- Loss of weight or Loss of appetite
- Fatigue/extreme weakness
- Night pains or disturbance in childs sleep
- Extreme irritability or lethargy
- Your child is drinking very little and is peeing very little
- Fever in newborns and infants
- Lymph node enlargement
- High inflammatory parameters(ESR/CRP/Platelets)
You Can Take a Temperature Digitally on the Rectum, Ear, Mouth, Forehead, or Armpit of a Child.
Symptoms of Unexplained fever & fatigue in children India, Hyderabad
Digital thermometers are preferred since they are easy to use, give a quicker result, and are way safer compared to glass thermometers, which may break and spill out mercury.
Rectal Temperature: This is the most accurate method. Apply lubricant on the bulb of the thermometer, insert it 1/2 to 1 inch inside the rectum, and hold the child still.
Oral Temperature: Place the thermometer under the tongue. This method is mostly recommended for children above 4 years of age who can hold a thermometer.
Armpit Temperature: This involves putting the thermometer directly on the skin in the armpit. This method is not very accurate but may be used when other methods cannot be done.
Ear Temperature: Insert the thermometer probe into the ear canal to close the canal and press the button. It is also not reliable for infants below 3 months.
Forehead Temperature: Rub the thermometer from hairline to hairline on the forehead with continued pressure on the scan button. This is also less accurate than rectal temperatures, more so in babies less than 3 months old.
When to Worry About a Fever
Most fevers are not of concern; however, there are some circumstances when parents should worry and seek immediate attention from the doctor:
Infants under 3 months: Most fevers in a baby don’t signal anything, but their immune system is not yet developed, and these babies are unable to express their feelings to the caregiver.
Fever with a dark rash: If the baby has a dark rash, like bruises, and they don’t get lighter when you press on them.
Excessive sleepiness or irritability: If the child seems sleepier or more irritable than normal in association with common illnesses, contact a healthcare professional. Moderate to severe symptoms should never be overlooked.
Difficulty breathing: In your child, if breaths are hard to come by, or very fast and forceful. This can be a sign of a very severe lung infection.
Other medical conditions or medicines: Your child has another medical problem or takes medicines that could put them at higher risk of not being able to fight off infections very well.
Also, call your doctor right away if:
Your child’s temperature is higher than 102°F: Probably not serious, but it’s always best to check with the doctor.
Your child has a rash with a fever: Most are not serious, but some, especially those associated with certain viral or bacterial infections, may need to be evaluated.
The fever lasts more than two to three days. It is recommended to seek advice from a professional.
Your child is drinking very little and is peeing very little. It could be a sign of dehydration. The doctor should be contacted for advice on a probable imbalance of fluids.
Fatigue in Children
A sense of weariness, exhaustion, or lack of energy is called fatigue. Too little or too much activity may make your youngster feel this way. It can also result from poor nutrition, boredom, stress, and sleep deprivation. Fatigue can be caused by a variety of medical conditions, including viral infections.
Here are some possible causes of chronic fatigue in children:
- Lack of Sleep: Poor rest, frequent waking, or having a sleep disorder, including obstructive sleep apnea, leads to fatigue. Kids need 8 to 10 hours of sleep in a day.
- Medication Side Effects: Some of the commonly used medications, such as those for allergies, induce drowsiness.
- Infections: Some infections, such as Epstein-Barr virus, can cause long-term fatigue.
- Chronic Illnesses: Conditions such as asthma can result in fatigue if not controlled correctly.
- Anemia: When RBCs are low-energy, a person can feel tired since the body is getting less oxygen.
- Hypothyroidism: A person may have fatigue and a slowed metabolism if their thyroid gland isn’t producing enough thyroid hormone.
- Problems with the Heart: Although it is very rare in children, weariness may result from a weak heart.
- Severe Diseases like cancers: Although they are quite uncommon, fatigue may be one of the initial signs.
- Lack of psychiatric well-being: Depression, anxiety, and stress will also make a child tired almost all the time.
Sometimes the reason for such constant fatigue remains unclear, even in medical diagnosis. If a child remains constantly tired, and it affects their everyday way of life, it is important to see a specialist for further medical examination.
You should schedule an appointment with your doctor if your child has been complaining of constant fatigue for longer than a week or two. This will allow the doctor to:
Make a thorough history of your child’s fatigue and any accompanying symptoms, and enquire about all aspects of their life, including their sleep patterns and any potential sources of stress or worry.
Conduct a comprehensive physical assessment, monitoring your child’s weight and growth while searching for any physical anomalies.
Conduct all necessary testing. Testing may involve blood or urine tests and would be based on your child’s physical examination and symptoms, or medical imaging like MRIs and x-rays.
Assess if it would be beneficial to schedule an appointment with a psychologist or other mental health expert.
Conclusion
In most cases of unexplained fever and chronic fatigue in children, there is no seriously life-threatening cause. In fact, it could be quite an easy problem to treat. So give your doctor a call and make an appointment. That way, they can do the tests and let you know what the problem is, so you can start treating your child and make them feel better as soon as possible.
FAQs for Unexplained Fever in Children
Unexplained fever is defined as a body temperature greater than 100.4°F lasting for at least seven consecutive days without an identifiable cause, even after thorough medical checkups and laboratory tests.
Unexplained fevers are relatively rare but can occur in children. Most fevers are usually linked to viral infections, which are common in childhood.
You should worry if the fever persists for more than two to three days, if your child is under 3 months old, has a dark rash, difficulty breathing, extreme irritability, excessive sleepiness, or if they are drinking or peeing very little.
Red flag symptoms include prolonged or recurrent fever, joint pain and swelling, unexplained rash, oral or genital ulcers, unexplained hair loss, redness of eyes or oral cavity, fatigue, night pains, lymph node enlargement, and high inflammatory parameters.
Yes, if left untreated, unexplained fever can sometimes indicate underlying serious health conditions that require prompt medical attention.
The most accurate method for taking a child’s temperature is rectal temperature measurement. Other methods include oral, armpit, ear, and forehead temperature measurements, though they may be less accurate, especially in infants.
The cause of unexplained fever can be difficult to identify. It may be linked to infections, inflammatory conditions, or other underlying health issues.
Diagnosis involves taking a detailed medical history, conducting a comprehensive physical assessment, and performing necessary tests such as blood or urine tests, and possibly medical imaging like MRIs or X-rays. The doctor may also consider the child’s sleep patterns, stress levels, and overall mental health.
Yes, unexplained fatigue can often be treated once the cause is identified. Treatment may involve addressing any underlying medical conditions, improving sleep habits, managing stress, or making adjustments to the child’s diet and activity levels.
If your child has been experiencing unexplained fever and constant fatigue for more than a week, it’s important to consult a Pediatric Immunologist. These symptoms could be signs of an underlying condition that requires prompt medical attention. Early evaluation by a specialist can help identify the cause and ensure your child receives the appropriate treatment to manage these symptoms effectively.
Author: Dr. Anjani Gummadi
Consultant Pediatric Immunologist and Rheumatologist