I am Sweating and Then Shivering, Do I Have a Fever?

Do you have an elevated heart rate? Are you breathing faster than usual? Is your body temperature higher than 100.4 degrees? Do you have the sweats and chills? If so, you might have a fever. A fever is classified as a body temperature greater than 100.4 degrees. You develop a fever when a bacteria or virus is seen by your immune system as an invader and sends an army to defeat the foreign presence. Infections are the most common cause of a fever, but other causes can include: reaction to a drug or medicine, cancer, heat stroke, immunization from a vaccine, an inflammatory episode such as a heart attack or a blood clot, or a brain abnormality.

Your doctor may use a couple of different terms when describing a fever. A fever without source is an unexplained fever greater than 100.4 degrees that lasts less than a week, and there is no apparent cause. A fever of unknown origin is a temperature higher than 101 degrees for three weeks and still unexplained after one week of tests. A fever can be contagious if it is related to a bacteria or a virus, but is not contagious if it is due to a drug reaction or heat stroke.

Common Fever Symptoms

A fever is not an illness. It is a sign that your body is fighting some sort of an invader (an infection due to a bacteria or virus) or reacting to external heat or a particular stimulant. Your temperature is lowest at six in the morning and highest at four in the afternoon. Keep those times in mind when taking your temperature.

Who is at Risk for Fever

Children are at a much higher risk to get a fever than adults as they have an immature immune system and also are in the process of receiving the immunizations they need to stay healthy. Adults can also get a fever when they develop a bacterial or viral illness, but can also spike a fever if they contract cancer or have a heart attack.

What Will My Doctor Ask Me?

Your doctor will ask you a variety of questions regarding when the fever started, what or where you were when it started, and how high it has become. Other questions your doctor will ask include:

• How much water are you drinking?
• Have you recently been vaccinated or started any new medications?
• Have you recently been traveling?
• Have you been out in the woods or on a hike?
• Have you been bitten by an animal?
• Have you had any recent dental work performed?
• What type of thermometer do you have?
• How did you take the temperature?
• Have you taken a fever reducer and if so, when was the last time you took a dose?
• Does anyone else in the family have a fever?
• What is your past medical and surgical history?
• What medications do you currently take?
• If the fever is in a child, is the child behaving differently than usual? Is he or she more tired or irritable than usual?

How Do I Treat My Fever?

The hardest part of treating a fever is figuring out what is causing the illness. Your doctor is not just going to give you an antibiotic for your fever. He/she needs to know the reason first because it could be from something that an antibiotic won’t cure. Plus, there are tests they will order to see if it is a bacteria and if you are on an antibiotic, it will skew the results of the test.

Tests

For a fever in a child or an adult, testing needs to be performed to uncover the cause of the illness. Your doctor will order tests such as:

• Complete blood count (CBC) to look for infections in the body
• Stool samples to detect an overgrowth of bacteria
• Urinalysis to detect bacteria in the bladder and urine
• Chest x-ray if a fever is accompanied by a cough or increased rate of breathing
• Infants less then twenty-eight days old should get a complete workup for fever without source including the above tests as well as blood, urine, and brain/spinal fluid (spinal tap)

Treatment

Hospitalization

The treatment for a fever depends on the cause of the illness. Infants and children are at much greater risk for complications and much of the time they have to be hospitalized for fever. Those who need hospitalization include:

• All infants twenty-eight days or younger
• All children and infants appearing toxic (signs of a toxic child include increased heart rate, increased breathing rate, increased temperature, listlessness, and head bobbing)
• Children or adults who are disoriented
• Children with weak immune systems
• Infants older than twenty-eight days and younger than three months may still need to be hospitalized even if the source of the fever has been discovered. Your doctor may feel it is warranted as the child could become dehydrated very quickly
• A child of any age with fever over 105 degrees should be hospitalized
• Any patient who is dehydrated
• Elderly patients at risk for dehydration and falls should be hospitalized

Outpatient

If hospitalization is not needed, your doctor will want you to watch your child very carefully! Keep them hydrated and call immediately with any signs of worsening. Your doctor will want you to be giving fever reducers such as Tylenol or Motrin around the clock when fevers are 103 degrees and higher. You can try giving your child a lukewarm bath after giving them oral fever reducers to decrease the temperature even more and make the child comfortable.

What Should I Know about Fever? – Patient Education

• When giving fever reducers, they only bring the temperature down one to two degrees. If your child has a 103-degree fever, Tylenol or Motrin will only it down to 101 degrees, and that is okay, the medicine is doing its job
• Do not give aspirin to children with a fever because of the risk of Reye’s syndrome which is a condition that causes brain swelling and confusion
• Drink extra fluids – offer your child fluids every thirty minutes
• Do not give Acetaminophen (Tylenol) to an adult or child with liver damage as the liver cannot clear the drug and it can build up to toxic amounts
• Do not give Ibuprofen (Motrin, Advil) to an adult or child with kidney damage as the kidney cannot remove the drug and it can build up to toxic amounts

Emergency Warning Signs/When to Follow Up

For infants, children, and the elderly, your doctor will schedule a return visit for the next morning to assess and evaluate your loved one’s condition.