Diagnosing and treating fever

Diagnosing and treating fever

Determining the presence of fever is not too difficult and can be easily measured. Finding and diagnosing an underlying cause can sometimes be somewhat tricky, depending on the nature of what brought on the fever in the first place (i.e. a fungus or bacteria).

How is a fever diagnosed?

At a consultation, your doctor will likely ask a series of questions to try and determine possible causes or rule out any potential reasons for elevated body temperature. It is important that you answer any and all questions as openly and honestly as possible, so as to assist your doctor in being able to make an accurate diagnosis. This ultimately ensures that you receive the most effective treatment plan.

Questions you may be asked can include:

      • When did you first notice symptoms, including fever? (how long ago did you start feeling unwell?)
      • Are you experiencing any other symptoms?
      • Would you describe all of your or your baby / child’s symptoms as mild or severe?
      • Have you or your baby / child recently been around anyone who has been unwell or ill?
      • Have you tried to measure your or your child / baby’s temperature?
      • If yes, how did you go about this?
      • Do you know what the temperature of the environment was where you measured this?
      • Did you take any known fever-relieving medications or give any to your baby or child?
      • Have you taken anything or given your baby / child something that has seem to improve or worsen symptoms?
      • Do you or your baby / child have any other known medical conditions?
      • Are you or your baby / child currently taking any medications or supplements?
      • Have you or your baby / child recently undergone a surgery?
      • Have you or your baby / child recently travelled (locally or abroad)?
      • Have you or your baby / child recently been exposed to animals, such as livestock?
      • Do you or your baby / child have any known allergies?

From there a doctor will request a physical exam to better assess your symptoms, as well as check your overall condition and note any relevant findings. Your doctor will take your temperature and note its classification type. If necessary, he or she will recommend tests to help rule out or diagnose a suspected underlying cause of fever. Tests can include blood tests (to measure white blood cell count) or a chest X-ray.

Other tests which may be recommended include:

      • A throat swab for strep culture
      • Blood culture
      • Sputum (mucus) sample
      • Urine culture or analysis
      • Stool (faeces) sample
      • A lumbar puncture or spinal tap
      • A CT scan
      • Liver function test
      • Thyroid function test
      • Endoscopy

If a baby, especially a new-born that is less than a month old, is being evaluated, it is highly likely that your doctor will admit the little one to hospital for careful monitoring, testing and treatment.

Treatment for fever

The nature of treatment will depend on the determined cause of fever. A general low-grade fever may not be given a recommended treatment plan. In some instances, treating a low-grade fever can lead to prolonging an illness or masking other symptoms. In this way, a cause may not be easily determined or treated.

Intermediate and high-grade fevers may be treated in the following ways, depending on the nature of the cause:

      • Medications (over-the-counter or prescription - NSAIDS and paracetamol): Your doctor may recommend medications (over-the-counter at the pharmacy or prescribed non-steroidal anti-inflammatory or paracetamol medications) to help alleviate fever and reduce body temperature to its normal baseline state. Your doctor will give you very specific doses and use procedures, which should be followed exactly as prescribed so as to minimise risk of side-effects (some side-effects and overdoses can lead to serious health complications and even death). Aspirin-based medications will only be recommended for adults. Aspirin should never be given to children or teenagers (under 18 years of age) suffering from viral infections as it can lead to a rare, but potentially life-threatening condition known as Reye’s syndrome. Antibiotics may be prescribed if the underlying cause of fever is found to be bacterial. Antibiotics prescribed will be specific to the type of bacterium in the body. If the cause is due to a virus in the body, antiviral medications may likely be prescribed, along with recommendations of plenty of rest and fluids. If the underlying cause is a fungus, antifungal medication will be prescribed. If an infant is being diagnosed, it is likely that a little one will be given intravenous medications (through an IV line) and round-the-clock care in hospital. Fever that is found to have occurred as a result of medication or drug use will be treated with a discontinuation of the particular substance.
      • Fluids: A doctor will also likely recommend plenty of fluids and rest. The intake of liquids is important to prevent the occurrence of dehydration. If you or your child are unconscious or unable to receive fluids orally, a doctor will administer an IV line.
      • Hospitalisation: Some bacterial infections, existing medical conditions or immune-resisting illnesses or a blot clot causing fever may likely require admission to hospital and careful monitoring. A person with fever due to environmental heat exposure will also require urgent hospitalisation to be treated with aggressive cooling methods. In this instance, vital signs and organs will be meticulously monitored to control a hyperthermia fever, and lower body temperature safely.

Treating a fever at home

Cold compress treating a feverA low-grade fever, accompanied by other mild symptoms can easily be resolved with a little bed rest (avoiding activity that elevates body temperature) and plenty of cool fluids (water, juices or broth).

Hydration solutions containing proportioned water and salts can also help to replenish a dehydrated body. If your doctor sends you home, you can help things along and treat elevated body temperature by:

      • Sponging yourself with lukewarm water or use a cool compress on the body’s pulse points (chest, arms, forehead, torso and legs) every 10 to 15 minutes (or when you feel that the cloth you are using is warming up).
      • Taking baths with cool or lukewarm water – It is best to take care not to make yourself feel physically uncomfortable. If baths make you shiver, this will work against you and cause your body temperature to start increasing.
      • Ensuring that the room you are resting in is at a comfortable temperature.
      • Sleep with a light blanket or sheet.
      • Dress in light clothing.

Is a follow-up appointment with the doctor necessary?

Low-grade fevers with mild symptoms typically clear with appropriate treatment over the course of a few days. A doctor may request a follow-up appointment to ensure that the underlying cause is completely cleared. Depending on the nature of the underlying cause, a doctor may request that you return for a check-up within a few days or weeks following your initial consultation.

During treatment, you may find that symptoms and fever don’t clear. If your fever persists with treatment, for longer than 3 days, or if you still have a fever for longer than a week without medicinal treatment, consult your doctor again.

A follow-up will be most important for those with existing conditions, such as cancer, or those who are experiencing fever due to an infectious or medication-induced cause, or hormone problem. Relapses are common and repeat treatment, or even hospitalisation, may be required.

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