Prolonged Fever in Children: Causes and Treatment

While a fever is a common response indicating that the body is fighting off an infection or illness, a prolonged fever can be particularly concerning.

It is not just about the number on the thermometer; it is about the duration and the potential underlying causes that might be triggering such a persistent response in a child’s body.

In this article, we will delve into the various reasons behind prolonged fevers in children, shedding light on when it is a mere symptom and when it might be a sign of something more serious.

What is prolonged fever in children?

A prolonged fever is characterised by a fever exceeding 38.3°C (101°F), occurring at least once daily for a minimum of 8 days, without a clear diagnosis following thorough evaluation, including a detailed medical history, comprehensive physical examination, and initial laboratory tests, either in an outpatient or hospital setting.

Read more: Fever in Children

What are the causes of prolonged fever in children?

The following are some of the common causes of prolonged fever in children:

• Infections: These encompass a wide array of viral, bacterial, fungal, and parasitic illnesses, such as urinary tract infections, tuberculosis, infectious mononucleosis, and various respiratory infections.
• Inflammatory conditions: Autoimmune diseases like juvenile idiopathic arthritis, Kawasaki disease, and systemic lupus erythematosus can provoke prolonged fever episodes.
• Malignancies: Certain cancers, including leukaemia, lymphoma, and neuroblastoma, might manifest with persistent fever as a symptom.
• Connective tissue disorders: Conditions such as familial Mediterranean fever and periodic fever syndromes can lead to recurrent or prolonged fevers.
• Drug reactions: Fever may arise as a reaction to specific medications or vaccines.

What are the symptoms of prolonged fever in children?

• Sleep disturbances
• Swollen lymph nodes
• Irritability
• Rashes
• Fatigue
• Joint pain
• Loss of appetite
• Nausea or vomiting
• Abdominal pain

How is prolonged fever in children diagnosed?

As prolonged fever in children is a serious concern, a multi-pronged diagnostic approach should be employed to determine the exact cause.

• Understanding medical history: Examining a child’s medical history, including recent illnesses and vaccinations, is crucial as it often holds vital clues to the current condition.
• Physical examination: A thorough physical examination helps identify signs of infection, inflammation, or other underlying conditions. This examination may also help uncover symptoms that were initially overlooked.
• Blood tests: This includes tests, such as complete blood count (CBC), blood cultures, urine analysis, and inflammatory markers like erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Additional tests may be ordered based on the suspected underlying cause.
• Imaging studies: X-rays, ultrasound, or computed tomography (CT) scans may be necessary to evaluate specific organs or areas of concern.
• Specialised testing: Depending on the clinical presentation and suspected diagnosis, specialised tests may be required. These could include serological tests for specific infections, autoimmune panels, or genetic testing for hereditary fever syndromes.

How is prolonged fever in children treated?

The treatment of prolonged fever depends on addressing the root cause. Treatment options include:

• Medications
  • Antibiotics for bacterial infections.
  • Antiviral medications for viral infections.
  • Antifungal medications  for fungal infections.
  • Antipyretics such as paracetamol may be used to reduce fever and alleviate discomfort.
• Supportive care: Ensuring the child gets adequate rest and stays hydrated is essential. Comfort measures such as cool compresses or lukewarm baths can help reduce fever. Encouraging a nutritious diet can also support the child’s overall health and immune function.
• Management of underlying conditions: If the fever is due to an underlying condition such as an autoimmune disorder or malignancy, treatment may involve managing that condition with medications, therapy, or other interventions.

How to prevent prolonged fever in children?

Preventing prolonged fever in children involves various strategies aimed at reducing the risk of infections and managing underlying health conditions. Here are some preventive measures:

• Healthy lifestyle: Encouraging a healthy lifestyle, including a balanced diet, regular exercise, adequate sleep can support a strong immune system and reduce the risk of infections.

• Vaccination: Ensure child is up-to-date on vaccinations.
• Hygiene practices: Teach children proper handwashing techniques and hygiene habits to reduce the risk of infections.
• Awareness and early detection: Parents should be vigilant and seek medical advice when child’s fever persists. Early diagnosis and treatment aid in a faster recovery.

Make an appointment at Pantai Hospitals

As caregivers, understanding and addressing prolonged fevers can make all the difference in ensuring our children’s well-being. Children are remarkably resilient, and with the right care, they often bounce back stronger. As a parent, always trust your instincts, keep a close eye on accompanying symptoms, and never hesitate to seek professional advice when in doubt.

Remember, appropriate treatment and early diagnosis are necessary to ensure the child’s well-being.

Get in touch with us to book an appointment today for a consultation, or visit our Paediatric Care Department at your nearest Pantai Hospital.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.