Every parent knows this sensation well: the back of your hand resting against your child's forehead and feeling heat. Fever can be alarming, even to a veteran parent. After the first few instances, the anxiety may morph into more of a constant, low-grade anxiety, where you think: "Is this normal? What could this be? Should I be doing more?"
At Vardaan Hospitals, our pediatric team can appreciate these concerns and hears these thoughts from families on a daily basis. We want to put you at ease: while recurrent fevers in children are not uncommon, and they usually don't represent a significant underlying illness, understanding the why is the first path to peace of mind, as well as your child's well-being.
In this article, you will read what we would explain to a family that calls us with a concern regarding recurrent fever—common causes, concerning symptoms that are worth a second evaluation, as well as treatment of those fevers that will help your child be more comfortable.
A "recurrent fever" does not, in pediatric vernacular, mean a single illness that is still lingering around. It is more classically defined as three or more distinct febrile episodes (a temperature of 100.4ºF or 38ºC or higher) that happen within a period of six months, where each individual episode lasted at least seven days between periods of the child being afebrile.
So, what does this mean? It means the child has fevers that wax and wane versus a fever that never really goes away.
For the overwhelming majority of recurrent fevers in otherwise healthy children, the picture is quite simple: they are just dealing with a succession of new infections. Young children, particularly those in daycare or school, are exposed to a steady stream of new viruses and bacteria. Their immune systems are continuously learning on the job and are ramping with each fever as they attempt to fight off an invader.
Common Causes Include:
Childhood Infection's "Revolving Door": This is most common. A child recovers from the first cold, returns to school, and a week or two later comes back with a completely different virus. Each new infection can lead to a new fever cycle.
Viral Favorites: Some are notorious for causing high fevers and recurring fever cycles. Roseola, for example, causes several days of high fever, and then the fever breaks as a painfully distinctive rash attacks.
Sinus or Ear Infections: Sometimes the child doesn't entirely get over a cold. They may develop a secondary bacterial infection, such as sinus infection, or ear infection, which can lead to fever after a couple of days of respite.
Urinary Tract Infections (UTIs): Young children can also experience recurrent fever cycles if they have UTIs when they are younger than the age to explain the specific discomfort.
In a small subset of cases, recurrent fevers may suggest underlying inflammatory or autoimmune conditions. Our Ranchi pediatric specialists are trained to consider these possibilities, once infectious causes have been excluded. These may include conditions such as Periodic Fever Syndromes (e.g., PFAPA syndrome), which have an expected pattern with fever, mouth sores, sore throat, and swollen glands.
The crucial takeaway? While the common causes are, well, common, a persistent pattern warrants a professional evaluation to rule out anything more complex.
Fever is not an illness, but rather a symptom. The most important thing to observe is your child's overall demeanor. A child with a fever that drinks fluids, engages and smiles in between bouts, is often less concerning than a child who seems very lethargic with a low grade fever.
Trust your instincts; you know your child best. If you notice a few of the following items along with recurrent fevers, please reach out to a Vardaan pediatrician for guidance:
At Vardaan Hospitals we always try to help your child be as comfortable as possible during the time that it takes us to determine what the cause of your child's fever is.
Comfort is Important- Parents should focus on comfort and not just the number on the thermometer. As directed by your physician, you can give age-appropriate doses of either acetaminophen or ibuprofen (never aspirin for children). Dress them in light clothing, encourage them to rest, and provide plenty of fluids (preferably water, diluted juice or broth).
Diagnostic Process – Your pediatrician will complete a thorough history taking and physical examination. Be prepared to discuss not only how long your child has had fever, but also the pattern of the fever and symptoms accompanying your child's fever. Many times, a doctor could order a blood test (often a CBC) or urine test to provide more information and clues.
Specialized Care – If a condition like PFAPA syndrome is suspected, we have a team of pediatric rheumatologists and immunologists who could provide a more accurate diagnosis and outline other treatment options that can often be very effective in getting rid of the child's repetitive fever – fever cycle, altogether.
Dealing with recurrent fevers may feel lonely, but you are not alone. Our caring pediatric team is here to be your partner, while we:
We want you, as the parent, to be informed, and we want your child treated with empathy.
If your child's pattern of fevers is perplexing you, reach out to us as soon as you can. We can help you move to understanding from worrying and facilitate your child's health and happiness once again.
To consult or meet with an expert in our Department of Pediatrics, call us today or book an appointment online.
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