About Medicine: Fever and the Common Misconceptions About It

Allisun Jensen, PA-C
Ravalli Family Medicine
411 West Main Street
Hamilton, MT 59840
(406) 363-5104

Fever is a common complaint and comes with a lot of misconceptions. We are all quite familiar with "normal" body temperature being 98.6°F. What many people don't know is this arbitrary number dates back to 'studies' done in the 1800s. In a much more recent study, average body temperature was closer to 99.9°F. But remember that in either case, it is just an average body temperature. Many people will fall naturally above and below these numbers. Baseline temperature also varies by time of day, age, menstrual cycle, activity level and many other factors. Patients have told me before that their temperature "runs low," so their 99.0°F temperature must be a fever. This is untrue as it may just be related to time of day or their activity before arriving. Because of these natural variations in normal temperature, standards have been developed to determine what does constitute a fever. These vary depending on site where it is taken and age, but in general, we use a temperature of >100.4°F to indicate a fever.

Once a fever is established there is a fear that it is inherently dangerous. While this is true in rare cases, fevers are thought to actually play a role in fighting infection. It can make a person uncomfortable or dehydrated and may need to be treated for these reasons but it cannot cause brain damage. In fact many providers feel that low grade fevers do not need any treatment at all and the first things to be tried would be decreased activity and extra fluids to prevent dehydration.

Also the height of the fever is not as important as how the person behaves. If a child is behaving normally, is playful and happy despite the fever, then observation and treatment at home is appropriate. If a child is inconsolable or alarmingly lethargic then evaluation by a

healthcare provider is much more imperative. Infants less than 3 months old should always be evaluated, as well as those with temperatures >104°F.

Treatment with Ibuprofen or Tylenol can be helpful for those that are uncomfortable or have a fever >104°F. Because of the physiology that creates a fever it is common to be fatigued and achy which decreasing the temperature helps. In children it is especially important to be careful about dosing and basing this on weight rather than age is safer. Normal over the counter dosing for adults is appropriate for fever control. Normally the use of these drugs is only necessary for a short period of time. Persistent fevers for greater than 4 or 5 days or a marked increase in fever over the course of an illness are also reasons to see a healthcare provider.

So keep in mind that fever is not an illness but a physiologic response most commonly to an infection from a virus or bacteria. It does not routinely need to be treated but if there is any question as to where the fever is coming from or if the person appears significantly ill then a trip to your healthcare provider is definitely warranted.

This week's health column is collaboration between Ravalli Family Medicine and Marcus Daly Memorial Hospital. Questions and or comments regarding this week's health column please contact Allisun Jensen, PA-C at Ravalli Family Medicine, 411 West Main Street, Hamilton, MT 59840. Working together to build a healthier community!

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