Allisun Jensen, PA-C
Ravalli Family Medicine
411 West Main Street
Hamilton, MT 59840
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!