Persistent High Fever in Toddlers: When to Seek Help

Fever in young children?

Hello Doctor: My daughter is 2 years and 4 months old.
Two weeks ago, she had a cold and we took her to see a pediatrician who prescribed medication.
However, she has not fully recovered.
On the evening of the 8th, she developed a high fever of 39.5 degrees Celsius.
I administered a suppository to reduce the fever, but by the morning of the 9th, the fever returned.
I took her to a hospital in Lixin District, Taoyuan City, where the pediatrician said it was nothing serious and was just caused by the cold.
He advised us to rest at home and continue medication.
I asked if it could be pneumonia, and he said it was unlikely.
However, after returning home, she continued to have persistent fevers, with the fever returning within four hours and reaching high temperatures again.
She has abdominal distension and only has a bowel movement every four to five days.
My daughter has not been coughing, only has a runny nose, and her voice is very hoarse.
I can hear wheezing sounds from her trachea while she sleeps.
I am very worried about her persistent fever and don’t know what to do.

Ami, 30~39 year old female. Ask Date: 2004/11/10

Dr. Lin Wenxian reply Pediatrics

Dr.
Lin Wen-Hsien, the Director of Pediatrics at Tainan Hospital under the Department of Health, Executive Yuan, responded to DEAR Ami: It must be very concerning for you that your child has had a high fever for several days.
During early childhood, due to insufficient immune resistance, children are more susceptible to infections from pathogens in their environment, such as upper respiratory infections, which can lead to fever.
However, after each episode of cold and fever, on one hand, the child's body will produce antibodies and develop resistance, and on the other hand, as they grow older, their immune function matures, leading to a gradual decrease in the frequency of these upper respiratory infections and fevers.

Fever is actually a natural defense response of the body, activating the immune system to combat external pathogens.
Therefore, parents need to learn how to manage a sudden fever in their child.
When the body feels hot, it is advisable to reduce clothing and bedding, and to use a damp washcloth to wipe the body, allowing moisture to evaporate and help lower body temperature.
It is also important to ensure adequate hydration.

Of course, if the child has had a high fever for several days without improvement, or if you notice a lack of appetite, decreased activity such as not playing or laughing even when not feverish, it is recommended that parents take their child to a pediatrician for a thorough examination.
Tainan Hospital wishes you good health and all the best!

Reply Date: 2004/11/10

More Info

When it comes to managing persistent high fever in toddlers, it is crucial to understand the underlying causes and when to seek medical attention. In your case, your daughter, who is 2 years and 4 months old, has been experiencing a high fever of 39.5 degrees Celsius, which has persisted despite treatment. This situation can be concerning for parents, and it is essential to approach it with care and knowledge.

First, it is important to recognize that fever is a common response in children, often indicating an underlying infection. In toddlers, viral infections are the most frequent cause of fever, but bacterial infections can also occur. Given that your daughter had a cold prior to the fever, it is possible that the fever is a continuation of a viral illness. However, the persistence of high fever, especially when accompanied by other symptoms such as abdominal distension and infrequent bowel movements, warrants further investigation.

The fact that your daughter’s fever returns shortly after administering antipyretics (fever-reducing medications) is a sign that the underlying cause of the fever may not be resolved. Additionally, the symptoms of abdominal distension and infrequent bowel movements could indicate gastrointestinal involvement, which may require further evaluation. The presence of a hoarse voice and wheezing sounds during sleep could suggest respiratory involvement, which might need to be assessed for conditions like bronchitis or pneumonia.

In general, if a child has a fever that lasts more than three days, or if the fever is very high (above 39 degrees Celsius) and does not respond to medication, it is advisable to seek medical attention. Other red flags include difficulty breathing, persistent vomiting, dehydration, lethargy, or any unusual behavior. In your case, since your daughter has been experiencing these symptoms for several days, it would be prudent to follow up with a pediatrician or visit an emergency department for a thorough evaluation.

During the medical visit, the healthcare provider may perform a physical examination and may order tests such as blood tests, urine tests, or imaging studies to determine the cause of the fever. It is essential to communicate all symptoms clearly, including the duration of the fever, any associated symptoms, and the effectiveness of any medications given.

In summary, while fever in toddlers is often benign and self-limiting, persistent high fever, especially with additional concerning symptoms, should not be ignored. It is always better to err on the side of caution and seek medical advice when in doubt. Your daughter’s health and well-being are paramount, and timely intervention can help address any underlying issues effectively.

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