Fever in Children: Causes and Treatment Options

High fever

My son is 5 years old.
This afternoon, he got lost in a mall and was very scared.
When we got home, he suddenly developed a fever (39.4°C) with no other symptoms.
After seeing a doctor, they found no issues and only suspected influenza.
I would like to ask: 1.
Can a child develop a fever from being frightened? 2.
Should he take antibiotics (since there are no other symptoms)? If so, when should they be taken?

Christine, 20~29 year old female. Ask Date: 2005/02/17

Dr. Lin Wenxian reply Pediatrics

Dear Christine,
I personally believe that there is no direct relationship between being startled and having a fever; it is possible that the infection was acquired in a public place or through other means.
If it is confirmed to be influenza, it is caused by the influenza virus.
Antibiotics are ineffective unless there is a secondary bacterial infection, as antibiotics are specifically used to combat bacterial infections.
If antibiotics are necessary, they should be taken according to the physician's instructions, as different bacteria require different antibiotics, and the treatment duration and administration methods may vary.
Improper use of antibiotics, or not using them for the required duration, can result in only eliminating easily killed bacteria while leaving behind more virulent and resistant strains, similar to cultivating bacterial virulence.
This may necessitate the use of stronger antibiotics in the future, which is counterproductive.

Wishing you and your child good health and all the best!
Sincerely,
Dr.
Lin Wen-Hsien
Director, Pediatrics Department
Tainan Hospital, Department of Health, Executive Yuan

Reply Date: 2005/02/17

More Info

Fever in children can be a concerning symptom for parents, especially when it arises suddenly and without clear accompanying signs of illness. In your case, your 5-year-old son experienced a high fever (39.4°C) after a stressful event of getting lost in a mall. This situation raises important questions about the causes of fever in children and the appropriate treatment options.

1. Can fright or stress cause fever in children?
Yes, emotional distress or significant stress can lead to a temporary increase in body temperature. This phenomenon is often referred to as "psychogenic fever." When a child experiences fear or anxiety, the body can respond with physiological changes, including an increase in heart rate and body temperature. However, this type of fever is usually mild and transient. In your son's case, while the stress of being lost may have contributed to his elevated temperature, it is essential to consider other potential causes, especially since he developed a high fever.

2. Should antibiotics be administered if there are no other symptoms?
Antibiotics are effective against bacterial infections but are not useful for viral infections, which are the most common cause of fever in children. Since your son has no other symptoms and the doctor suspects influenza (a viral infection), antibiotics would not be appropriate. The use of antibiotics should be reserved for confirmed bacterial infections, as unnecessary use can lead to antibiotic resistance and other complications.

Recommendations for Managing Fever in Children:
- Monitor Symptoms: Keep a close eye on your son's symptoms. If he develops additional symptoms such as a persistent cough, difficulty breathing, rash, or signs of dehydration, seek medical attention promptly.

- Fever Management: For fever management, you can use over-the-counter medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to help reduce fever and alleviate discomfort. Ensure you follow the dosing instructions based on your child's weight and age. These medications can help your child feel more comfortable, especially if he is experiencing any discomfort due to the fever.

- Hydration: Encourage your son to drink plenty of fluids to stay hydrated. Fever can lead to increased fluid loss, so it's essential to ensure he is drinking enough water, clear broths, or electrolyte solutions.

- Rest: Ensure that your child gets plenty of rest. The body needs energy to fight off infections, and adequate sleep is crucial for recovery.

- Follow-Up: If the fever persists for more than three days, or if your son develops new symptoms or if his condition worsens, it is important to follow up with a healthcare provider. They may recommend further evaluation or testing to determine the underlying cause of the fever.

Conclusion:
In summary, while emotional stress can lead to a temporary increase in body temperature, it is essential to monitor your child's overall health and symptoms. Antibiotics are not indicated in this case, given the absence of bacterial infection signs. Instead, focus on supportive care, including fever management, hydration, and rest. If you have any concerns or if your child's condition changes, do not hesitate to consult a healthcare professional for further guidance.

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