Can Hives Cause High Fever in Children? the Connection

Can hives be associated with a high fever?

My child is currently 5 years old.
One night around 7 PM, he suddenly developed a high fever, and when I measured his temperature with an ear thermometer, it was 38.9 degrees Celsius.
However, he did not exhibit any cold symptoms such as coughing or a runny nose.
I quickly administered a rectal suppository to help reduce the fever, and it gradually subsided.
However, around 10 PM, I noticed redness on his forehead, and then hives appeared on the side of his neck, resembling mosquito bites.
He said it was very itchy, and eventually, more hives developed on his body.
By 5 AM, he started to have a fever again, measuring 38.9 degrees Celsius.
This time, the redness on his forehead and the hives on his neck had disappeared, but he had more hives on his body and thighs, and his eyelids and nose were swollen, with his upper lip swollen like a pig's snout.
I administered another suppository and managed to hold off until morning when we went to see a doctor, at which point his temperature had dropped to 37.5 degrees Celsius.
The doctor diagnosed him with acute urticaria and prescribed antihistamines and fever-reducing medication, and he received an injection before we went home.
I would like to ask the doctor if urticaria can cause a high fever? Why is his upper lip taking a long time to reduce swelling? Could there be other issues to be concerned about, and what should I pay attention to? Thank you very much for your help!

Zhuó jí de māmā, 30~39 year old female. Ask Date: 2006/08/01

Dr. Jiang Zheen reply Dermatology

Generally, hives do not cause fever unless the underlying cause of the hives is a bacterial or viral infection in another part of the body, or if the hives are due to an autoimmune disease.
In such cases, it is more likely to experience accompanying fever, so it is important to rule out these possibilities in the patient.
As for some patients with hives who experience significant swelling of the eyelids or lips, this condition is referred to as angioedema, which indeed tends to resolve more slowly, but there is no need for excessive concern.
Wishing you peace, Jesus loves you.

Reply Date: 2006/08/01

More Info

Hives, also known as urticaria, are raised, itchy welts on the skin that can occur due to various triggers, including allergies, medications, infections, or stress. In children, hives can sometimes be accompanied by other symptoms, including fever. However, it is essential to understand the connection between hives and fever to address your concerns effectively.

In your child's case, the sudden onset of high fever (38.9 degrees Celsius) without typical cold symptoms, followed by the appearance of hives, suggests that the fever may not be directly caused by the hives themselves. Instead, the fever could be a response to an underlying condition or trigger that also caused the hives. Common causes of hives in children include allergic reactions to food, insect stings, medications, or even viral infections. In some instances, the immune response to an infection can lead to both fever and hives.

The fact that your child experienced a high fever and then developed hives indicates that there may be an underlying allergic reaction or infection at play. The itching and swelling of the skin, particularly around the eyes and lips, can be concerning, especially if the swelling is significant. This condition, known as angioedema, can occur alongside hives and may require medical attention, particularly if it affects breathing or swallowing.

Regarding your specific questions:
1. Can hives cause high fever? While hives themselves do not typically cause fever, the underlying cause of the hives may lead to fever. For example, if your child had a viral infection that triggered both the fever and the hives, then it is possible for them to occur together. The immune system's response to allergens or infections can result in both symptoms.

2. Should you be concerned about the swelling of the upper lip? Swelling of the lips and face can be a sign of a more severe allergic reaction. It is essential to monitor the swelling closely. If the swelling persists, worsens, or if your child experiences difficulty breathing, swallowing, or any other concerning symptoms, seek immediate medical attention. In some cases, antihistamines may help reduce swelling and itching, but if the reaction is severe, additional treatments such as corticosteroids or epinephrine may be necessary.

3. What other symptoms should you watch for? Keep an eye out for any signs of respiratory distress, such as wheezing, difficulty breathing, or swelling in the throat. Additionally, monitor for any signs of anaphylaxis, which is a severe allergic reaction that can be life-threatening. Symptoms of anaphylaxis include rapid swelling, difficulty breathing, a rapid heartbeat, and a drop in blood pressure. If any of these occur, seek emergency medical help immediately.

In summary, while hives themselves do not directly cause high fever, they can occur alongside fever due to an underlying condition. It is crucial to identify the cause of both symptoms and to monitor your child closely for any changes. If you have any concerns or if symptoms worsen, do not hesitate to consult a healthcare professional for further evaluation and management. Your child's health and safety are the top priority, and timely medical intervention can make a significant difference in their recovery.

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