Summer Fever in Children: Symptoms, Duration, and When to Seek Help

Regarding the issue of summer heat!

Hello Dr.
Hsiao: On the early morning of May 18th, my younger brother suddenly developed a fever of 38 degrees Celsius.
We took him to the emergency department at Kaohsiung Chang Gung Memorial Hospital for blood tests, urinalysis, and stool tests, and he was given antipyretic medication.
However, after one hour, his fever did not subside and remained at 38 degrees.
Since the antipyretic medication had not yet taken effect, we could not administer more, and because his temperature did not reach 38.5 degrees, we could not use suppositories.
Instead, we applied an ice pack, but eventually, the ice water leaked out, and we did not notice it in time, causing his temperature to rise to 40 degrees.
We then administered a suppository and admitted him for further treatment.
Throughout the time in the emergency department and during his hospitalization, he continued to have diarrhea and fever, but all blood tests, urinalysis, and stool tests returned normal results.
The doctor diagnosed him with gastroenteritis.
By Monday afternoon at 5 PM until the next morning, he did not have a fever, so the doctor allowed him to be discharged.
However, he still had diarrhea upon discharge, and the next day he developed a fever again.
Instead of returning to the doctor at Chang Gung, we first visited a clinic near our home, where it was noted that his throat was slightly red and there was some phlegm in his lungs.
The doctor prescribed ibuprofen for fever and some cold medication, instructing us to give him 3.5 cc of ibuprofen each time he took his medication.
Until yesterday, when the medication ran out, we returned to the clinic for a follow-up examination.
It was found that his throat was no longer red and there was no phlegm in his lungs, but his temperature remained slightly elevated at 37.2 degrees.
The clinic doctor advised us to return to Kaohsiung Chang Gung for further examination to determine the cause of the abnormality.
After returning home from the clinic, around noon, I checked my brother's temperature, which had risen to 38 degrees, so we took him back to the emergency department at Kaohsiung Chang Gung.
He underwent blood tests and urinalysis again, all of which were normal, and the doctor found no abnormalities, concluding it was "summer heat." Today, I recorded my brother's temperature: at 7 AM, just after waking up, it was 37 degrees in an air-conditioned room at 26 degrees; at 8 AM, ear temperature was 37.3 degrees; at 10:30 AM, it was 37.4 degrees; at 11:53 AM, it was 37.6 degrees without air conditioning at 29 degrees; at 1:58 PM, it was 36.7 degrees after a nap in an air-conditioned room at 27 degrees; at 3:54 PM, it was 36.8 degrees right after waking up; at 6:40 PM, it was 37.1 degrees without air conditioning at 28 degrees; at around 8 PM, left ear temperature was 36.8 degrees and right ear temperature was 37.2 degrees in an air-conditioned room at 25 degrees; at bedtime, it was 36.3 degrees in an air-conditioned room at 25 degrees.
He had two loose stools, urination was low, and he was not very keen on drinking water, but he would drink some electrolyte solution.
He sweats a little but not excessively.
His energy levels seem fine, and his appetite is good! 1.
Does this seem like summer heat? 2.
How long does summer heat typically last? How long should we wait before seeing a doctor? 3.
Is it normal for my brother to sweat easily while sleeping?

Zhuang Tai Tai, 30~39 year old female. Ask Date: 2013/05/27

Dr. Xiao Kaiwen reply Pediatrics

1.
Summer heat is commonly observed during the hotter months, particularly in infants aged six months to three years.
This may be due to the immature thermoregulation function in young children, causing their body temperature to rise with increasing environmental temperatures.
Typically, this pattern is regular (higher during the day, decreasing in the evening, and gradually rising again by morning).
The body temperature usually reaches around 38 degrees Celsius (axillary) or 38.5 degrees Celsius (tympanic), and it rarely exceeds 39 degrees Celsius.
Other illnesses must be ruled out, and the recorded temperature must align with the aforementioned pattern before diagnosing summer heat.
2.
Summer heat is related to climate and may improve only when the weather cools down in the fall.
It is a benign condition that generally improves as the child grows older, and there is no specific timeframe after which a doctor must be consulted; the primary concern is the diagnostic criteria mentioned above.
3.
Rapid metabolism and increased sweating in children are common and normal.
Rare pathological causes, such as heart disease, hyperthyroidism, or tuberculosis, may occur, but these are usually accompanied by other symptoms.

Reply Date: 2013/05/27

More Info

Understanding summer fever in children can be quite challenging for parents, especially when symptoms fluctuate and the cause remains unclear. Based on the information provided, it appears that your brother has experienced a series of fevers, gastrointestinal symptoms, and a recent diagnosis of "summer heat" or "summer fever." Let's break down the situation and address your questions.

1. Is this likely summer fever?
Summer fever, often referred to as "summer heat," is a term used to describe a mild viral infection that typically occurs during the warmer months. It is characterized by fever, often accompanied by gastrointestinal symptoms like diarrhea, and is usually self-limiting. Given that your brother had a high fever (up to 40 degrees Celsius) and was diagnosed with gastroenteritis initially, it is plausible that he is experiencing summer fever, especially since his blood tests and other examinations returned normal results. The fact that he has shown some improvement, such as a reduction in throat redness and lung congestion, further supports this possibility.

2. How long does summer fever last, and when should we seek medical help?
Summer fever generally lasts for a few days to a week. However, if the fever persists beyond three days, or if it exceeds 39 degrees Celsius consistently, it is advisable to consult a healthcare professional. Additionally, if your brother exhibits any concerning symptoms such as severe lethargy, difficulty breathing, persistent vomiting, or dehydration (e.g., very little urine output, dry mouth), you should seek medical attention immediately. Monitoring his hydration status is crucial, especially since he has been experiencing diarrhea and is not drinking much water.

3. Is it normal for my brother to sweat while sleeping?
Yes, it is normal for children to sweat during sleep, especially if the room is warm or if they are bundled up in blankets. Sweating is a natural response to help regulate body temperature. However, if he is sweating excessively or if it is accompanied by other concerning symptoms (like fever or irritability), it may warrant further evaluation.
In summary, while your brother's symptoms align with summer fever, continuous monitoring is essential. Keep track of his temperature, hydration, and overall behavior. If he shows signs of dehydration, persistent fever, or any new concerning symptoms, do not hesitate to return to the doctor. It’s always better to err on the side of caution when it comes to the health of children.
Lastly, ensure that he stays hydrated, perhaps with electrolyte solutions, and encourage him to rest. If his condition does not improve or worsens, follow up with a healthcare provider for further evaluation.

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