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BN Doctors’ Lounge: Pyrexia in Children



Few things send parents’ fear skyrocketing like a child’s rising temperature. It’s hard to predict children. A child who was so active all day can get suddenly hot, dull and cranky at night.

A sympthom often experienced when caring for children  is Pyrexia commonly known as FEVER. This is usually a pointer that something is wrong. While a lot of parents may know what to do once this occurs, others may be unsure.

Fever may seem subtle and common but can come with complications. What is done in the nick of time would make a difference to the outcome and the health of the child.

What is a Fever?
Fever can be defined as having a temperature above the normal body temperature range which is 36.5- 37.5 degrees celsius or  97.7- 99.5 degrees fahrenheit.

What Causes a Fever?
Fever can be a response to injury, inflammation, or infections such as respiratory  infections due to virus such as colds or flu. It could also be a response to infections of the digestive tract due to a virus ,bacterial infections – particularly ear infections(otitis media), pneumonia, urinary tract infections. Other illnessess include malaria and typhoid.

Newborns and young infants are at a higher risk of certain serious infections because their immune system is not fully developed. Less common causes are side effects of vaccinations and certain drugs.

Types of Fever
High grade fever – the temperature is near the extreme of a specified range which is highest .

Low grade fever – the temperature is near the extreme of a specified range which is lowest .

Acute fever – which lasts for less than 7 days.

Chronic fever – which lasts for more than 7 days.

Symptoms of a Fever
Infants and children with a fever are usually warm or hot to touch, irritable, may not sleep or feed well and may lose interest in play.

How Can You Be Certain Your Child Has a Fever
Most times, this is recognised from touch. The child feels warm or hot to touch but this can only be confirmed by taking the child’s temperature with a thermometer. This can be taken from the rectum, ear, mouth, armpit, forehead.

There are different types of thermometers -Glass, digital , infrared thermometers .

Every home should have a thermometer.

Detecting a fever is not difficult, but determining its cause can be. This is the reason you need to consult your doctor as your child will need further evaluation and laboratory tests to determine the underlying cause of the fever.

Tips for Home Care
Once you determine your child is above normal limits of body temperature, do the following:

  1. Expose the child – Remove all layers of clothing .
  2. Tepid sponge – This is an act whereby you get lukewarm water put a small cloth or towel in it. Wring out excess water and mop your child’s body with it. This reduces the body temperature. A lukewarm bath can be given, initially.
  3. Administer paracetamol – Give the right dosage according to the instruction on the medication. It’s advisable to always have this at home (kept safe and away from children).
  4. See your doctor – This is essential as fever is not a diagnosis and the underlying cause can only be determined by laboratory tests.

In a Nutshell
Fever is very common and can be initially managed at home; but to prevent further complications, a clinical diagnosis of the underlying cause of the fever is important.

Did you know?

  • Although we often worry about how high a temperature may read,the height of a fever doesn’t necessarily indicate how serious the cause is. Some minor illnesses cause a high fever and some serious illnesses cause a mild fever.
  • Fever in children between ages 6months to 5 years can lead to febrile seizures and convulsions.
  •  Teething, contrary to old wives myths, is not typically a cause of a high grade fever. See your doctor.

Photo Credit: Dreamstime | Hongqi Zhang (aka Michael Zhang)

Kemi Tokan-Lawal is a Medical doctor , milliner, medical writer, maternal and child health advocate. She graduated with a bachelor of medicine, bachelor of surgery from Obafemi Awolowo university .An alumnus of Lagos Buisness School.She is passionate about maternal and child health. She runs an NGO - Oystercare foundation which is an initiative to help the reduction of maternal mortality and under five deaths in Nigeria. Find her on Instagram [email protected] .


  1. Brendz

    September 8, 2015 at 2:27 pm

    I had a horrible scare with my 4yr old, whose temperature spiked suddenly and he stopped breathing. Imagine the horror of watching life slip away from your child…… It still haunts me. I lost m y mind for a couple of minutes. Thank God his dad knew how to administer cpr….thank God for God! At the hospital they couldn’t tell us what caused it….. He had the flu

  2. tilda

    September 8, 2015 at 9:25 pm

    Research suggest that tipid sponge baths can increase risk of rigors that can lead to a spike in temperature see NHS direct. Teething can cause an elevation in temperature above 37.5, but it’s advisable to check for any other symtoms to rule out any thing sinister.

  3. Sandra

    September 9, 2015 at 8:29 am

    Thank you so much . This is so useful . I also had a scare with my toddler . I didn’t know what to do . But now I do ! Thank u

  4. Ktl

    September 10, 2015 at 7:58 am

    A cold bath will crash the temperature , cause rigors and a temperature spike.This is discouraged . Tepid (lukewarm ) water is encouraged this reduces the body temperature.Teething can cause a temperature but might not be the only cause of fever at that time. It’s advisable to see your doctor to double check.

    • maureen

      September 10, 2015 at 10:01 pm

      I refer you to the National Institue Of Clinical Excellence ( NICE ) sponging children with lukewarm water is not evidence bssed practice. Medicine in most places is a science, relying only a on a sound evidence based .There is a place for anecdotal evidence but even then, its no longer medicine. First do no harm. There is no scientific evidence to suggest its effectiveness at effectively reducing fever and preventing fits . At the very least its a placebo ,worse case it can be dangerous. It is not a practiced used in developed countries any more, much like sweating out a fever, even peadiatric nurses know this. Please attend your mandatory training and keep updated .
      Kind regards

    • Dr.Craig

      October 3, 2015 at 11:14 am

      Dear Maureen,

      Evidence based medicine is indeed the way to go in moving our profession forward.
      However I agree with Dr. Tokan-Lawal in that evidence will differ depending on geographic location and the NICE guidelines do not govern practice in Nigeria where this article’s primary audience reside.
      Would you prescribe PhenoxyPenicillin to a child in Nigeria with a bacterial purulent URTI because that’s what the CCG and NICE guidelines dictate? Of course not. Local antibiotic sensitivities in Nigeria show that most URTIS in the community are Penicillin resistant.

      Keep up the good work Dr.KTL.

  5. KTL

    September 11, 2015 at 8:19 am

    I acknowledge the NICE guidelines however, in the tropics like Nigeria where the weather condition differs and illnesses like malaria is one of the first five leading causes of under5 deaths .This is commonly practised using room temperature water and a sponge to reduce the fever before seeing a doctor . As a mother of two underfives based in the tropics ,I have had to use this method a lot of times as a first aid with no downsides.

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