Q: My child has had a high fever of 39°C for 4 days with a swollen throat, despite negative flu and COVID tests. Should we revisit the doctor?
Medically reviewed by Sang Hyun Ahn, MD
Content edited by Myeongchan Kim, MD
This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
Question:
My child is on the 4th day of a high fever. On Friday dawn, the temperature hit 39°C, so we went to the clinic and were told the throat was swollen. There are no other symptoms. On Saturday, we did flu and COVID-19 tests, along with a chest X-ray, and everything was normal. On Sunday, the fever spiked to 39°C every 6 hours. I gave a fever reducer at 8:30 PM, but the temperature was still 38.8°C at 11:30 PM. I gave another dose, and my child went to sleep, sweating heavily at dawn. The temperature returned to normal at 6:00 AM, but it is back up to 38.8°C now. It has been over 3 full days since the fever started. Should we visit the doctor again?
Answer:
You must be very worried since the high fever has lasted for more than three days.
To summarize the current situation:
• High fever of 39°C since Friday, with only throat redness confirmed.
• Flu, COVID-19, and chest X-ray tests on Saturday were all negative.
• Fever spikes to 39°C every 6 hours, indicating the fever reducer's effect is short-lived.
• No other symptoms (such as cough, runny nose, rash, vomiting, or diarrhea) are present.
Why You Need to Revisit the Doctor Today:
If any of the following apply, you should visit the pediatrician again today:
• The fever has lasted for more than 3 days (Applies to your case).
• The effect of the fever reducer lasts less than 4 hours (Suspected in your case).
• The child is lethargic, or their fluid intake and urine output have noticeably decreased.
• New symptoms appear (rash, worsening throat pain, ear pain, abdominal pain, etc.).
Information to Share with the Doctor:
When you visit the clinic, be sure to communicate the following details clearly:
Fever pattern: "It is the 4th day since Friday, spiking to 39°C every 6 hours, and the fever reducer only lasts about 3 hours."
Previous tests: "Flu, COVID-19, and chest X-ray were all negative."
Current condition: Fluid intake, urine frequency, and overall activity level.
What the Doctor May Consider:
• Blood test (to check inflammation levels and white blood cell count).
• Urine test (to rule out a urinary tract infection).
• Streptococcus test (to find the cause of the throat redness).
• Observing the viral infection's progression versus evaluating the possibility of a secondary bacterial infection.
What You Can Do at Home Now:
• Offer water or oral rehydration solutions frequently in small amounts (50-100 mL at a time).
• Dress the child in light clothing and maintain a room temperature of 22-24°C (71-75°F).
• Administer fever reducers only when the child is uncomfortable. (Avoid using wet towels or lukewarm baths).
• Monitor urine frequency and color. (Not urinating for over 8 hours is a sign of dehydration).
Go to the Emergency Room Immediately if You See These Signs:
• Difficulty breathing (chest retractions under the ribs, bluish lips).
• The child is hard to wake up or unresponsive.
• Stiff neck accompanied by severe headache or vomiting.
• Red spots on the skin that do not fade when pressed.
Because the fever has persisted for more than three days and the fever reducers are providing only brief relief, please make sure to have your child evaluated by a pediatrician today for a thorough assessment.
For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.
