Q: My child has had a high fever for a week and tested positive for strep throat. The fever reached 40.4°C despite 3 days of antibiotics. Should we go to the ER?
- Myeongchan Kim, MD
- 4 hours ago
- 2 min read
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 8-year-old child has had a cough and a high fever (up to 39.5°C) for four days. We visited a doctor, and a swab test came back positive for strep throat. The doctor prescribed Amoxicillin for ten days. We have been giving the antibiotics for three days now, along with fever reducers and cough medicine, but the fever is still going strong. It has been exactly a week of having a fever in total, and today it spiked to 40.4°C. I have read that if a fever lasts for more than five days, blood tests or X-rays are recommended. It is currently nighttime. Should we go to the ER right now, visit the hospital in the morning for tests, or just continue the antibiotics and wait?
Answer:
It is completely understandable to be very worried, especially with your 8-year-old child experiencing a prolonged fever that has now reached 40.4°C.
⚠️ This is a situation that requires prompt medical evaluation.
Having the fever spike higher despite three days of antibiotic treatment for strep throat is a concerning sign. Please check your child's current condition for the following warning signs:
• Are they unable to drink fluids?
• Is their throat significantly more swollen, or are they having severe difficulty swallowing?
• Are they struggling to breathe or complaining of chest pain?
If your child is experiencing any of these symptoms, please take them to the Emergency Room immediately.
If these severe symptoms are not present and you can wait until morning (meaning the fever decreases slightly with medication, they can drink fluids, and they are fully conscious and alert), you must visit the hospital first thing in the morning. A prolonged fever over five days, especially reaching over 40°C while on antibiotics, warrants further investigation such as blood tests or a chest X-ray to check for antibiotic resistance or potential complications.
For nighttime management:
• You can alternate fever reducers like acetaminophen and ibuprofen (every 4 hours) to help control the fever.
• Continue to encourage fluid intake to prevent dehydration.
• Keep a detailed record of their temperature changes.
Do not wait for the 10-day antibiotic course to finish before seeking help. A high fever persisting after 3 days of antibiotics definitely requires additional testing and a thorough re-evaluation by a medical professional. Please see a doctor as soon as possible.
For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.
