Q: My child has Influenza A and a persistent high fever of 39.6°C despite cross-dosing fever reducers. What should I do?
- Myeongchan Kim, MD
- Jul 13
- 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 child started having a fever on Sunday evening and was diagnosed with Influenza A on Monday at 11 AM. They received an IV flu medication at the clinic, but the high fever has persisted since then. My child weighs 23kg.
At 9:40 PM, I gave 11ml of acetaminophen, but the fever remained above 39.5°C. At 11:50 PM, I gave 11ml of ibuprofen. It is now 12:50 AM, and the temperature is still 39.6°C. The fever is not dropping at all despite cross-dosing the medications. What else should I do right now?
Answer:
It must be very concerning to see your child's high fever persist despite the medications.
First, let's assess your child's current condition. Please check the following:
• Is your child able to drink water and urinate?
• Are they breathing comfortably (without panting or wheezing)?
• Do they make eye contact and respond appropriately when you wake them up?
[Go to the Emergency Room immediately if any of the following apply:]
• Difficulty breathing (e.g., the area under the ribs pulling in, or nostrils flaring).
• Difficult to wake up, excessively lethargic, or unresponsive.
• No urination for more than 8 hours.
• A stiff neck accompanied by a severe headache or vomiting.
[If the above emergency signs are absent, and your child is drinking and responding:]
Please note that during the first 1 to 2 days of a flu infection, it is very common for a fever to remain high and stubbornly resist dropping, even with fever-reducing medications.
What you can do right now:
• Dress your child in only a single, light layer of clothing and keep the room temperature comfortably cool.
• Offer a sip or two of water or an electrolyte beverage every 5 to 10 minutes to maintain hydration.
• Do not give more medication right now. Wait at least 4 hours before giving the next dose of Acetaminophen, and ensure you wait at least 6 hours between doses of Ibuprofen.
Tomorrow morning, contact your pediatrician and inform them:
"My child received IV flu medication, but the high fever persists above 39°C despite cross-dosing fever reducers."
Go to the ER tonight if you notice:
• The fever is accompanied by shortness of breath or wheezing.
• You have difficulty waking the child up.
• They completely refuse fluids and stop urinating.
For tonight, focus primarily on keeping your child hydrated. Make sure to contact your pediatrician first thing in the morning for a follow-up evaluation.
For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.
