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Q: My 20-month-old has a 39.9°C fever from swollen tonsils. Should we go to the ER for a fever-reducing injection tonight?

  • Myeongchan Kim
  • 5 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 20-month-old daughter (12.5 kg) had the flu two weeks ago. Last night, her temperature was over 38°C, so we visited a clinic this morning. The doctor mentioned that since she had the flu two weeks ago, a reinfection is highly unlikely, and they suspect swollen tonsils are causing the fever.


While her temperature was around 38°C yesterday, it has spiked to 39.8–39.9°C tonight. I gave her 5ml of dexibuprofen at 6:00 PM and 5ml of acetaminophen at 10:30 PM. If her fever doesn't come down soon, should we take her to the emergency room to get a fever-reducing injection? Thank you for your help late at night.


Answer:

It is completely understandable to be worried when your 20-month-old child has a fever approaching 40°C, especially late at night.


Based on the information provided, here is an assessment of the current situation:

  • Medication Timeline: Alternating between dexibuprofen (5ml) and acetaminophen (5ml) with a 4.5-hour interval is an appropriate and safe approach.

  • Dosage: Administering 5ml is the correct dosage for a child weighing 12.5 kg.

  • Tonsillitis Characteristics: Tonsillitis very commonly causes high fevers, and it is typical for temperatures to peak on the second or third day of the illness.


To determine your next steps, please observe your child for the following to see if an emergency room visit is necessary:

  • Go to the ER immediately if: Your child is showing signs of difficulty breathing, is drooling or unable to swallow saliva (which could indicate severe swelling in the throat), or shows signs of severe dehydration (such as not urinating for more than 8 hours).

  • Observe at home if: She is alert, responsive, and able to take small sips of water.


If she is doing well enough to stay home, the next dose of acetaminophen can be given around 2:30 AM.


Regarding your question about the emergency room: fever-reducing injections actually contain the same active ingredients as oral medications and are not necessarily more effective at lowering a temperature. A child's overall condition and behavior are far more important indicators than the number on the thermometer. If she is drinking water and remains responsive, you do not need to rush to the ER just for an injection; following up with your pediatrician in the morning is a perfectly safe plan.


For now, focus on keeping her environment comfortably cool, dressing her in thin, lightweight clothing, and encouraging frequent, small sips of fluids to keep her hydrated. Please see a doctor in the morning for a re-evaluation of her throat and general condition.


For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.






 
 
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