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Q: My 3-year-old had Influenza A and the fever dropped, but a 40°C (104°F) high fever returned after 5 days. Is this normal or should we see a doctor?

  • 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 3-year-old child was diagnosed with Influenza A on Monday. After receiving IV fluids, the fever seemed to be well under control. However, starting on Friday (5 days later), a high fever of up to 40°C (104°F) has suddenly returned. Can a flu-related fever spike this high again after subsiding? Could there be another cause, and should we visit the hospital?


Answer:

I understand how worried you must be to see your child experience a recurrent 40°C (104°F) high fever five days after being diagnosed with Influenza A.


⚠️ A recurrent high fever after initial improvement requires immediate medical re-evaluation.


Here are the possible causes of a fever returning after a flu infection:

  • Secondary Bacterial Infection: This is the most common cause and can include conditions like pneumonia or otitis media (middle ear infection).

  • Double-Peak Fever Pattern: While relatively rare, the flu virus itself can sometimes cause a biphasic (double-peaking) fever pattern.

  • Viral Co-infection: Your child may have contracted a new, different virus while their immune system was vulnerable.

  • Dehydration or Other Complications.


You should visit a hospital or urgent care immediately, especially if you notice any of the following danger signs:

  • Fast, labored, or difficult breathing

  • Chest pain or a severely worsening cough

  • Pulling or rubbing the ears while crying (signs of an ear infection)

  • Refusal to drink fluids or a noticeable decrease in urine output


When you go to the hospital, please prepare the following to share with the doctor:

  • A record of the fever pattern (when it spiked, when it dropped, and recent temperatures)

  • A list of all medications your child is currently taking

  • Any newly developed or changing symptoms


A high fever returning 3 to 5 days after a flu diagnosis carries a high probability of a secondary bacterial infection, which may require a prescription for antibiotics. Please make sure to have your child evaluated by a pediatrician today for an accurate examination and proper treatment.


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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