Q: My child has a sudden high fever, chills, sore throat, and vomiting. With a history of pneumonia, should I rush to the ER?

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Question:

My child has had a manageable fever for a few days. Tonight, they woke up crying from a cough, complaining of a sore throat. About an hour later, they began shivering with severe chills, and their temperature spiked from normal to 39°C (102.2°F) in just 30 minutes. I gave a fever reducer about 40 minutes ago, but their temperature is now 39.3°C (102.7°F), and the chills continue. They have also vomited and are complaining of neck and arm pain. We had a similar experience before that turned out to be pneumonia, which makes me very worried. Given that it can be difficult to be seen at an emergency room here, I'm unsure if we should go. Could this be pneumonia again?

Answer:

It must be very worrying to see your child's condition change so suddenly, especially when you are abroad.

【Check These Things Now】

• Breathing: Look for retractions (skin pulling in under the ribcage), nasal flaring, wheezing, or bluish lips → If present, call local emergency services immediately.

• Consciousness: Are they making eye contact and responding when you call their name?

• Hydration: Have they urinated in the last 8 hours? Are their lips and tongue moist?

• Neck Pain: Do they have difficulty or severe resistance when trying to bend their neck forward?

【Signs You Need to Go to the ER】

If any of the following apply → Go to a local emergency room now.

• Difficulty breathing (fast breathing, ribcage retractions, wheezing).

• Persistently lethargic, not making eye contact, or difficult to wake.

• Unable to bend their neck forward due to severe pain.

• No urination for more than 8 hours.

• Repeated vomiting, unable to keep even water down.

• Bluish lips or fingernails.

【What to Do at Home for Now】

• You gave a fever reducer 40 minutes ago → Wait up to an hour to see its effect (it takes 30-60 minutes to work).

• Dress them in light clothing and keep the room cool.

• Offer one or two sips of water every 5-10 minutes (go slowly since they vomited).

• Prop their upper body up slightly to help ease coughing and throat pain.

• Do not use wet towels or give a tepid bath to cool them down.

【When to See a Doctor in the Morning】

• The fever is controlled by medication, but the sore throat and cough persist.

• Vomiting occurs 1-2 more times.

• They are urinating, but the amount is small and the color is dark.

• They seem generally weak and are not eating well.

→ Visit a local pediatrician or urgent care clinic to have their throat and lungs checked. Further tests like a throat swab or chest x-ray may be needed.

【Regarding the Possibility of Pneumonia】

Given the history of pneumonia and the current combination of cough, sore throat, sudden high fever, and vomiting → a lower respiratory tract infection cannot be ruled out. However, if their breathing is comfortable and they are conscious and alert → you can monitor them for a few hours, see how the fever reducer works, and get them evaluated in the morning.

For now, check for the emergency signs listed above every 5-10 minutes and watch to see if the fever reducer takes effect. Let us know if there are any changes in their condition—we can decide on the next steps together.

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

https://fevercoach.us