Q: My child has a sudden high fever of 39.4°C on day 4 of taking antibiotics for tonsillitis. Should we see a doctor immediately?
- Myeongchan Kim
- 3 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 child had a high fever for two consecutive days over the weekend, so we visited the pediatrician on Monday. After testing negative for COVID-19 and the flu, my child was diagnosed with tonsillitis and prescribed antibiotics. Since starting the antibiotics, the fever went away, but today (day 4 of the medication), a sudden fever of 39.4°C (102.9°F) spiked. The morning dose of antibiotics was delayed by about 4 hours today. Could that be the reason? Or could my child have caught the flu in the meantime? There are no symptoms like a cough or runny nose, just the fever. If I can control the fever with reducers, is it okay to finish the antibiotics and visit the pediatrician on Saturday? Or should we go to the hospital right away?
Answer: It is completely understandable to be worried about a returning high fever on the fourth day of taking antibiotics. A temperature of 39.4°C (102.9°F) is quite high, and a 4-hour delay in taking the morning dose is not the direct cause of this sudden spike.
A recurrent fever during tonsillitis treatment could indicate a few possibilities:
• The current antibiotics may not be effective against the specific bacteria causing the infection.
• Complications, such as a peritonsillar abscess, may have developed.
• There is a possibility of a new, overlapping viral infection (such as the flu).
You should immediately check your child for the following warning signs:
• Is the inside of the throat significantly more swollen, or is it very painful to swallow?
• Is the neck stiff, or is it difficult for them to open their mouth wide?
• Are they experiencing any difficulty breathing or drooling?
I strongly recommend that you take your child to see a doctor today rather than waiting until Saturday. Since the fever returned after 4 days of antibiotics, a change in medication may be necessary, and a doctor needs to examine your child in person to rule out complications like an abscess or a co-infection.
In the meantime, here is what you can do:
Administer a fever reducer (acetaminophen or ibuprofen) to help manage the temperature.
Ensure your child stays well-hydrated by offering plenty of fluids.
Continue giving the currently prescribed antibiotics until a doctor advises you otherwise.
Please do not wait. Seek an in-person medical evaluation today. If the fever reducers are ineffective or if your child exhibits any of the severe symptoms mentioned above (stiff neck, drooling, difficulty breathing, or severe difficulty swallowing), you should take them to the Emergency Room right away.
For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.
