Q: My child has had a persistent fever over 40°C since Thursday despite ER visits. Should we just wait until Monday's appointment with fever reducers?

Medically reviewed by Sang Hyun Ahn, 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 has had a persistent high fever since Thursday night. We visited the pediatrician on Friday, and flu and COVID-19 tests were negative. From Friday night to Saturday morning, the fever spiked to 40.9°C with chills, so we went to the ER. Flu was negative again, the chest X-ray was normal, but blood tests showed slightly elevated inflammation markers. We were sent home after a fever-reducing injection.

However, a high fever (39.8°C) continued Saturday morning. By Saturday afternoon, the temperature hit 40.6°C, and my child vomited once. We went to the ER again, but the urine test was clear. Now that we are back home, the fever keeps exceeding 40°C every 5-6 hours. Should I just keep giving fever-reducing medication and wait it out until our outpatient appointment on Monday?

Answer:

I understand how incredibly worrying it must be to see your child's fever persistently stay over 40°C, especially after two trips to the emergency room.

To summarize your current situation: Your child has been battling a severe high fever for three days, accompanied by chills and one episode of vomiting. Fortunately, tests for the flu, COVID-19, and a urinary tract infection are negative, and the chest X-ray is normal. The blood tests only showed mildly elevated inflammation markers.

Since the fever keeps spiking, you can continue managing it at home until Monday, provided there are no new emergency symptoms. Here is how you can manage the fever in the meantime:

1. Alternate Fever Reducers: You can cross-medicate by alternating acetaminophen (Tylenol) and ibuprofen every 3 to 4 hours to help bring the temperature down safely.

2. Focus on Hydration: Offer small, frequent sips of water or electrolyte-replacement fluids whenever your child is awake.

3. Keep the Environment Cool: Dress your child in light, breathable clothing and maintain a comfortable room temperature (around 24-26°C or 75-78°F).

4. Log the Symptoms: Keep a written record of the time, temperature, administered medications, and any other symptoms to share with the doctor on Monday.

⚠️ When to Return to the ER Immediately:

Please do not wait for the Monday appointment and go back to the emergency room right away if you notice any of the following danger signs:

* Your child becomes increasingly lethargic, confused, or unresponsive.

* They are struggling to breathe, breathing very fast, or their chest is sinking in with each breath.

* They have not urinated in over 8 hours.

* Repeated vomiting prevents them from keeping fluids or medication down.

* A new skin rash appears, or their lips, hands, or feet turn blue.

A fever exceeding 40°C for more than three days could indicate a developing bacterial infection, which will likely require further evaluation during your outpatient visit on Monday. If none of the emergency signs are present, continue managing the fever with medication at home. However, if your child's overall condition appears to be worsening at any point, do not hesitate to revisit the emergency room.

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