Q: My 35-month-old has pneumonia and a persistent fever of 38.7°C for three days despite medication. Should we go to a university hospital today?

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 35-month-old child was diagnosed with pneumonia this past Friday. The fever started while we were waiting at the clinic, but it initially dropped to the 37°C range after taking fever reducers. However, since Saturday, the fever has not dropped below 38°C (peaking at 38.7°C), even when alternating different fever reducers.

The doctor told us to take the medication until Tuesday and then return, but since the fever isn't going down, I'm wondering if we should go back to the hospital today. We live about an hour away from both general clinics and university hospitals. If we have to make the trip, should we go straight to a university hospital? Is it normal for a fever to persist like this with pneumonia? This is our first time dealing with pneumonia, and it's really exhausting for both of us.

Answer:

It is completely understandable that you are very worried about your child having a persistent high fever for three days.

Here is a summary of your current situation: Your child was diagnosed with pneumonia on Friday, and despite alternating fever reducers, the fever has stayed above 38°C since Saturday, reaching up to 38.7°C today.

Pneumonia Fever Progression & Warning Signs

The antibiotics prescribed for pneumonia typically take 48 to 72 hours to start showing their full effect. However, if any of the following symptoms appear, you need to visit the Emergency Room (ER) for an evaluation today:

• Breathing very quickly or chest retractions (the skin pulling in under the ribs when breathing).

• Lips or nails turning blue (cyanosis).

• Refusing to drink or eat, and not urinating for more than 8 hours.

• Extreme lethargy, constantly trying to sleep, or lacking eye contact and responsiveness.

• Complaining of chest pain.

If your child does not have the symptoms above, is still able to drink water, plays a bit, and is breathing comfortably, you can wait until tomorrow morning. Call the clinic that originally prescribed the medication, explain the current situation, and follow their instructions. The doctor may decide to adjust the medication or evaluate the child sooner than Tuesday.

University Hospital vs. General Clinic

Initial pneumonia treatment can typically be well-managed at a general pediatric clinic. It is standard practice to monitor progress at the clinic where the diagnosis was first made, and they will refer you to a larger university hospital if necessary. Given the long distance, it is best to consult with your current clinic by phone before making an unnecessary long trip.

What You Can Do at Home Now:

• Offer small amounts of fluids (water, electrolyte drinks, or clear broth) frequently, about every 5 to 10 minutes.

• Elevating your child's upper body slightly when they are lying down can help make breathing more comfortable.

• Use fever reducers only when the child is uncomfortable (there is no need to aggressively force the temperature down to normal if they are resting comfortably).

• Keep a simple log of their breathing rate, fluid intake, and the number of times they urinate to share with the doctor.

To summarize the next steps: If there are no danger signs, contact your prescribing clinic tomorrow morning. If any of the danger signs listed above are present, please head to the ER immediately for an in-person evaluation.

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

fevercoach.us

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