5-year old with repeated high fevers lasting only a few hours each (4 times in 2 weeks)

March 9, 2009 2:25 PM

At 8 am this morning my five year old son was fine. At noon he had a temperature of 40.4 C (104.7 F). By 4:30 his temp was normal again. This is the fourth time in the last two weeks he's had a high fever (over 39) that lasts for only a few hours . What's up?

The previous fevers were the afternoon of Wed Feb 25th and early morning (peak around 2 am) on Monday March 2nd and Tuesday the 3rd.

He's been somewhat more irritable than normal over this whole period and had a bit of a cold, but nothing remarkable. He generally refuses to say (and will try to cover up) anything that hurts or bothers him (we sometimes joke that he's the black knight from Monty Python's Holy Grail) so we haven't got any useful feedback from him on what, if anything, hurts.

Wednesday to Friday of last week he peed his pants alot and he's had UTIs before so I took him in to get a urine test which came back negative.

I called his pediatrician this afternoon when his temp was high and they were quite overbooked (lots of stuff going around right now apparently) and asked that we go to the after-hours pediatric clinic which opens at 6 pm (in half an hour). Of course now his temp is normal.

So we will be visiting the pediatrician about this yet. What should we be asking about when he will likely have no symptoms during the visit?

posted by winston to health & fitness (9 comments total)

I should also add that he had one dose of acetaminophen at about 1 pm and that's all.
posted by winston at 2:28 PM on March 9

I've heard that referred to as a spiking fever. Also keep an eye out for any skin rashes, which sometimes come with fevers.

Fevers can have a pretty wide range of causes, so I'd just list the symptoms to the doctor. They likely can do some tests, give you information even when he's not feverish at the time, especially as you're keeping good notes about when they occur.
posted by ejaned8 at 2:36 PM on March 9

Has your son been recently vaccinated? Fevers can sometimes be a side-effect of immunization.
posted by LuckySeven~ at 2:52 PM on March 9

Between the ages of about 5 - 7, my son had frequent bouts of fever of unknown origin. Mostly 100 - 102F. Generally accompanied by crankiness. Lots of tests, no conclusions. There are many bacteria & viruses that are not yet known. I was always concerned about it, and his doc took it seriously, but the cause was never identified.
posted by theora55 at 3:06 PM on March 9

I've had some weird food allergy-related things that caused me to break out in temporary, 2-3 hour sweats/fevers.

First time I ever noticed this was 5 to 6 hours after eating the food in question, which resulted in night sweats/fever, but was gone by the morning.

Could be a milk/food allergy if your kid's getting it 5 hours after breakfast, etc.
posted by bhance at 3:52 PM on March 9

When this happens to me, I always assumed it was my body fighting an infection. Successfully.
posted by gjc at 7:00 PM on March 9

My children have had fevers similar to this when they were cutting teeth, including as they've lost baby teeth and gotten their permanent ones.
posted by lilywing13 at 9:42 PM on March 9

Not enough info to be complete, but as a pediatrician, nothing here sounds super-duper worrisome (as in "go to the ER now" worrisome). Of course, IANyourD, so take things here with a grain of salt.

Repeated high-spiking fevers (as in daily) in a 5 year-old with irritability/rash/red eyes would make me worry about something called Kawasaki's disease, but this is pretty uncommon. To meet diagnostic criteria, you need a fever of 5 days duration. Patients also can have red tongues and big lymph nodes.

The incontinence (assuming he's toilet trained) is unusual and would make me a little more suspicious of a UTI. Does he complain of feeling like he needs to pee (urgency), or is he peeing frequently? Of course, UTIs are uncommon in boys compared to girls, and that in turn would make me thing more about anatomic issues (vesicoureteral reflux) is he has a long history of UTIs.

Playing the odds, though, this is likely a virus that will run its course. Kids throw bigger/higher fevers than adults -- they have far more robust immune responses than us gray-hairs. Keep him hydrated, use tylenol per instructions, and look for patterns/other associated symptoms (viral exanthems, or rashes). But the presence of URI symptoms make me think viral URI of some sort.
posted by scblackman at 8:11 AM on March 10

Thanks for the responses. Yeah, "just a virus" is probably the explanation.

(FWIW, no recent vaccinations, he's been checked out for anatomic issues regarding UTIs, no rash.)
posted by winston at 6:46 PM on March 11