How high can a fever get before seeking care?
April 22, 2013 8:19 AM   Subscribe

Feeling ill yesterday and today, with a fever, slight cough, stuffed nose, sore joints. Taking dayquil and nyquil, and keeping track of my temperature every few hours. What temperature means "go to the hospital?" What other symptoms re: the cough and nose might man go to the hospital?

In america, with an okay PPO but no regular doctor yet.
posted by jsturgill to Health & Fitness (28 answers total)
I mean, it totally depends, but 103 would do it for me. Maybe a high 102.
posted by roomthreeseventeen at 8:20 AM on April 22, 2013 [2 favorites]

Anything below 100 barely rates as a fever so as long as the stuff you're taking keeps your fever below that, you're OK.
posted by fiercekitten at 8:21 AM on April 22, 2013

If you get a sudden, blinding headache or stiffness in your neck, go. You may be overreacting, but it could be menegitis.

I'd say 102 or 103 is problematic.

FWIW, I find that Asprin (not Tylenol) is a better fever reducer. Cool baths can help as well.
posted by Ruthless Bunny at 8:28 AM on April 22, 2013

103 is the rule of thumb I've heard as well (and not just from Foreigner, either). I would also think about calling the doctor if your cough gets way worse.

Feel better.
posted by EmpressCallipygos at 8:29 AM on April 22, 2013

Temperature itself (except in extremis) isn't a reliable indicator of how 'ill' you are. The time to seek emergency treatment is when other factors come into play - such as feeling unusually sleepy, being very dehydrated, having a non-blanching rash, or convulsions. If medications are having no effect (even for an hour or two) in bringing down your temperature, that may also be cause for concern.

Judging from your description of your symptoms, it sounds like the standard cold/flu-like virus - in other words, nothing that a doctor or a hospital visit is likely to help.
posted by pipeski at 8:32 AM on April 22, 2013 [1 favorite]

The guidelines also say that you should call the doctor if the fever stays above 103.
posted by Cygnet at 8:33 AM on April 22, 2013

What other symptoms re: the cough and nose might man go to the hospital?

Basically unless you are very old, very young, or immunocompromised, there should be no reason for you to need to go to a hospital. If you really are suffering with a cough that doesn't go away and interferes with your sleep, dropping by a walk-in clinic for a prescription for Tussionex might be worthwhile. Some doctors I know are REALLY big fans of tamiflu, but the truth is that it only cuts things short by a day or two.

I've had the flu plenty of times, but I don't think I had a "fever scare" requiring medical intervention since I was 3 years old.
posted by deanc at 8:34 AM on April 22, 2013 [1 favorite]

100.4F (38C) or above is a fever.

No one is going to be able to give you medical advice on if or when you should seek medical attention vs wait something out; pipeski is correct that typically the degree of fever does not tell you how sick someone is. In fact, roseola, a common, viral infection in kids that goes away on its own and requires no treatment -- typically presents with a very high fever. (104 is quite common.)

I'm not aware of any good data suggesting a correlation between adult temperature and risk of having a "serious" or life-threatening illness. (In fact, in this recent study (in children), there appeared to be no correlation between severity of illness and degree of fever.)

In medicine, we all have a "chicken" factor -- a number at which we're all going to get worried or want to treat or see a patient -- that's why you're going to get different numbers from different guidelines. There are people with 105 degree fevers who appear really well, and just have a very reactive thermostat, and there are people with 105 degree fevers who are certainly critically ill.

105 and up gets my attention, but it's the patient as a whole that might make me concerned, not just a temperature--which is why the internet isn't great for medical questions. (And of course, there are other things that cause fever besides infection, but that's a story for another day.)
posted by gramcracker at 8:43 AM on April 22, 2013 [1 favorite]

For adults, over 102 or lasting longer than three days means that your immune system isn't fixing it on it's own, and you should see a doctor. Or one of those 'urgent care' centers. But NOT the ER.
posted by MeiraV at 8:49 AM on April 22, 2013 [1 favorite]

If you have an okay PPO there is almost certainly a 24-hour nurse line that you can call to discuss your symptoms. Let them make the call about what kind of care you need.
posted by Wordwoman at 8:53 AM on April 22, 2013 [4 favorites]

I've always heard that 104 means that you need to go to the hospital, but since you are getting conflicting advice, I'd call your insurance company's 24hr nurse hotline and check with them.

At some point, high fevers can cause brain damage, so a very high fever that does not come down with medication does need an ER visit. But, for a low fever and flu or cold symptoms, I just rest and stay hydrated.
posted by insectosaurus at 8:54 AM on April 22, 2013 [1 favorite]

If you are having difficulty breathing, blood coming out of a place you don't generally expect it (eyes, ears, rectum, urethra), a fever of 103 or higher that does not respond to medication, severe headache with motion-limiting neck stiffness, or you are so dehydrated that when you pinch up the skin on the back of your hand it does not smooth back out on its own, you should consider going to the hospital. (Though urgent care can probably handle IV hydration if that's your major problem.)

If you just feel like gilded shit on a platter (which for me starts at around 99 degrees, with awful joint/skin/hair/eyeball pain at 100) or are suffering the kind of vomiting or diarrhea that is preventing you from keeping down any water, you can go to urgent care or the doctor or wherever the PPO wants you to go for short-notice appointments.

I think Dayquil and Nyquil are kind of crap and tend to cause rebound discomfort. Take the individual components (fever/pain reducer of choice, the good pseudoephedrine from behind the pharmacy counter, benadryl for an antihistamine and sedative, dextromethorphan for cough with or without guaifenesin) at their own recommended intervals and dosages. I find decongestants work better for me if I'm only taking them 12 hours on/12 off, otherwise it starts to rebound. And the big Q uses acetominophen (tylenol), which is better for fever for a lot of people but not as good for body aches. Ibuprofen isn't quite as great for fever but better for pain. Buying all this separately when you feel like Death's cousin is not super fun, but get yourself a treat at the drugstore. Drugstores sometimes have great fluffy socks.

Like the others said, call the nurse line if you're really considering going to the hospital. It's a terrible use of resources (and the likelihood of catching something worse, on top of waiting for hours and hours because you are not having a heart attack or gunshot wound) and not the right place for a really crappy cold.
posted by Lyn Never at 9:12 AM on April 22, 2013 [2 favorites]

You may NOT be able to assess for yourself that your fever is in the danger zone, lord knows I sure wasn't. Or rather, by the time my fever was in the true danger zone, I was incapable of doing anything but lying on the floor and babbling. Which, uh, you probably want to avoid.

No need to check it every few hours, but go ahead and check a couple times a day. And 103-104, when it persists despite meds and cold baths, is time to contact a doctor.
posted by like_a_friend at 9:14 AM on April 22, 2013

When my husband had a temperature of 104.7, the nurse on the care line said that if we couldn't get it down under 103 with ibuprofen and tylenol that we should go to the ER. He was also glassy eyed and had cognitive and mentation changes. Fortunately, his temp did come RIGHT down with drugs, and his clarity of mind came back with the lowered temp. He had the flu. 102-103 is sick, but doesn't require an ER visit all by itself.

Non feverish things that would require an ER doctor include losing consciousness, feeling short of breath like you had just run up a couple of flights of stairs but while you're just sitting on your couch, vomiting up blood, etc. The ER is for imminent danger to life or limb. If you are sick enough that you would see you regular doctor if you had one, but you DON'T have one, then you want a minute clinic or an urgent care.
posted by KathrynT at 9:17 AM on April 22, 2013

Anecdata: it really depends on you... I've hardly ever gotten fevers so they are not a good indicator of illness for me, despite the guidelines (and any new MD I've ever gotten... *sigh*.) My baseline temp is actually around 97.4 (the 98.6 is an average, remember.) I always have to explain that to MDs, and they never believed me, until I landed in the hospital with bilateral pneumonia, sepsis, and acute renal failure (!) with a temp that never got above 101.5 (which is why MDs were kind of shrugging me off until that point.) I don't share this to scare you, simply to point out that everyone is different, and that you should be your own best advocate.

SO, know your body, record your temps (write them down, because hey, you have the info, and might as well make a graph :) and if after two or three days the fever hasn't broken or if it doesn't come down with relievers, see your MD. If at any time you have trouble breathing, confused thinking, vomiting, hallucinations, etc. call your MD immediately.

On Preview: What like_a_friend and KathrynT said.
posted by absquatulate at 9:20 AM on April 22, 2013 [2 favorites]

Personally, I would go to Urgent Care at an extended fever of 103, if it didn't come down after a cold shower and Tylenol. Other symptoms related to a cold or flu that might make me consider an ER visit would be fainting, or coughing up any blood.

If you have a PPO, they may have a nursing hotline that you can call for medical advice. I would search the website of your health care insurer.

You might also be able to get a regular appointment with a doctor if you call a local healthcare provider.

And you're not "high maintenance" for asking and/or being worried about your health. Most likely you just have a really tough flu or cold but when you feel really miserable it's understandable you'd be worried and what to know what to be alarmed at. Hang in there!
posted by pazazygeek at 9:21 AM on April 22, 2013

like others have said, it's important to know what your normal temperature is. i also have a lower than average temp, so if i had a 102 that i couldn't get down, i'd go to my doc or a walk-in clinic.
posted by nadawi at 9:39 AM on April 22, 2013 [1 favorite]

Good answers above, and I think it covers my position - it's not just temp, but also what could possibly be going on.

If everything else makes me think flu then that's going to be a higher threshold for getting outside help than if I think it could be an infection. One, because of what else could reasonably be done anyway, two, because I don't want to be right up against the brain-damage boundary if available treatment will take time to work.

Shorter: if you're thinking you need care then go get care, don't treat this like it's a right/wrong thing based on a 0.1 degree difference.
posted by phearlez at 9:52 AM on April 22, 2013

If you have a fever and are responsive, you're still OK. Not responsive, that's another story.

The last time I had a really bad fever in college, a friend of mine was keeping track of me and her mom (a nurse) told her that 103 was OK as long as I was responsive and lucid.
posted by plinth at 10:32 AM on April 22, 2013

I think it's pretty hard to give clear cut advice here. A few years ago I woke up feeling sick as a dog and was running a fever of 102 all day. At the end of the day I felt worse than I ever had before and went to the ER. It turned out I had pneumonia and was severely dehydrated. I ended up being admitted to the hospital for two days.

So yeah, you kind of have to know what's 'normal sickness' and what's truly unusual.
posted by pombe at 10:33 AM on April 22, 2013

Eh. I'm not going to tell you when YOU should go to the doctor, but I can say that last time I had a high fever 103 meant "watch carefully" and 104 meant "go to the doctor now".

Fever peaked at 103.9 and I was fine.
posted by Justinian at 10:37 AM on April 22, 2013

Note that the fever was only that high for part of one day. I would have sought medical attention if it had lasted more than that.
posted by Justinian at 10:38 AM on April 22, 2013

As others have said, it depends. But at 105, you are in danger of brain damage. At 108 the body develops a positive feedback loop, can no longer cool itself and the result can be death. With that in mind, I once forced my husband to see a doctor after his temp went up 8 tenths of a degree every day until it was over 104. He was on track to hit 105 within the next 24 hours, it was not coming down, yadda.

So if you can't break it, if it stays high, if it keeps going up, etc, you should see a doctor. I agree that 104 is a good time to see a doctor promptly, today.
posted by Michele in California at 10:56 AM on April 22, 2013

Extreme headache and neck stiffness that prevents touching chin to chest are the other symptoms that in conjunction with fever/chills would send me to the hospital. Bacterial meningitis is usually fatal if untreated. It is also very rare, but you should be aware of whether you fall into any higher-risk categories: for example, there is currently a bacterial meningitis outbreak among men who have sex with men in NYC. Beyond that, the other things Lyn Never mentioned.
posted by en forme de poire at 12:01 PM on April 22, 2013

Is there someone who can check in with you periodically, even just over the phone, to make sure you're lucid and doing okay? Could someone bring you to the urgent care if you suddenly need to go? If your fever gets high enough that your mental status is altered, you obviously shouldn't be driving yourself.* I wouldn't worry too much, but it might be nice to have that piece of mind. Otherwise, stay hydrated and get some rest. Eat some popsicles!

*A couple of years ago, my mom had a kidney infection and ended up in the hospital. She decided to go after her fever reached 106 degrees, because she started hallucinating. She drove herself and told me about it afteward. I was appalled.
posted by easy, lucky, free at 12:11 PM on April 22, 2013

Like absquatulate, I typically have a temperature of 96.8°F. Yep, 96.8, NOT 98.6, doctors never believe me. When I get sick, I just start adding on 2.2 degrees for the laypeople. "Yes, I have a fever which is roughly 103.4" for people who don't have a lower normal body temperature.

Doctors, unfortunately, again like absquatulate, don't believe me, but my family's gotten used to it. If I waited until I actually had a 104°F fever to go to the hospital, I would probbbbably be hallucinating. Or, you know, brain damaged.

You may have this same problem without realizing it if: people check your temperature and refuse to believe that you're sick, you never got sent home from school because "you weren't running a temperature", or your GP has asked you repeatedly if you feel cold or if you've had multiple thyroid tests run.

So, yeah, what I did was get a home thermometer, get a baseline reading when you first wake up for a week or so when you're not sick. Check it every six months or so and if the readings are in line with before, use that as a baseline temp and go from there.
posted by saveyoursanity at 2:07 AM on April 23, 2013

Response by poster: All is well today. Thanks.
posted by jsturgill at 8:49 AM on April 23, 2013 [2 favorites]

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