Stephen J. Schueler, M.D.

Overview Evaluation taking temperatures Treatment Home Care medications vomiting warning signs Underlying Cause Types

Child Fever Evaluation

An evaluation of a fever in a child begins with a medical history and physical examination.

Options for measuring the temperature include:

  • Oral thermometer:
    • Reliable and easy to obtain in older children
  • Rectal temperature:
    • Very reliable, but more difficult to obtain
    • Best option for infants and young children
  • Under the arm temperatures:
    • Unreliable results
  • Thermometer ear probe:
    • In some cases can provide unreliable results
  • Thermometer skin patches:
    • Unreliable results

Test may be required in the following children:
  • A child less than 2 months old, who has a fever over 100.4 degrees F (38 C)
  • A child less than 2 years old, who has a fever over 101.9 degrees F (38.8 C)

Tests that may be used to evaluate a child less than 3 months old, who has a fever over 100.4 degrees F (38 C) include:

Tests that may be used to evaluate a child less than 2 years old, who has a fever over 101.9 degrees F (38.3 C) include:

Additional tests may be performed, based on the presence of additional symptoms.

Child Fever Taking Temperatures

Oral Method
The thermometer must be placed under the tongue with the lips closed. Most digital thermometers will beep when the temperature has been determined and the thermometer can be removed.

A glass (mercury) thermometer should be left inside the mouth for a full three minutes before reading. If performed correctly, oral temperatures can be very reliable. Oral temperatures normally vary anywhere from 97.5 to 99.5 degrees Fahrenheit. This is a little lower than the core body temperature.

Oral temperature should not be taken for at least 20-30 minutes after drinking a hot or cold liquid, smoking, or eating. Wait at least one hour after taking a hot (or cold) shower or bath prior to measuring body temperature.

Rectal Method
This method is the most accurate and should be the only method used for very young children. A well lubricated (e.g. KY jelly, Vaseline) rectal thermometer should be inserted gently into the rectum no more than 1/2 to 1 inch. Mothers should not be concerned, rectal temperatures are very safe and are not harmful. Do not use oral thermometers rectally. Rectal temperatures tend to run about 1 degree Fahrenheit above oral temperatures.

Continue to Child Fever Treatment

Last Updated: Dec 13, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Child Fever References
  1. Cunha BA. Fever of unknown origin: clinical overview of classic and current concepts. Infect Dis Clin North Am. 2007 Dec;21(4):867-915, vii. [18061081]
  2. Knockaert DC. Recurrent fevers of unknown origin. Infect Dis Clin North Am. 2007 Dec;21(4):1189-211, xi. [18061093]
  3. Losek JD. Acetaminophen dose accuracy and pediatric emergency care. Pediatr Emerg Care. 2004 May;20(5):285-8. [15123898]
  4. McCarthy P. Fever without apparent source on clinical examination. Curr Opin Pediatr. 2005 Feb;17(1):93-110. [15659971]
  5. Miller LC, Sisson BA, Tucker LB, Schaller JG. Prolonged fevers of unknown origin in children: patterns of presentation and outcome. J Pediatr. 1996 Sep;129(3):419-23. [8804332]
  6. Noyola DE, Fernandez M, Kaplan SL. Reevaluation of antipyretics in children with enteric fever. Pediatr Infect Dis J. 1998 Aug;17(8):691-5. [9726342]
  7. Perrone J, Hollander JE, Datner EM. Emergency Department evaluation of patients with fever and chemotherapy-induced neutropenia. J Emerg Med. 2004 Aug;27(2):115-9. [15261351]
  8. Russell FM, Shann F, Curtis N, Mulholland K. Evidence on the use of paracetamol in febrile children. Bull World Health Organ. 2003;81(5):367-72. [12856055]
  9. Tolia J, Smith LG. Fever of unknown origin: historical and physical clues to making the diagnosis. Infect Dis Clin North Am. 2007 Dec;21(4):917-36, viii. [18061082]
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