Male1: Doctor, a very common question to pediatricians why a little baby has a fever. Is fever a disease?
Male2: Fever is not a disease. Fever is a manifestation that the child has an illness. It sort of like the gauge of temperature on the car or the red light that indicates that something is wrong with the car engine.
Male1: So if you have a temperature and you bring it down, is the kid well?
Male2: In and by itself, that is not true because if there is an illness, the illness obviously is still there and the temperature when it comes down, just make someone feel more comfortable, may look well but that does not necessarily mean that for example an infection is gone. And that is why often times, there is some concern because the temperature will come back again once the effect of say Tylenol fades after several hours and the temperature comes back. That does not mean that the infection is worse or it was gone and came back again. It may take several days for, usually the duration of the illness for the fever to go away completely.
Male1: General rule for kids like three months and less, fever is a greater concern because it can lead to more serious infection, is that true?
Male2: The concern in that age group is that it is more difficult to tell if they are seriously ill, unlike in older children who can speak for themselves and the pediatrician can judge better by their interaction with the surroundings.
In a very young infant that is more challenging, so even though that the same type of infection may be more serious in a very young infant simply because it is more challenging to make the diagnosis.
Male1: So the general rule, you should have that kid assessed pretty quickly by your pediatrician.
Male2: Absolutely.
Male1: In an older child, the kid is playful and alert, does not seem to be too sick and has a temperature, not such a great concern by most pediatricians, is that true?
Male2: That is true. The challenge in the very young infant is that on one hand, they are prone to infections and on the other hand, they do not have the typical symptoms and signs. They do not talk and they do not interact with the surroundings the same way older children do.
Male1 : And having a fever, it is really a concern for like, working to fight against something, is that true?
Male2: That is true and in fact, experiments do show that white blood cells work better when the temperature is elevated, but up to a degree obviously. So low grade fever, in and by itself is not harmful even higher fever is not harmful in and by itself which just makes the child or an older person just not feel well and feels crummy, so—
Male1: So we bring it down to make the kid more comfortable, the general rule is if the kid is older, it is over 100, so we bring it down and make the kid more comfortable, but generally, bringing it down is not always the best thing to do, is that true?
Male2: It helps to bring the temperature down to make them feel comfortable, but in and by itself, that is not the aim of the treatment for example if someone has pneumonia, an antibiotic would treat that infection, but does not treat the fever, so we do not give antibiotics to treat fever. We give it to treat specific toxins for infections when it is indicated. The fever in and by itself is just a symptom and indicator that something is wrong and if we take care of the underlying illness, the fever will go away.
Male1: So general rule, if a kid is sick, you always check with your primary care physician and he will assess the situation—all we are trying to give you is a little bit of a guideline, is that correct?
Male2: Yes, I hope it helps.
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