Q: My friend was telling me about a high fever that she had. It was up around 104 for several hours. I told her to go to the emergency room but she chose to wait it out. At what point should an adult seek emergency treatment for a fever?
When Foreigner sang, “I’m hot blooded, check it and see. I got a fever of a hundred and three,” he did not go rushing off to the emergency room. But should he have?
Many people use the term “fever” loosely, often meaning that they feel too warm or clammy with chills and sweats. But to be more accurate, you really have to take your temperature.
Fever in an adult is defined as a temperature greater than 100 degrees Fahrenheit taken by an oral thermometer. Fever is one mechanism by which our body helps fight off infections, and in most cases, fevers in healthy adults are due to respiratory or gastrointestinal viruses and are short lived.
Although many people worry that fever can cause harm, these temporary elevations in temperature from 100.4 degrees to 104 degrees are well tolerated by healthy adults. However, a moderate fever such as this can be slightly dangerous to those adults with heart or lung disorders because this can cause elevations in both heart rate and breathing efforts.
Any fever can also worsen the mental status of an adult with an underlying dementia. The symptoms people have during these episodes are due mainly to the condition causing the fever rather than the fever itself.
Extreme temperature elevations are fevers more than 105.8 degrees and may be damaging in adults. A body temperature this high can cause malfunction and ultimate failure of most of our body organs.
Although these extreme elevations can be a result of severe infections such as sepsis, malaria or meningitis, they are more commonly found with heatstroke or certain drugs. Drugs that cause extreme fever include cocaine, amphetamines, PCP, anesthetics and antipsychotic medications.
Infection is not the only cause of fever. Other less common causes include a reaction to a drug, an inflammatory condition, an allergic reaction or even undetected cancer.
If a fever in an adult lasts four days or less, the overwhelming likelihood of the origin is an infection. Recurrent or long-lasting fevers make inflammatory conditions like rheumatoid arthritis and lupus or cancers like leukemia or lymphoma more probable.
In adults with a fever, there are certain warning signs that make me more concerned about getting checked by a doctor right away. These include confusion, severe headache with a stiff neck, low blood pressure, rapid heart rate or rapid breathing. These could all be signs of a serious infection requiring immediate medical intervention.
Also, those adults who have traveled to an area where there are serious infectious diseases like malaria or those who have low immune systems from other medical conditions or medications should also call their doctor right away.
Because fever does help the body fight off infection and most fevers aren’t dangerous, there is some debate over whether to treat the fever itself. Most adults with mild fever do feel better when treated with Tylenol, aspirin or other anti-inflammatories, lots of cool fluids, and a lukewarm bath.
Peggy Lee sang, “When you put your arms around me, I get a fever that’s so hard to bear. You give me fever when you kiss me, fever when you hold me tight.” Regardless, please call your doctor if any fever lasts more than four days.