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What to do after a fever visit

 

If your child has a fever, you are right to be concerned. After examining your child carefully, the doctor might choose to treat your child as an outpatient instead of inpatient.

What is fever?

  • Fever for patients older than 3 months:
    • An oral (by mouth) temperature of 100.9 degrees F (38.3 degrees C) or higher;
    • An oral temperature of 100.4 degrees F (38.0 degrees C) or higher that persists for one hour;
    • An under-the-arm (axillary) temperature of 99.9 degrees F (37.7 degrees C);  or
    • An under-the-arm temperature of 99.4 degrees F (37.4 degrees C) or higher that persists for one hour.
  • Fever for patients younger than 3 months is an under-the-arm (axillary) temperature of 99.4 degrees F (37.4 degrees C) or higher.

Why did the doctor decide to treat my child outpatient?

Despite the fever, the doctor might treat your child as an outpatient in these cases:

  • Your child is not neutropenic (NOO truh PEE nik), having an absolute neutrophil count (ANC) of less than 500. Neutrophils are a type of white blood cells that kill bacteria. If the ANC is above 500, your child’s risk for infection is lower.
  • There are no symptoms of a possible serious infection other than the fever.

What should I expect to happen next?

The doctor sent your child’s blood sample to the lab. If it shows bacteria, the doctor will call you and admit your child as an inpatient. Make sure your contact phone number is correct in Patient Registration.

Your child may have gotten an antibiotic that is effective for 24 hours. If they need to continue the antibiotic, the doctor will let you know.

What do I do if my child still has a fever?

If your child was evaluated for fever within the past 24 hours, your child does not have to be seen again unless there are new concerns. 

In general, we do not recommend giving NSAIDs, such as ibuprofen (Advil®) and naproxen (Aleve®), for the fever. These drugs can create a bleeding risk in cancer patients who already have low platelet counts because of treatments. Talk to your child’s doctor about possibly using acetaminophen (Tylenol®).

There is no need to check body temperature many times throughout the day, unless your child is warm to the touch, looks ill, has chills, or is pale or flushed.

If your child still has fever but has not been seen in the past 24 hours, call the doctor.

When should I call the doctor right away?

Call the doctor right away if your child:

  • Looks ill and is drowsy or fussy
  • Seems to be getting worse
  • Has new symptoms, such as seizure, stiff neck, severe headache, severe sore throat, vomiting or diarrhea that won’t stop
  • Has signs of dehydration (not enough fluid in the body)
    • In children and teens: dry mouth, less urine and dark yellow urine.
    • In infants: fewer wet diapers and sunken fontanels (spaces between scull bones)
  • You can always call your doctor if you are worried about your child.

Follow up

If your child was seen in the Medicine Room, call your child’s primary clinic the next weekday to review the treatment plan and blood test results. 


 

This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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