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An increase in body temperature above normal (98.6 degrees F), usually caused by disease.

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Fever in children: How can you reduce a fever?

When children have a fever, they don't always need to be given medication to lower it. But it can be a good idea to treat the fever if they are feeling extremely unwell or the fever is very high.It isn’t always clear whether the child's symptoms are being caused by the fever or by an underlying illness. So lowering the fever won't necessarily make them feel better.There are basically two ways to lower a fever: using medication or applying a cooling treatment from outside the body Some parents hope that they will be able to prevent febrile seizures with medication. But there is a lack of good research on whether fever-lowering medication can actually prevent febrile seizures.Many parents also try homeopathic products, including aconitum D12, belladonna D12 or chamomilla D12. But there is no scientific proof that these homeopathic treatments are at all effective.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 17, 2016

Penicillin reduces the risk of streptococcal throat infections and attacks of rheumatic fever in people who have already had a bout of rheumatic fever

Rheumatic fever is a rare complication of throat infection, that can damage the heart. People who have had rheumatic fever can suffer from it again following streptococcal throat infection if they do not receive regular penicillin. Penicillin for prevention can be given by injection or as tablets. Taking tablets is easier but might not work as well as injections. The review of trials compared different ways of giving penicillin. Penicillin seemed to work better as injections than as tablets. Injections given every two or three weeks worked better than when given every four weeks. However, more research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

How is body temperature regulated and what is fever?

A healthy body functions best at an internal temperature of about 37°C (98.6°F). A body temperature of 38°C (100.4°F) or more is considered to be a fever.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 17, 2016

Paracetamol for treating fever in children

Plain language summary pending.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Antipyretic measures for treating fever in malaria

Fever is a common symptom of malaria. Antipyretic drugs (fever‐relieving medicines) and physical measures (such as tepid sponging) are widely used by caregivers and health care workers to treat fever in adults and children with malaria. Some researchers have questioned the belief that treating fever with antipyretic drugs is beneficial. They suggest that it may actually prolong the time taken for the malaria parasite to be cleared from the blood system. This review looked for evidence from appropriate types of research that addressed these issues. We found only a few small trials and could not obtain sufficient information from these trials to reach a conclusion on whether the antipyretic drugs actually help to resolve malaria symptoms or prolong the illness.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Hay fever and dust mite allergies: Allergic rhinitis: Non-drug interventions

Various medications and allergen-specific immunotherapy often provide effective relief from the symptoms of hay fever or dust mite allergies. But there are also other ways to prevent or relieve the symptoms.The most effective way to prevent the symptoms is by avoiding exposure to allergens (allergy triggers) in the first place. Whereas some allergens can be avoided, others are very difficult or impossible to avoid. Trying to prevent contact with allergens, such as dust mites in your home, is not always worth the amount of effort involved.If the allergy symptoms are mild, saline (salt water) solutions might also help relieve symptoms in your nose.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 23, 2017

Fever in children: What are febrile seizures?

Febrile seizures may occur in children if their temperature rises quickly and by a lot, or if they have a very high temperature. During a febrile seizure, sometimes also called a febrile convulsion, muscles in their body contract. These seizures are particularly common in toddlers: About 2 to 5 out of every 100 children will have had at least one febrile seizure before the age of five.Although febrile seizures can be alarming, they are usually harmless. Children usually recover fully within about an hour of the seizure. But it is still a good idea to see a doctor and have the child examined afterwards.When children have a febrile seizure, they become unconscious and the muscles in their body contract. Their arms and legs may twitch or their body may become unnaturally stiff and rigid. Their eyes often roll back, or they may have dilated pupils or a fixed gaze. Sometimes their lips or face turn blue. Their arms and legs might relax quite suddenly again.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 17, 2016

Physical methods for treating fever in children

Plain language summary pending.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Acyclovir can reduce the number of days with fever in otherwise healthy children with chickenpox, but its effect on sores and itching is not yet certain

Chickenpox (varicella) is caused by a virus. It begins with a fever, followed by a rash of red pimples which become itchy sores that form scabs. Chickenpox usually affects children from one to 14 years. In young babies, adults or people with impaired immune system, chickenpox is more severe. Treatments include lotions to relieve itchiness, paracetamol (acetaminophen) for fever and the antiviral drug acyclovir. The review of trials found that acyclovir reduces the number of days of fever from chickenpox in otherwise healthy children, usually without adverse effects. It is not clear whether it improves sores and itching.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Sublingual immunotherapy for allergic rhinitis (including hay fever)

Allergic rhinitis is characterised by red, itchy eyes, a blocked and runny nose, and sneezing. The most common causes of allergic rhinitis are different pollens (grass and tree), house dust mites, mould and animal dander. Allergic rhinitis can be intermittent (such as hay fever) or persistent (all year round). The treatment of allergic rhinitis depends on its severity and duration, and is usually based on the use of antihistamines and nasal corticosteroids. If these drugs cannot control symptoms immunotherapy is recommended. Immunotherapy involves the administration of gradually increasing doses of the allergen over a period of time to desensitise the patient. It is the only known treatment that modifies the immune response and treats the cause rather than the symptoms.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Antibody therapy is better that steroid treatment for reversing the first acute rejection episode, however antibody‐treated patients are more likely to experience an immediate reaction of fever, chills and malaise than those receiving steroid.

Kidney transplantation is the treatment of choice for most patients with end‐stage renal disease (ESRD). Strategies to increase donor organ availability and to prolong the transplanted kidney's survival have become priorities in kidney transplantation. Fifteen to 35% of all kidney transplant recipients will experience one episode of acute rejection in the first year. Options for treating these episodes include pulsed steroid therapy, the use of an antibody preparation, the alteration of background immunosuppression, or combinations of these options. This review investigated the role of mono‐ or polyclonal antibodies (Ab) used to treat acute rejection in kidney transplant recipients. Twenty one trials (1387 patients) were included. Any antibody was better than steroid treatment for reversing the first acute rejection episode and preventing graft loss, but showed no significant difference in reversing steroid‐resistant rejection episodes. Antibody‐treated patients were 28 times more likely to experience an immediate reaction of fever, chills and malaise than those receiving steroid treatment. The main limitation of this review is that none of the included trials were performed using contemporary immunosuppressive regimens, with the most recent study performed in 2000.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Fever in children: When is it a good idea to go to the doctor?

When children have a fever, the cause is usually a harmless viral infection. They are only rarely seriously ill. It is good for parents to know which symptoms could be signs of a serious illness, though.Many parents of children who have a fever feel worried and ask themselves the following questions: Is it something serious? Should we go to the doctor? Does the fever need to be lowered?Parents are in the best position to judge whether their child is behaving abnormally – for instance reacting differently to them or to a toy. The child may be much less active, feel very unwell or stop drinking. Their judgment and experience are very important, and can also be of help to the doctor.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 17, 2016

Fever in children: Taking a child's temperature

There are several different ways to take a child's temperature – for instance in their bottom (rectally), under their arm or in their ear. A number of things may influence which approach you choose, including the child's age and preference.When measuring a young child's temperature, it is particularly important that it can be done quickly and with as little effort (such as undressing and dressing, or keeping still) as possible. Some children prefer a certain approach, in which case it can be easier to do it in that way.You can often tell that a child has a fever just by looking at them. Typical signs include a hot, red face, tired-looking or glazed eyes and otherwise pale skin. Many parents who suspect that their child has a fever first place their hand on the child’s forehead. If the child’s forehead or neck feels hot, it could be a sign of fever. “Feeling” the temperature with your hands like this is quick and practical.Using a thermometer to take the child's body temperature is quite easy. The temperature can either be measured in their bottom (rectally), in their mouth (under the tongue), under their arm, in their ear or on their forehead. The most accurate way to measure someone’s temperature is probably rectally or – in older children – in the mouth. But under the arm or in the ear is more comfortable for the child. How long it takes to measure will depend on where it is measured and what kind of thermometer is used – you will find more information in the instructions that come with the thermometer.The formerly common mercury thermometers have been banned within the European Union (EU) since April 2009. These thermometers contain a toxic heavy metal called mercury, which can leak if the thermometer breaks. Nowadays battery-operated digital thermometers (contact thermometers) are the most common kind of thermometer. They can be used to take your temperature rectally, in the mouth or under the arm. They usually cost less than infrared and chemical thermometers and are particularly accurate.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 17, 2016

Cancer patients with fever and suspected infection can be treated with a single 'new‐generation' beta‐lactam antibiotic

Cancer chemotherapy or bone marrow transplantation disrupts the immune system, exposing patients to severe infection. The major sign of infection is fever, and the hallmark of damaged immune defences is a decreased white blood cell count. Patients have usually been treated with a combination of two different classes of antibiotics. Evidence shows that treatment with a new single drug (monotherapy), belonging to the beta‐lactam class of antibiotics, is associated with better outcomes. Survival is improved when single‐drug therapy is used, and side effects, mainly damage to the kidneys, are more frequent with combination therapy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Antibiotics to prevent bacterial infections due to chemotherapy in cancer patients with a low white blood cell count and no fever

For patients receiving chemotherapy, there is an increased risk of infection due to a low white blood cell count (neutropenia) caused by a toxic effect of chemotherapy on the bone marrow. The objective of this review was to establish whether preventive antibiotic therapy (prophylaxis) before the development of fever prevents illness and death in people with a low white blood cell count after chemotherapy and to assess whether certain types of antibiotics are better than others. We included 109 randomised controlled trials conducted between the years 1973 to 2010.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Spectrum of the initial antibiotic treatment for cancer patients with fever and low leukocyte counts

Background: cancer patients develop neutropenia, a decrease in the subset of leukocytes responsible for protection against bacteria, as a result of chemotherapy or cancer. Neutropenia predisposes the patients to severe bacterial infections. Standard antibiotic regimens for cancer patients with neutropenia and fever are directed at most of the bacteria that can cause infections. However, a subset of resistant bacteria belonging to the the Gram‐positive group (Staphylococcus aureus and Streptococci) remain untreated unless specific antibiotics are added to the treatment.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Hay fever and dust mite allergies: Medication for the relief of allergic rhinitis

People with seasonal hay fever often have very severe, but temporary, symptoms – for example during the grass pollen season. Others are allergic to dust mites and have allergy symptoms all year round. Whatever the cause of allergic rhinitis, particular medications can relieve it.Although medications for the treatment of allergic rhinitis can have side effects, they are usually well tolerated. Various medications can reduce the symptoms. You can talk with your doctor to find the most suitable one for you.Factors that influence the choice of medication include the severity and type of allergic rhinitis (seasonal or year-round), as well as personal preferences and experiences. For instance, some people would prefer to take tablets rather than use a nasal spray. Others might feel tired when they use a certain medication, and decide to try a different one instead. Age and other things like medical conditions or pregnancy can play a role too.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 23, 2017

Hay fever and dust mite allergies: Overview

If you have hay fever or a dust mite allergy, you’re not alone: These conditions affect about one in four people. Various medications and allergen-specific immunotherapy often provide effective relief from the symptoms of hay fever or dust mite allergies. But there are also other ways to prevent or relieve these allergies.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 23, 2017

Single‐agent antibiotic treatment for cancer patients with fever and low white blood cell counts

Cancer patients develop neutropenia, a decrease in the neutrophil subset of the white blood cells, as a result of chemotherapy. Neutropenia exposes patients to infections, mainly bacterial. Without antibiotic treatment these infections may be fatal, therefore antibiotic treatment is administered when a patient with neutropenia develops fever. The objective of this review was to compare antibiotic treatments currently recommended in consensus guidelines for the initial treatment of cancer patients with fever and neutropenia.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Ty21a and Vi polysaccharide vaccines are effective in reducing typhoid fever; new vaccines are promising

Typhoid fever is a bacterial infection found mainly among children and adolescents in south and east Asia, Africa, Latin America and the Caribbean. Typhoid fever is spread by food, drink, or contaminated water. It is characterized by fever, abdominal symptoms, headache, loss of appetite, cough, weakness, sore throat, dizziness and muscle pains. The infection also sometimes causes psychosis and confusion. Mortality varies and can reach 10% of cases. Treatment normally consists of antibiotics, but problems with drug‐resistant strains have been reported. Improved sanitation and food hygiene are important control measures. However, these are associated with socioeconomic progress that has been slow in most affected areas. Therefore vaccination is an effective way to try to prevent this disease. The review found 18 trials (17 with usable data): Six evaluated vaccine effectiveness only; six evaluated vaccine effectiveness and adverse events; and six provided data only on adverse events. The two major vaccines currently licensed for use, Ty21a and Vi polysaccharide, were effective in reducing typhoid fever; adverse events such as nausea, vomiting and fever were rare. Other vaccines, such as a new, modified, conjugated Vi vaccine called Vi‐rEPA, are in development and appear promising. A vaccine that could be given to infants would be helpful as they are probably at increased risk of this infection.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

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