Understanding and Managing Prolonged Fever in Children

Prolonged fever, also known as persistent fever, is a fever that lasts for more than three days. This condition can lead to fatigue, dehydration, electrolyte imbalances, and in severe cases, even convulsions in children.

1. Causes of Prolonged Fever in Children

1.1. Fever Due to Viral Infections

Viral infections are a common cause of persistent fever in children, with illnesses usually resolving within 5-7 days. Some viral infections and their associated symptoms include:

Dengue Fever: Characterized by sudden high fever lasting 2-7 days, accompanied by bleeding spots or rashes under the skin. Severe cases may involve nosebleeds, bleeding gums, and internal bleeding.

Influenza Virus: Initial symptoms include a blocked nose, sneezing, dry cough, and runny nose, along with mild fever (37.8 - 38°C). In some cases, superinfections can cause high fever, irritability, loss of appetite, and refusal to breastfeed.

Rubella Virus: Manifests as low-grade fever, followed by a rash and upper respiratory tract inflammation. Lymphadenopathy may occur in the occipital region, behind the ears, and neck.

Measles Virus: Presents with continuous fever, cough, runny nose, and red eyes. A rash appears on the face around day 4 and spreads to the extremities.

Hand-Foot-Mouth Disease: Children experience prolonged fever and develop blisters on the hands, feet, and inside the mouth. This can cause difficulty in eating, leading to loss of appetite and fussiness.

Chickenpox Virus: Initial symptoms include fever, headache, body aches, followed by red spots on the body. These spots turn into blisters, which then scab over.

1.2. Fever Due to Bacterial Infections

Several bacterial infections can cause prolonged fever in children, such as:

Pharyngitis and Acute Tonsillitis: Symptoms include sudden onset of high fever, painful swallowing, sore throat, hoarseness, and lymphadenitis in the neck region.

Respiratory Tract Infections: These infections can lead to fever, cough, sputum or blood in cough, chest pain, and shortness of breath.

Urinary Tract Infections: Manifests as fever with painful and frequent urination, cloudy or pink urine, edema, and low back pain.

Hepatobiliary Tract Infections: Present with high fever, jaundice, and liver pain.

Infection of the Brain and Meninges: Causes continuous fever, severe headaches, vomiting, convulsions, hemiplegia, or coma.

Blood Infections: Symptoms include persistent fever, inability to eat and drink, vomiting, lethargy, rapid pulse, rapid breathing, and possibly a skin rash.

1.3. Other Possible Causes

Fever Caused by Malaria Parasites: Children with a history of living or traveling in malaria-endemic areas may experience prolonged fever, fatigue, headache, and muscle aches.

Fever Due to Typhoid: High fever lasting for more than 5 days, accompanied by abdominal pain, distension, vomiting, and diarrhea or constipation.

Fever Caused by Tuberculosis: Symptoms include continuous fever, low-grade fever in the afternoon, night sweats, loss of appetite, weight loss, and profuse coughing, sometimes with blood.

2. How to Treat Prolonged Fever in Children

• Ensure the child rests in a well-ventilated area and limit the number of people around them.

• Monitor the child's temperature regularly using a thermometer (under the armpit or in the anus), and adjust clothing and blankets accordingly.
• For temperatures below 38°C, remove excess clothing and provide plenty of fluids, especially fresh fruit juices.
• For temperatures around 38 - 38.5°C, consider using physical methods to reduce fever (e.g., warm body wiping) along with common antipyretics.
• For temperatures above 38.5°C, administer paracetamol according to the correct dose, weight, and interval as instructed.
• If the child is nauseous and unable to take oral medication, consider using suppositories.

Seek medical attention if the fever lasts for more than 3 days, if the fever continues despite medication, or if the child experiences alarming symptoms such as lethargy, vomiting, difficulty breathing, convulsions, or bloody stools.

In case of allergic manifestations or a history of hepatitis or jaundice due to biliary obstruction, do not administer medications at home. Instead, take the child to a medical facility for proper evaluation and treatment.

Vaccination is a highly effective and economical method to prevent diseases that can impact children's health positively.