First, I’ll recap. There are three things that get on my nerves to the point that I have had to rant about them: Cell phones, using the term “emergency room,” and anyone who engages in “baby talk.”
Introducing #4: The “low grade fever”.
This peeve is more about doctors than it is about patients. Most patients don’t and shouldn’t know about medical definitions. I sympathize with patients and families who are inappropriately sent to the emergency department for evaluation of “low grade” fevers. Most of the time, this isn’t your fault. Just don’t go telling everyone else what your doctor said so that the problem gets worse.
The definition of a fever is either a core temperature of more than 100.4 degrees OR an increase of 2.4 degrees or greater above the patient’s basal body temperature. Before you use part B of this definition, you better be showing me some graph paper with temperatures plotted on it. Some experts even state that a temperature isn’t a fever until it hits 101 degrees. Hyperthermia is considered an elevated temperature beyond the body’s normal set points and is generally defined as a temperature of 106 degrees and above. Hyperthermia is bad news and requires immediate medical evaluation.
In 99+% of cases, fever isn’t the enemy. Fever is potentially dangerous in newborns and infants less than 30 days old. Seek immediate medical care. Fever in kids less than 3 months old is still possibly dangerous, but less likely so. Kids older than 3 months are generally safe with fevers. I’ve had several parents come to me concerned that their kid’s brains are going to fry. Your kids aren’t eggs and their skulls aren’t skillets. Brains don’t fry unless you’re in Hannibal Lechter’s kitchen.
If you’re using tympanic thermometers, don’t. There are many studies showing that tympanic thermometers are unreliable or at least less reliable than other methods. Yes, some studies show that tympanic thermometers are reliable. If you had three measuring devices showing that a cup was 8 ounces and six showing that a cup was anywhere between 6 and 12 ounces and couldn’t tell the difference between any of them, which one would you use to bake a cake?
I’m getting off track.
First, don’t try to BS me and tell me that you’ve taken your temperature or your child’s temperature when you haven’t. When parents of an 18 month old bring him in for evaluation of “low grade fever” of “ummmm 99 …. point …. 2 or3,” sorry, but my BS meter has already gone off. No Motrin for you … 1 year!
Second, I don’t care what your doctor told you. Less than 100.4 degrees is not a low grade fever. It isn’t a fever period. I know it’s probably not your fault. I know you’re trying to be a good parent. If your doctor insists that a temperature less than 100.4 degrees requires an emergency department visit, get another doctor.
A temperature of 99.4 is not a low grade fever any more than a blood pressure of 100/60 is low grade hypertension or driving 50 MPH on the highway is low grade speeding.
And no, you don’t need antibiotics for a low grade fever … even if it really is a fever. Amoxicillin doesn’t contain Tylenol and Zithromax isn’t a decongestant. They won’t help.
I noticed that this post still tends to get quite a few hits and quite a few comments even though it is four years old.
My sentiments haven’t changed. Low Grade Fevers are a non-entity and until someone shows me medical research to the contrary (no, stories about your cousin’s sick child whose temperature usually runs in the 80’s don’t count), Low Grade Fevers will remain a non-entity.
It’s almost comical how many people have engaged in ad hominem attacks against me and suggest that I pick another specialty because I dare to present some medical studies and factual information to burst their bubbles about something this simple. No, your baseless assertions that I am mean, have poor bedside manner, and that I’m a female hygiene product in disguise don’t hurt my feelings. They just show me how many people possess no logic and try to win an argument by whining and crying when no one else agrees with their assertions that the world really is flat.
However, with the recent Ebola hysteria and the influenza season looming on the horizon, I had to put this question out there.
For all of you people whose systems go into shutdown when your temperature hits 98.75, let’s suppose that you are traveling internationally. Are you going to go to the customs agents and tell them “I’m not like everyone else. My temperature may be normal by your standards, but when I hit 98.75 degrees, I could be in the early stages of Ebola infection and I should be quarantined for 21 days”?