Low Grade Fevers


Just found another thing to add to my list of pet peeves.

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.


UPDATE NOVEMBER 4, 2014Ebola Picture

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”?


  1. 2 things you should know: every pediatrician I’ve taken my children to (in two different countries!) have used tympanic thermometers. Why do that if they are so inaccurate?

    And 2, where we live now, Switzerland, my ped wouldn’t give my child a vaccine because his fever was elevated–37.2 celsius–99 fahrenheit.

    This is why parents worry and use tympanic thermometers. Their pediatricians have told them to.

  2. And what about the return visit because the Tylenol or Motrin “wore off” and the fever “keeps coming back”? That one is just a huge eye-roll for me.

    • I beg to differ. Three days ago I suddenly felt dizzy and my friends took me to the ED. At first I was referred to a neurologist, who referred me to a pathologist because of tachycardia and a temperature of 99.32 which she called a mild fever. The pathologist examined me, requested blood tests ( a complete blood count and various other things), a urine analysis , chest and skull x-rays. After several hours I was diagnosed with sinusitis and am on antibiotics. That’s the standard of care you receive over here in Greece . I suspect that in the US I would of been sent home and insulted by a doctor such as the original poster.

    • It’s “Hear Hear.” For Christ’s sake, don’t tell me you’re a doctor; no wonder most of the parents disagree, as the incompetence must be high-grade among you and your colleagues in agreement with this ridiculous post.

      • I’m going to take a wild stab here that your parents wanted you to be a doctor, but you failed out of undergrad? Seems to be the case every time in these angry Doctor-bashing retorts. Let me teach you something: no matter how much you whine about it, your physician is the doctor and you aren’t. If you have a problem and are oh-so-much smarter, by all means, try to even get accepted in the next decade.

        • There have been cases (Very few cases but it happens) where doctors misdiagnose patients while their patients kept telling them its not the case, that their symptoms are more directly related to something else but the doctors wouldnt listen. You cant diagnose yourself by googling your symptoms but you can give relevant suggestions to your doctor. Especially if treatments are working. And some doctors just dont listen.
          My point is, just because you have a medical degree, it does not mean you are right 100% of the time. It could be that that one patient out of however many others you treated, was right.

          • I agree that doctors can’t be right all of the time… I am complete proof of that. Plus, there’s a reason why they call it a Doctor’s “Practice”… They are always learning, practicing; even after med school.

            However, I disagree that you can’t diagnose yourself by Googling your symptoms. I happened to do that very thing over the years, and was right 99% of the time when I presented my research to my doctors.

  3. Well said! It doesn’t matter how many times you explain this to some people, though, they still drag their kiddos in for 99.1 “fevers”. These are the kids who are doing cartwheels in the ED waiting area.

    • I work in daycare and we have to send children home at 100* I’ve yet I have seen a child with a fever of 99 and up EVER do a cartwheel or anything other than stare off pale. And I’ve sent hundreds of ifs home thousands of times over the year. They aren’t fine in fact feverol seizures begin at 100* which I’ve also had happen. Explain that how did those children get feverol seizures If they didn’t have “fevers” at least not by your definition.

      • A: FEBRILE seizures.
        B: FEBRILE seizures are more likely to start around 102, though they can start lower it is less likely.
        C: FEBRILE seizures are more harmful in that they are scary for parents and caregivers rather than directly harmful for kids.
        D: You should know more about FEBRILE seizures if you are taking care of children who so frequently experience them while in your care.
        E: Why are so many children getting so sick at the daycare in which you are employed? I would be very concerned.

        • Wow, I am astounded by the doctors’ comments. Absolutely amazing. I think all of you who talk about patients and parents in such a nasty sarcastic manner should consider a career change. I hope I never have the misfortune to be your patient.

        • My child has febrile seizures at 100.4. So I don’t agree with not medicating at 100. His Neuro and pediatrician agree that at 100.4 he is to be given meds and head to er.

      • My daughter has been running a “fever” of 99.3F-99.8F for about two months. Ibuprofen will bring it down but she’s not sick! She’s clear for strep, ear infection and flu. She’s eating like normal, jumping off the walls and playing soccer. Her nose isn’t running her throat isn’t hurting her body isn’t aching. I’m not taking her into the doctor again like an idiot.

        Also, I don’t treat fevers until they reach 102F and over (unless they’re infants) because fever is good. It’s your body’s mechanism for beating that infections butt. That’s university biology 101
        This doctor is right, too many idiotic cases that can be treated at home crowd the ER. There are people who need the ER and those people cannot walk in and get treated immediately because of this kind of BS. In order to get seen ASAP you have to take a $1200 cab ride aka the ambulance. That’s unfair.

        • Hi is your daughter still fine as my son age 10 yes is having same problem he maintains constant temp of 99.1 to 99.9 in a full day. Rest he is fine in every aspect playing,eating, running etc I await your reply

        • How is your daughter now? As my son is 3yrs 3 months and have fever for last 2 weeks, somem times it goes to 102, but mostly it stays around 99.4-100C

      • My son who’s 2ys 4 months has he fevers of 103/104 and he’s been running around. Playing acting completely normal they only difference is his face & eyes are red .. None of my 3kids stare off or get pale she their fevers get to 99 or even 100 .. And being the owner of a daycare I know that because if licencing and state regulations a child with a fever of over 100• must be sent home no matter how they look or feel .. Of course not all kids are going to react like mine and some do get lethargic when their temps rise . But to say that febrile seizures happen often at low temp of 99/100 is insane an highly unlikely .. Please for the sake of those children educate yourself better in that area !

  4. Mama On A Budget on

    Don’t even bother with the basal temperatures and MDs. I have taken my waking temperature with a basal thermometer for over 4.5 years (with the exception of a pregnancy thrown in there). I’ve brought my records with me to every doctor’s appointment. I can prove with data and graphs that my highest temp is 98 even and my average temp is about 97 even – and they all say I’m crazy.

    Which is why when I get a fever, I drink more water, take some vitamin C, and let it burn off whatever it is that is making me sick. And yet I (as well as my 3 and 4.5 year olds) were able to survive the “Swine Flu” and 104-105 temps last year without being told to take antibiotics (that weren’t necessary) or get a vaccine for the same damn thing after the fact.

    A fever is just the body’s way of killing off the virus. If it doesn’t last more than a couple days, everyone needs to just chill the heck out. Bringing your snot-nosed febrile kid to the doctor’s office and letting them sneeze all over the toys is just your way of sharing the bug with everyone else. Then going to the grocery store to fill the unnecessary Amoxicillin Rx just gets the little old people waiting for their blood pressure meds and insulin refills sick, too. Stay home, feed them (and yourself) some chicken soup and orange juice, and get some rest – for everyone’s sake!

      • Likely for fertility reasons. Natural family planning techniques use basal body temps (among other things) to track fertility. A woman’s body temp increases right around ovulation a few tenths of a degree (F). Women who are either trying to conceive or trying to avoid pregnancy often track BBT to assist in their endeavors. I personally know several couples using this technique. It is not uncommon.

      • Nurse K — there are folks who measure BBT to _increase_ their chances of getting pregnant. You seem blissfully unaware of anything fertility-related beyond the Nuva-Ring.

      • Mama On A Budget on

        Yes – to GET pregnant. Thanks.

        Some of us prefer to trust our bodies over big pharma. Nuva ring… around for 5-10 years. Temperature rising at/after ovulation and changes in cervical position and discharge… since the dawn of man.

      • And I think if “Mama’s on a Budget” she’ll have a problem with the Nuvaring since it’s $125/month
        Insurance rarely covers it.
        But I digress.

      • I don’t know why Mama on a Budget kept track of her temperature, but maybe it was because she knows that hers is always lower than “normal,” and wanted some evidence for the doctors. I did the same thing, as part of my doctoral research, and was not surprised to find that my body temperature didn’t even approach 98.6 until evening. I woke up cold (in the 96 degree range), and didn’t get much warmer as the day progressed. My average afternoon temperature was 97.6. I have always felt my fevers in my skin, and was recently shocked to realize I had fever. I knew it before I checked because the way my skin feels is very specific (and pretty gross). When I checked, the thermometer said 99.3. I was feeling brutal already. My temperature climbed to 100.5 over the next 45 minutes, and I was sick as a dog most of the night. Now that’s not “just the beginning of fever.” For me, 100.5 is a raging fever!

        • i take my morning temp because i’m hypothyroid. and according to OP temps, it sounds like she is/was too. if morning temp is in the 96-97 and doesn’t come up much, check the thyroid.

      • Not if you’re trying to conceive
        Also because I’m TTC I know my bbt is 97.8 precisely.
        Still wouldn’t qualify my 99.4 temp now as a fever according to this guy!

    • Eight years in the Navy…In that time, a dual-humerus fracture, two tumor resections, a grade 3 ankle sprain, and I’m a female with abnormal results all the time until every 4th or 5th which came out normal.>:(
      90% of those temperatures were 97.0 to 97.3.
      The way I figure it: Throughout history, males were allowed to formally study medicine centuries before females. Males tend to ‘run’ warmer than females…Doctors tended to use each other as subjects (Listening to each other’s heartbeats, taking temps, feeling glands etc..) therefore, it make sense to me that the ‘typical’ human temperature would be that of most males…98.6-ish. I am very glad someone posted that a LGF is classified as 2.4 degs over normal basal temp. Progressive.

  5. I think this was intended for children and worrisome young adults with fevers, although it doesn’t really say.

    However, I’d like to give a little shout-out to the fact that very elderly people with serious infections often have no fever…20-30% in fact.

  6. The low-grade fever is rant-worthy, to be sure. Maybe not as frustrating as allergies (which you covered very well last year) but pretty bad.

    My fever peeve regards decimals. The nursing home tells the family the patient’s temp was 100.6, but when they’re telling me in the ED, it becomes 106. At least in that case there are records I can fall back on.

  7. Off topic, sort of. I never had trouble getting pregnant…but I did do the BBT as part of a paper for college. I actually discovered over 3 months of measuring that I ovulated twice a month!! I spent a ton of money to confirm it with those predictor tests, too. I got pregnant on the 7th day, 23rd day, 19th day and 14th day respectively with my four kids. I still find that amazing and I did document it!

    As for my kids and fevers…I used the tympanic thermometer, but many times felt it was wrong and did a rectal to confirm a high fever.

  8. Body Heat..if anybody remembers that movie…Kathleen Turner was always a sizzlin’ 100 degrees or somethihg like that.

  9. Both community hospitals I am familiar with use tympanic thermometers ..both in the ED and on the floors. I often guide them to put it all the way in and nurses say it doesn’t matter..which doesn’t make any sense to me because when I guide them in they kind of have to go around the bend and I can definitely tell a difference. I would think it would be warmer all the way in then just on a ledge in the outer ear. ?? Does the depth matter?

    And ..if no one should use these tympanic thermometers ..then *WHY* do hospitals use them …and does it matter ..does the temp accuracy matter?
    I used to take my basal body temp for about a year. I had infertility concern with first child. However ..when you’re afraid you may never conceive ..you become a *slave* to the chart and it can get mechanical. You get so obsessed with timing.
    The Soup Nazi – My FAVORITE Seinfeld episode! Ha ha! When I think of all the scenes in that episode ..but the Soup Nazi – EXCELLENT! 🙂

    Another favorite – Scrubs – My Machines!


    I can watch that over and over and over and over again and now will before signing off. 🙁

    That actor is just PERFECT playing the extremely irate radiologist! 🙂

  10. We had a guy that kept coming in with lowish “real” fevers (101 or so); finally got diagnosed with malaria. That was kinda cool.

  11. I get irritated with that too. Just last night I had “Oh, I checked my temp and it was 99.0 so I have a fever since I usually run at 96.5”. Yeah right, prove it to me.

  12. One more thing …my normal temp was always 98.6 …until I had sepsis, etc back in 06.

    But ever since then ..my norm seems to be in the 97s.

    I did ask a doc about it and I don’t recall his explanation ..but an illness like that can cause the normal temp to reset to a lower norm.

    Can anyone explain that?

  13. According to this article the gold standard for temperature measurement in the clinical practice should be RECTAL temperature. Oral temp outperformed tympanic temp measurement. All patients seeking help in the ED for ‘low grade fever’ should be alerted about these facts, and thus all need to have their temp measured up their ass.

  14. Peds do not always send fevers to the ER. When my son had a fever of 106 and we couldn’t get it go down with Motrin, I called my pediatrician (middle of the night) and he told me to just give him Tylenol with the Motrin–it worked–got it down to 103 and my son was able to sleep.

  15. Of course, the urgency in which moms think their child needs immediate medical attention is directly correlated to whether or not they are on medicaid. It is only going to get worse now that more people are about to get “free” care…

  16. in no way do i find that a fair statement. i am a mother on medicaid. i dont rush my son in for everything because its free. i took ny son to the er last night because his fever kept spiking to 104.4 despite the tylenol and motrin i had been rotating in four hour intervals. you must be the kind of know it all nasty nurse i put in there place last night. i am finishing my training as an ma now so im not an idiot, im just poor hence the medicaid. i would suggest if ypu dont enjoy working with cranky people without adopting there attitude, you should probably find another career.

  17. Pingback: pet peeve list

  18. Concernedmother on

    When you have a child with a fever that pretty much does not break down regardless of following the instructions (Tylenol every 4 hr), crying with headache, tummy ache, does not want to eat anything, lost almost 10lbs in 5 days, what a mother should do then? I have insurance and not on Medicaid. I don’t think it is any doctor’s business for being cautious with my child. You are getting paid so what do you care how frantic a parent feels. Doctors attend medical school to put parents and children’s mind at ease and to get paid comfortably. But I may be wrong. Maybe their main focus is the almighty dollars. Those same doctors are the ones who will quickly contact child services to state that the parent was negligent and if he or she had reached out immediate medical attention, this or that would not happen. So you know what, maybe some of the doctors in here chose the wrong profession and need to return to school for something else. This is a person-approach type of career just like Sales or Customer Service. If you (doctors) are grouchy all the times and start taking everything personal, then you will always need to post frustrating comments in similar sites to release your nerves. So chill and do your JOB!!!!

  19. OP
    Who the hell are you? You sound like an imbecile. Is this post supposed to be amusing? You seem hung up on semantics. You may not like referring to a borderline fever as “low grade” but it is a valid way to describe it. Also, as the first commenter said, there are physicians out there who will consider a 37.7 temperature to be above normal. But even if you don’t, it strikes me as ridiculous that you would waste time ranting about concerned parents. It seems that someone wants (needs?) to feel important. Were you not given enough attention growing up?

    • Well I each its on if my daughter is running a 99.9 degree fever sore throat sleeping all day I know it’s something wrong with her

  20. First World Problem. Be thankful for the compassionate parents that bring in a child for a “low grade temp” instead of the ones whose neighbors have to bring in their battered children.

  21. So I care for a little one, I’m the nanny, anyway…the boys that I watch have a body temp of 97.4 when they are healthy. I’ve checked, many times while they are healthy. The mom is the same way. Anyway for the last 4+ months now, the baby, who is 16months has had fevers, almost daily…they usually brake with “Tylenol” and run from 99.4 (according to you not a fever) to 102. A few times 103 to 104. He has also been exteamly fussy these past months, and has at least 3+ movements of diarrhea per day. His doctor says not to worry unless he has like 5+ movements a day. He’s just not himself. His appetite comes and goes. I know that’s normal but this isn’t. I know you can’t diagnose, but does this sound like anything..? At what point do we take him back to the doctor?

  22. Err…Here’s a story about why “low grade” or non-febrile “fever”, or maybe “subjective fever” is a better terms, is an important piece of the puzzle, even and perhaps especially when it disappears by the time the patient is triaged. I seem, it first glance, like the kind of neurotic somatosizing attention seeker that clot ERs and inspire frustration, disdain, and belligerent blogs: Anxious, wan, complaining of “low-grade fever” and headache that improve miraculously by the time the disgruntled resident who drew the short straw arrives to examine me. In Dec 2011, I presented to the ER of a nationally prominent teaching hospital with all the vague symptoms you might reasonably hate at 3 am on a Friday-Sunday shift. I was told by a smirking resident I had no fever. When I quoted his hospital’s own outreach pamphlet he threatened to call security (clearly my supine position and crushing headache belied murderous intent…) I demanded to see his attending, and we discussed Dr. Smirking’s education. I was then discharged without any treatment or test.

    I subsequently discovered, ten days later, that I was suffering chronic CO poisoning within my home.

    There is no excuse for this in the NW, where “flu-like symtpoms” beset residents as soon as it gets cold and gas heaters are turned on. The CDC, the news media, public service announcements all warn that CO poisoning is the most common missed ER diagnosis, because CO poisoning mimics the flu, allergies, a cold…causes headaches, malaise and elevated body temperature. Some studies have suggested more than half of “flu” Dx in cooler months are, in fact, CO poisonings. CO poisoning often “resolves” in the wait for ER attention: Carboxyhemoglobin’s half life is only a few hours.

    And before you whinge about the impracticality of running a carboxyhemoglobin blood test on every fluish patient, please remember there are now portable pulse spectrometers that can distinguish serum Osat from carboxyhemoglobin saturations. Your hospital probably has one. If it doesn’t, go straight to risk management and demand one. Sound like too much trouble for a pain in the ass subset of patients? You might want to consider the cost-benefit analysis of a $45 blood test versus a malpractice suit for failure to Dx.

    And yet, I think I still hear the resentful teeth-grinding of ignorant curmudgeons. Still, there is NO EXCUSE for missing a CO poisoning. Even without a portable COhb enabled P-spect, even before the bloodtest(which ought to be routine during winter months in cold climates) comes back, ONE SIMPLE HISTORY QUESTION CAN SAVE YOUR ASS AND SPARE YOUR PATIENT A WORLD OF HURT:

    “Have you recently turned on or started using a different gas heater/ woodstove/ fireplace/ boiler/ old water heater/unvented gas cooking stove?”

    Are you really to busy to ask that one question? Or is it that you’ve become so hardened to ignorance you fail to recognize it in yourself?

    And why should you “be nice” to “difficult patients” like me? After all, haven’t you been taught that we’re litigious, and that your chances of being sued increase with contact time? Maybe. And maybe not. The prestigious teaching hospital failed me, and the attending missed my Dx. I suffered substantial harm as a result. But because the attending treated me with respect and kindness, I could not fault him for his mistake and have no desire to litigate.

    Believe it or not, I actually do know how hard your job is even without “difficult” patients like me. Indeed, the reason I and others like me often give you too much, largely irrelevant information is because WE WANT TO HELP YOU HELP US.

    And in case you’re wondering: When you took your CPx to get your license, your “history” segment was one I helped beta-test and standardize during the initial development of the CPx. To be a doctor, you must have credentials. But it is seeming to me that increasingly, to be a “successful” patient one must be bland as store-bought pudding.

    Hippocrates has left the building–but wasn’t that Freud I saw in the lounge?

  23. Hmm… All of my children suffer from genetic autoinflammatory disease ( HIDS/ TRAPS). When they flare they will run temps as high as 106. Now that being said they will run what we call low grade fevers between 99.5- 101 we call they low grade because they are taking maintenance NSAIDS daily so who knows what the temp would be if they were not on the NSAID. It may not be an “actual” fever to you but one can still feel pretty lousy with 99.5- 100.4. Just a not Dr.Kastner at the NIH you know what the NIH is right? the National Institute of Health recommends treating these flares at 99 degrees because if you don’t they temps rage and the flares are harder to control. We HATE going to the ER and only go if we can’t get a fever to drop…because I Hate running into healthcare “professional” who don’t know what they’re talking about…we’ve been battling this for 17+ years please don’t treat me like I’m an idoit.

    • Hmmmm.
      That’s it. You’re getting a slapdown.

      OK my punctuation-challenged commenter, show me where “Dr.Kastner at the NIH you know what the NIH is right” says every person in the emergency department with a temperature of 99.5 requires aggressive “fever” management.
      Yeah. Didn’t think you’d find anything.

      But, while we’re at it, maybe we should change standard medical treatment for every patient in the United States whose parent thinks he or she feels “warm” because you’ve got a chip on your shoulder over your kids’ genetic disease. My kids have a genetic disease, too. Maybe I could impose all of their medical restrictions on your family while we’re at it.

      If you’ve been battling healthcare professionals who don’t know what they’re talking about for the past 17 years, then why don’t you go see Dr. Kastner next time your kids have a “fever”? Get his cell phone so you have a direct line at all times to his competent care. See how well that works for you — HE DOESN’T TREAT PATIENTS.
      You expect “ER” physicians to have an in-depth knowledge of every possible disease and genetic syndrome on Earth then be at your beck and call when you snap your fingers and walk into the emergency department spouting off run-on sentences about how your kid needs STAT ibuprofen with a normal temperature? Get a clue.

      If you don’t want to be treated like an idiot, don’t act like one.

      • Yes my punctuation and grammer isn’t the best when I’m tired or my spelling for that matter. You are taking my post as a personal attack, which it was never meant to be. I don’t expect my ER docs to know every possible genetic disease and we don’t go to the Er for ibuprofen. Actuaally I can email Dr.Kastner and my pediatric rheumatologist.
        The point of my post was not everybody with temp under 100.4 is normal and maybe just maybe you could show some kidness and understanding to some weary parents who may be struggling with something your not familar with? By the way I don’t have a chip on my shoulder. let me give you a case senerio. 16 year old son spikes a 106 degree fever and we are sent by our pcp to ER. By the time we get there and sit through triage temp has gone down to 101. We are then told by the ER personel there is no possible way your son has had a 106 temp he wouldn’t have been able to walk in here !??? He way more tachacardic(sp?) then he should have been with 101 temp but because I’m just his parent and they are the professionals what could I possibly know? Those are the battles I was talking about. We are ever so thankful for the wonderful healthcare professionals that we deal with on a regular basis it would be nice to encounter that in the ER whenwe have to go in also.

    • Grumpy Old Bastard on

      Your children all suffer from both HIDS and TRAPS? How unusual for 100% of children in a family to be suffering from two very rare genetic disorders, one autosomal recessive and one autosomal dominant, with defects in both chromosome 12q and chromosome 12p). The geneticists must love studying your family.

      It’s also odd that you say you only take your kids to the ER if you can’t get their fevers to drop, yet as per your second comment, an hour or two in an ED waiting room is all it takes to magically lower their temp from “106” to 101. I hope you gave that ED glowing Press-Ganey scores for having worked such magic.

    • Grumpy Old Bastard on

      Also: “Just a not Dr.Kastner at the NIH you know what the NIH is right? the National Institute of Health recommends treating these flares at 99 degrees”.

      Every single one of your children suffers from these two rare genetic disorders, and you’ve been dealing with them for 17 years, and your regular doc hasn’t helped you learn how to treat these flares at home so you don’t have to keep rushing off to the ED? What can an ED do for a child with periodic fever syndrome running a 99 degree temp that a parent can’t do at home?

      Don’t subject your kids to hospitals unnecessarily. That’s where all the sick people are.

      • I have 4 children each have one mutation for HIDS. And two of them have the one mutation for HIDS and Traps. Yes we hit the genetic lottery. We do not go to the ER for 99 temp. Do you guys really read a post before answering or just react to what you don’t like? We treat a temp with prednisone at home when a temp is at 99 because if we don’t treat then it tends to be harder to control the higher the temp. We try not to go to the ED at all they are on immune suppressant meds. There have been occasions when a temp won’t drop no matter the nsaid or prednisone and then we have to go in and yes once we sat in the ED and by the time we were seen med given at home have kicked in other times they have been admitted to peds floor.

        The only reason I responded at all to this post was to point out that sometimes a temp under a 100.4 should be taken seriously. That not all parents just drive into the ED because they have nothing better to do. And it would nice to be met with compassion instead of arrogance and contempt by those we are looking to for answers. A lot of peds docs. have never heard of periodic fever syndrome it took us 9 years to get a diagnosis.

  24. How disgraceful you are to the medical profession. Those of you who think you are high and mighty, and know it all… posting that a temp. of under 100.4 is nothing to be concerned about…. that a temp like that is not a fever and basically nothing to worry about. To concerned parents reading this ridiculous thread, if your child is running frequent temps over 99.5 this should alert you that something may be wrong. Perhaps it doesn’t warrant a trip to the ER but certainly must be brought to the attention of your childs Dr. and should not be blown off. For my daughter a temp over 99.5 is typically related to a Lupus flare. Most often this is accompanied by extreme fatigue and chronic pain. Even on the naproxen she takes for inflammation and the disease modifying medication, plaquenil. And before you snarky @$$holes try the same $h!t you tried with HolyRoar6… Yes Kids get Lupus too. Maybe you should go back to med school and study up about Autoimmune disease. But please, don’t even consider going into ped. rheumatology and try to treat my my child with your condescending, narcissistic attitude.

    • A temperature is but one data point. If the ‘elevated’ temp is the only complaints than I am unlikely to greatly care.
      However if it is accompanied by severe ear pain, abdominal pain, rash, shortness of breath, sinus pressure of 7 days duration, undue fatigue, new joint pain, or something else that suggests possible bacterial infection OR you have a history of some disease where slight changes in temperature have some meaning than this post is not about you.

    • Yeah. My kids stop listening to me any time their temperature goes above 97.7 degrees. I keep telling their pediatrician about it and he just says to give them Tylenol, but it never seems to work.

      You’re another one who apparently thinks that medical treatment for the entire universe should be modified to conform to your child’s idiosyncrasies. Let’s give everyone DMARDs for a “fever” of 99.6. Woo hoo.
      So you mean to tell everyone here that your pediatric rheumatologist busts out the immunoglobulin every time your child has a “temperature” of 99.6? Bull.
      When you find any medical articles that suggest testing a child to see if “something is wrong” when the child has a temperature over 99.5, you post them here.

      Until then, if you’re relying on solely the presence of a 99.6 degree “temperature” to clue you in to your child having a lupus flare, then maybe you should read a little more about your child’s disease rather than running your yap on a medical blog.

    • Dear SIL: This post is not about patients who are exceptions to the rule. It seems you are taking this quite personal and you shouldn’t be. It appears that with either syndrome that children can go years without a fever and if they do have one often present with multiple symptoms. Hence the term “flare up”.
      For you to become so indignant when WC was clearly referring to people who should wait to see their GP if a fever is the ONLY symptom is just over the top. The attitude is not condescending or narcissist, but a result of frustration that people (and some general practitioners) not using common sense. It amounts to wasted ER resources and money, frankly.

  25. Victoria Ashley on

    I have to say, I’m kind of surprised by some of the “Dr’s” comments on this thread. There is in fact such a thing as a “low-grade” temp/fever,& no it’s not nearly as serious (obviously)as a regular fever(& usually it doesn’t warrant a trip to the ER,unless the pt has some kind of underlying condition etc.) HOWEVER, with that being said…have some compassion please. This exact attitude is one of the main reason’s for the major lack of respect now for the healthcare professional in the last few years!!

    Not all future patients are up for a Darwin award Doc’s. Trust me, I get it (I’m a nursing student, so I literally see both sides of it, & sometimes the pt can be in the wrong & give the Dr undeserved grief & expect them to be Houdini.)

    Generally speaking though, parents are in fact intuitive(& can be right at times)when it comes to their child (yes,some parents can be overly extra-anal & in you’re head you can’t help but want to scream the word “Munchhausen’s” just so they stop.)However,for the regular half-decent parent, they really are just trying to do what’s right. I highly doubt most parents are thrilled at the prospect of sitting in an ER for all hours of the night, extremely tired,& with a child who isn’t feeling well. All to be told by some Doggie Houser lookalike, that it’s “no big deal” & treated like they are nothing more then over-dramatic idiot’s who wasted the very important Doc’s time.

    Put YOURSELF in their shoes Doc, the “you” BEFORE med school. The “you” before “you” knew everything. Just have a little bit of understanding, it’s not a parent’s or a pt’s fault that their particular case isn’t a runner up to help you get a Lasker Award or the like.

    The good thing is that I’ve recently heard,that med school’s are now starting to teach a little bit more about communication & the importance of it. The sad thing is that with the lay-off’s of most RN’S & LPN’s recently,in favor of “MA’s” and “PA’s”(no,NOT physician assistant’s-the other PA.)Who are just taught the simple “skill” & not the reason & theory behind it. Ma’s/Pa’s who aren’t taught(because it’s simply not in their scope of practice to) advocate for the Pt and be a valuable asset for the Doctor(like Nurse’s are required to!) Compassion is going to be nothing but a long lost English word. All healthcare in the future will undoubtedly suffer because of this, most of all the Patient’s and even the Doctor’s.

  26. Our nephew ran a “non-fever” of 99.4 to 99.8 for for more then a week..only other symptom was some intermit. fatigue otherwise he was acting like a normal 7yr old boy..he was diagnosed with leukemia after my sister in law took him to see his pediatrician…so sorry, as a parent of 4 and an Aunt to a cancer survivor..your blog was way off the mark.

  27. Med Staff Credentialer on

    Regardless of your medical and personal opinions, it’s obvious that you never learned effective communication skills. You’ve shown how you would (and obviously do) relate to parents and others who come to the ED with their concerns, but you have also shown the same blatant disregard for other people’s opinions that have taken the time to post comments. Whether you agree or not, your delivery and smug responses will no longer be tolerated in U.S. hospitals as they begin to fully implement focused and ongoing professional practice evaluations and sound credentialing practices. When someone treats the hospital’s “customers” with this attitude, they should be addressed immediately by the department chair and not allowed to continue this behavior. It can wreak havoc on relationships of patients and other healthcare providers, and it also has the ability to obstruct good clinical care. There are plenty of doctors out there who can deliver good care along with good customer service, and those that can’t conform will be weeded out, probably to work in outpatient clinics or private practices where there is not as much oversight and accountability for bad behavior and possible missed pathology. I hope you are intelligent enough to recognize your improvement opportunities and take advantage of them soon. Otherwise, I hope the medical staff leadership will accept their responsibilities to assist you into another career path. “First, do no harm.” Words, actions, non-actions, verbal and non-verbal communications all funnel into those powerful four words.

  28. Picklesticks, thanks for sharing your nephew’s story. So sorry to hear about his diagnosis. Hope he’s doing well with the treatments. I have to agree with the importance of following up a persistent “low grade fever.” I’m not a doctor but I have been seen by a team of specialty doctors, all of whom agree that a temp 99.5-101 over 1-2 weeks and still not resolving warrants some work-up/investigation. It could be autoimmune issues, infectious disease, drug reaction, or malignancy. A normal bacteria or viral infection would have run it’s course and the patient should be well on the road for recovery. It is worth noting that GI tract will slow down significantly when the core body temp is above 99.5. When you can’t eat and digest well, you get sicker. Thus, our body is not built to be dealing with a persistent core temp over 99.5 for a long time.

  29. This is an Emergency Medicine blog. All the exceptional stories here (leukemia, lupus, HIDS) really have nothing to do with emergency medicine.

    The fact remains that there is almost no circumstance in which it is either necessary or appropriate to go racing into the emergency department of your local hospital, child in tow, simply because your child has a slightly elevated temperature. Your child’s regular pediatrician is far better placed to deal with your concerns.

    And whether you like it or not, it’s not technically called a fever (“low-grade” or otherwise) unless it’s 100.4 °F (measured rectally) or higher. That’s not Dr. Whitecoat being mean, that’s just the definition.

    The emergency department is for emergencies. A temperature of less than 100.4 in a child, unless there is some underlying medical condition, is rarely an “emergency” that needs medical attention right away.

    • I don’t know where you live but in ont if you don’t have a doc which is most ppl … You go to emerg… I’f you call telehealth they tell you to go emerge. My docs answering machine says to go to emerge if it something that requires attention before 2 weeks which is their booking time…

      • Who “doesn’t have a doc” if they have kids? Oh, let me guess… You have Medicaid so you don’t care how much a visit to the ER will cost, since the taxpayers will cover it?

      • Umm I’m in Canada … A) docs have huge waiting list so now we have nurse practitioners to try to fill in the gap a little but still most people don’t have docs. Expecially when they choose addresses closest to them leaving the people in the smaller outlying areas “out of their area” B) um no I don’t have “Medicaid” whatever that is… And C) no It doesn’t cost me to go to emerg it but there is also no option to pay for even the doctors….

  30. I’ve had a body temp of 99.3 to 99.6 for the past 6 months. prior to that it was around 96. I was exposed to black mold for 3 years. I know for a fact I’m fighting about 5 different infections. I’ve seen my blood under a microscope. I’ve seen parasites, lyme like microbial cysts. mycoplasmsa, I have gut dysbosis, Sibo. and fungal infection. I has a very vibrant full of life person a few years ago. Now i’m a shell of my former self. I’ve been on all the protocols for mold and lyme but it’s just not breaking.. In any event. a 99.3 persistent low grade fever is something to take seriously. Maybe if it only happens once in a while no big deal. But if you feel like crap and the fever is constant chances are you have something chronic.

  31. You’re kind of a d!@%. I am very lucky to have very healthy kids. My oldest daughter has been on an antibiotic once when she was five and had a temperature of 103.5 due to a kidney infection. My second daughter is 18 months and has yet to be on an anti biotic. I, on the other hand, am not so lucky. I was hospitalized with bacterial pneumonia twice. Both times my temp didn’t get above 99.6. The my symptoms, examination, and xrays said I had pneumonia but the entire time I was in the hospital I never had a ‘fever’. I understand why parents freaking out over the bodies natural response can be annoying but do you really have to be so douchtastic about it.

    • Do you teach your kids to construct an argument like that?

      Also, bacterial pneumonia tends to do the “sneak up on you” thing and ride low in terms of body temperature. I have been DX’d with it too- and if you take any NSAIDs or a couple other things that is also going to have a hand in lowering your temperature as well.

      If a person deals with patients/clients telling them day in day out that they don’t know how to do their job, they are going to get irritated. Many health professionals feel this way- but it obviously didn’t stop you from getting care.

  32. I know you will just flame me, and I don’t really expect anything different after reading the posts and comments made here, but the majority of you are in the wrong profession. It is so disheartening to see that doctors and health care professionals are so cold and callus. It is unfortunate that bedside manner is not more important today. Please remember that one day you will be on the receiving end of this one day when your health fails you, and for your sake, I hope your health professionals have just a touch more sympathy and respect than the folks here seem capable of showing.

  33. So.. The individual that wrote this, might as well call it quits. I am a mom of two special needs children. Not once in here does she refer to children with different than “average” health. Once my daughter hits about 99.2, her system is completely out of control regardless of what the original cause was. She ends up with a runny nose and a bad cough that is always followed with vomiting.. resulting in Pneumonia, every time. She has seizures by 100 degrees and needs hospitalization for IV fluids. This person is a quack. My son, after 100.4 is automatically hospitalized for 48 hours because of his needs. This person didn’t take any other individual other than a normal person, to thought. How disgusting.

    • …Really?

      The fact that you refer to your children as “special” needs indicates that they are unique cases. This is a short entry, a blip document about general peeves. If you believe it does not apply to you because your children are unique and likely have immune system issues or other particular issues that set them apart? WHY are you so offended? They likely didn’t take “any other individual other than a normal person, to thought” because maybe they don’t represent the majority of the issue.

      And if the author did address YOUR specific situation, they would then have to address every “special” situation, including mine, and anyone else’s who might possibly not pass for “average”. I mean, right? Because otherwise, not “fair”?

      Get over it. Really. If they aren’t calling you out? Maybe there is a reason. I have auto-immune disfunction and documented [in medical records and frequent charting] low BBT. But it doesn’t actually matter- even when I go to an unassociated urgent care, the fact that I have an auto-immune disorder and present with symptoms along the lines of “feeling like death” even though I’m not presenting with an “official” fever, they will take me seriously. Because I’m not abusing the system and having trouble walking from the front door to the walk-in kind of signals something is amiss.

      if you aren’t abusing the system? Don’t suck and attack the author who is sounding off about people who muck up urgent care. I mean, unless you are actually doing that and are a bit sensitive.

  34. I also consider fever to be the body’s natural defense mechanism! It’s a sign that the body is fighting the virus that is invading the body, so why weaken it by administering Tylenol or Motrin at the first sign of fever? God knew what he was doing when he designed our immune system, so unless my family comes down with really high fevers, I leave them be, make them rest, and push fluids! At night, they may get a half dose of Tylenol to help make them more comfy so they can sleep. I’d like their livers to stay healthy, thanks!

  35. I’ve had swollen lymphs for three years. I have allergies. I have had fatigue for the last three months. My temp is now naturally any where from 99.9 to 100.8 for the past month! I was given antibiotics three times and lidocane because I asked for it. I had epstein Barr and I’m sure it’s just a flare up. No it’s more serious they say. Yeah, or you need my copays tobpay off your school loans.

    At least I know what’s wrong with me, because they sure as hell do not!

    Doctors, book smart, yes, ethical? Hell no, caring? As IF! Greedy? Hmm, bitter because insurance has their nuts in a sling? Yeah, that too!
    George Carlin said it best, “ever wonder why they call it medical practice? It’s all guess work in a white coat!”

    Never trust doctors,lawyers or insurance companies. They sure as hell aren’t in it for betting your life. They do it for the money. How about you sad sack doctors shut the fuck up and stop biting at the hands that feed you. You should all be so lucky to have a patient you ungreatful, smug,egotistical asshats! Why are any alleged doctors bitching about temps? Not like you take them, that’s what medical assistants do! Where is Dr. House when you need him? Oh that’s a fantasy, a doctor who actually knows what their doing!

  36. Stephanie Reynolds on

    I think it’s about time for everyone here to get a grip. I, too, suffer from multiple Autoimmune diseases (Severe Crohn’s disease, Thyroid disease with a history of ThyCa, and Sjogren’s Syndrome, to name a few) and frequently suffer from Dermatological manifestations and a slightly elevated BBT when my body is entering a flare. My base temperature is between 96 and 97 F. However, I am well acquainted with procedures and medications to deal with these flares, as does most anyone with a chronic illness. White Coat and the other ED physicians posting here are not discussing chronic illness. ED physicians are not likely to diagnose chronic illness. This is the job of practicing physician who is able to perform the battery of tests and evaluations necessary for such diagnoses.
    My own diagnoses came after years of illness and suffering without a specific diagnosis.
    I still make trips to the ED when I am showing signs of emergent complications such as a bowel obstruction; however, I do not go to the ED every time my temp goes above 100 F, because I will simply see my regular physician at my next opportunity.
    When speaking of children without chronic illness, a “low grade” fever is most often a good thing as it is indicative of the bodies’ natural defenses for dealing with minor infection or viral illness.
    Crowding the ED with such minor illness that can wait until the Doctor’s office opens, simply causes chaos and diverts the ED physician’s attention from actual emergent patients.
    When you have to wait for six hours in the ED to see a physician, it is probably because patients are triaged in order of severity, and a “low grade” fever simply doesn’t rate very high on this list.

  37. Dear Doc,

    I hear you on this…see my husband is a physician and not only agrees with you 100% about the temperature thing, he even SOUNDS like you–like he has a major chip on his shoulder about why the rest of us plain folk still want to believe 99.4 degrees is a low-grade temp.

    That is until this week. I have consistently asserted throughout our marriage (and shown him on multiple types of thermometers) that my body temperature is generally at 97.2-97.6. However, for the past week and a half, every night, I have run a “low grade fever” of 99.5ish. (Complete with the aches and shivers and sweats when it breaks in the middle of the night) We ARE supposed to be leaving the country this weekend for a family vacation with all the in-laws (a year in the making), and so YES, I am going to go try to get blood work done because I DON’T want to spread something. Moreover, even he is now a little nervous that something is wrong with me. I have had no other symptoms and prior to this straight stretch of “feverish” nights, I’ve had two or three other random “fever nights” with no other symptoms since Christmas. My thought for you, is that every human is unique–should we run to the “Emergency Room” everytime–of course not, but having such a strong dismissive attitude toward thinking folks, and not admitting that there are variable situations, is a bit silly on your part.

    And the last thing I’d say, is that LOVE for our family members is why we bring them in–I don’t know if you have kids or not, but when we have a child who is visibly ill and uncomfortable, the child is scared (and so area we as the parents). If my husband wasn’t there to wrangle me in, I’m sure my pediatricians would be much more annoyed by me. As it is, I have someone under my roof with years of knowledge to prevail upon my logic. But even my stoic Doc husband, admits that something is wrong with me and that a little blood work is in order. Folks who are irritated at you on this post, just want to you to admit that perhaps, once in a very rare while, 99.4% IS evidence of something bigger. This post and your “You idiots” attitude IS contributing to the general hatred of doctors, despite the years and years of study and sacrifice you (and my family) have endured.

  38. I hate having to go to the ER. That is a fact. The last time I was there is still very clear in my mind. I had had a “genuine” fever for eight days and finally, my breathing was too bad from my asthma that I relented to my parents and soon found myself iin the ER. My temp before driving there (about 15 min. drive) was 104, taken with a mercury oral thermometer. Once we got there, they took my temp with one of those thermometers that swipes across the forehead and it read 100.1. huh. No fever?? The ER doctor started to look a bit annoyed like I had come in for this?? He looked at me and asked “YOU think you have pnuemonia?” I said Yes. I think I have pnuemonia. He didn’t seem to believe me, but ordered the x-rays anyway. Little while later he came in in a hurry and said that I DID have pnuemonia and it was quite extensive…I should be hospitalized right away. I was so taken aback by this sudden change that I didn’t respond right away. He then went on trying to convice me but little did he know I had come packed for it.
    So, why I hate the ER is because there are so many people working there who just aren’t, yes, kind! I get pressured and scorned there when I plain don’t feel good. I’m sure they get plenty of people who don’t really need to be there, but they can still be kind.
    As to temps, I hear both back and forth all the time. My big question is about how accurate the new thermometers are. Obviously the mercury is not going to be faulty… and how could my temp drop from104 to 100.1 in 15 minutes? The answer seems too obvious to me.

  39. …I last commented on this in November, but I continue to get updates.

    Since I last commented I have had to make more than one reluctant trip to the ED at Mass General in Boston. [for those not following along at home, this is hardly a medical establishment behind the times]

    I have trouble when I show up at someplace like an ED or urgent care. I don’t like going there, I show up when I really definitely know I need to- often because I am at the point where I am worried about breathing. I will kind of put up with everything up to that point [which isn’t great either]. When it comes to describing my symptoms, they’ve presented on option which kind of skirts the whole “low grade fever” issue, though. *Subjective fever*, which I often experience and is apparently helpful information, has helped to express that I feel shaky and hot and can’t get comfortable, sweaty but have something like chills, but my temperature seems to still be within the normal limits.

    This seems to have fixed many issues when attempting to communicate my symptoms. Just saying.

  40. Most of these comments eem either clearly dull and not worthy of a response or in support of the claim. I have to ask, is it wrong of me to call a nurse if I’m concerned about symptoms and be frustrated by the question “do you have a fever?” I’m sitting here on the line barely warm yet have symptoms and you’re concerned if my temperature is high? This nurse gave me the hardest time about not having a fever. Am I in the wrong for thinking there might be a reason I’m feeling awful?

  41. Amber Hamilton on

    Thank you so much for this article! I am a nurse with old injuries causing muscle spasms and I have seasonal allergies. I just needed some confirmation that my persistant 99.5 temperature probably is just due to pain or allergies, or I just run high. Too many people out there believe that they must have cancer, etc. etc. But “when you hear hoof beats, first think ‘horse’- not ‘zebra’.” 🙂

  42. I love you right now. I just love you. My daughter is 8 and for the past two months she’s had a consistent 99+ fever. She feels absolutely fine. She’s playing soccer and hopping around goofing off like a kid normally does. The month she got the strep infection that took three rounds of antibiotics she was noticeably sick even though her fever barely reached 101F.
    I’m beginning to think her basal body temp is just higher than the average temp. The pediatrician wants to do some bloodwork to rule anything out because I have RA and Sjogrens so I normally run at a higher temp if I don’t take immunosuppressants and those AI diseases are genetic. Anyway I’m getting off track.
    You’ve eased my worries. If she’s acting fine and has no sore throat, cough, ear pain, vomiting or headaches I’m just going to let it ride.

  43. I do have a question about this 100.4 C though, seems like an arbitrary number. When the basal body temperatures vary widely, why isn’t that a person might feel ‘feverish’ or their body be in a state ‘alarm’ while they are not registering a 100.4 C? I agree that a fever of 99.9 or even a 100.4 probably does not warrant a visit to the emergency room, but low grade fevers that are intermittent and recurring are a tell tale sign of a few cancers as well. it isnt exactly helping anyone by asking them to adhere to a number because their thermometer did not say 100.4 C and instead stayed 100C.

    Let me ask you a question similar to the ‘ebola’ question (in sarcasm anyway): Are you going to tell the family of a man or woman who died of undiagnosed stage 4 cancer that his ‘recurrent low grade fever’ just didnt reach the magical 100.4 number on your scale, so meh!

    Once again, a low grade fever or even a ‘fever’ might not warrant a trip to emergency room, but a magic number of 100. 4 sure as hell doesn’t mean much in terms of recognizing ‘fever’ as a symptom of an underlying cause.

  44. Column sounds as if written by a pompous ass. Clearly not an MD any person should endure. If you are so smart- perhaps you should recognize your need for human skills. This column is a disgrace to medicine. All feeding into it here perpetuate this. The comment about Medicaid demonstrates the truly unprofessional, unkind and inhuman people who really need to find another career and get out of the way of those of us who do actually care.
    Perhaps in all your greatness you should rewrite the reference text definition of low grade fever: “low-grade fever,
    an oral temperature that is above 98.6° F (37° C) but lower than 100.4° F (38° C) for 24 hours.”
    low-grade fever. (n.d.) Mosby’s Medical Dictionary, 8th edition. (2009).

  45. What about those who KNOW their normal body temperature is not the average 98.6 like it’s “supposed” to be? I know my normal body temp is 97.1 because I have had to chart my temp for medical reasons. So when I have a temp of 99 and I’m not feeling my best I know that my body has a fever. I’m not a baby by any means. I can deal with a 99 temp. I’m just pointing out that you can not say that there is no such thing as a low grade fever when you do not know that every single person has the 98.6 degree “normal” temp. And why is it that doctors have discovered cancer in children that have continuous low grade fevers and yet you sit here laughing at those who have tracked their childs health because of that very reason. You may be educated and smart but you do not know everything. Being open minded is how science is discovered.

    • “What about those who KNOW their normal body temperature is not the average 98.6 like it’s “supposed” to be?”

      Did you even read the original post? Where Whitecoat wrote:

      “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.”

      And if you have a child with “continuous” low-range fevers, you’re better off tracking that and taking him or her to your regular paediatrician. It’s not one of those things where you’ve been tracking it for weeks and suddenly one Sunday afternoon you think, “Hey, maybe I should get this looked into, I think we’ll go off to the emergency department.”

  46. My friends has been having low grade fever for the past 15 months taken all tests,all tests have shown negative ,liver has little damage, Please let us know if a pet scan is required

  47. I work in an ED and all I have to say is thank you. You don’t know how many times I want to punch people who tell me their child has had “a fever of 99.2 for an hour.” And that is why I pay $178/month for my health insurance….idiots.

  48. These so called over protective parents bringing their kids in with 99.1 temperatures are helping to pay your bills as doctors. I don’t personally have children, but maybe you should give these parents kudos for even being concerned enough to bring their children to the doctor. It seems you ungrateful doctors obviously don’t need our money, so maybe the answer is to not go to the doctor and just wait until we all have to go to the ER. We can always consult the internet until then.

  49. So, I just missed my birthday celebration yesterday because I spent another sleepless night with a 101 fever and chills and was afraid I might have something contagious. Over the last year, this seems to happen to me almost once a month. Sometimes accompanied by vomiting. I have no ovaries, not HIV POS, no TB, good lab values, yet I feel like crap and then it mysteriously disappears by the end of the day. My doc just shrugs when I mention it. So, my questions to you bastions of humanity (ha!) are: Should I worry about contagion and isolate myself or should I press my doctor for testing he doesn’t seem to think I need? What would you do?

    • C’mon. Bastions of humanity … “(ha!)”???
      The article wasn’t really addressed to people who truly do have fevers, only to people who claim they have fevers with a normal temperature.
      However, because I do happen to be a bastion, I’ll give you a couple of ideas.
      Even though fevers may result from an infection, that does not mean that an infection causes every fever. Similar to saying that every beagle is a dog, but not every dog is a beagle. There are multiple other things that can cause fevers – especially long term fevers. Here’s a link to some of the other diagnoses associated with chronic fevers:
      Note that these include connective tissue diseases, medications, and even some cancers.
      Exactly what is causing the fever in your case is going to require some further testing and some detective work. If your doctor shrugs it off, then it may be time to find another doctor.

    • Hi Yvonne,

      I saw someone go through the same thing. Her kid spiked a fever once a month almost to the day, and then it went away. He had no medical conditions. They found out he had a parasite, and it was when the parasite laid eggs once a month that he spiked a fever. They went through countless doctors to find one that tested for parasites, so good luck. It might be something else for you, but it could be if they can’t find anything else wrong with you. Hope this helps.

      • Thanks for the advice, WhiteCoat. I hadn’t thought of a parasite – and I’m a retired lab supervisor. Sheesh.

        My doctor’s response when I emailed him asking if it could be diverticulitis was – if it continues to happen make an appointment. My response to him was: Can I have your cell number so I can call you at 0300 when I actually have a symptom for you to observe?

        I have Kaiser, where the docs are over-worked and bleary-eyed husks of their former caring selves. I actually like my doc and he seems rather knowledgeable – and exhausted – like I should be caring for him.

        What most people bitching on this site don’t understand is the ceaseless waves of ER visits,by the uninsured, drunks brought in by the cops, the mentally impaired, the homeless looking for a bed, the drug seekers, and yes, concerned parents, who should be at an urgent care – not an ER. It’s no wonder that [some] staff members tend to get their humanity sucked right out of their souls. In my experience as a trauma team member, which meant responding to every ER call, I’ve seen the gamut of bad behavior toward patients, mainly by nurses, but I’ve also seen lives saved. If you can’t have a blog where you can vent your frustrations, yet you are expected to be, again, a bastion of humanity, there will be more of this behavior in the workplace, not less. If these delicate, little fleurs who complain here think this grousing is bad, they should get an earful of the black humor after a team has lost someone they tried valiantly to save. People, even doctors, need a place to vent.

        These detractors need to get their head out of their posteriors and off of a site designed to release some steam. Thanks for your help, Bastion WhiteCoat. I didn’t expect a rely. Thank you, as well, Ashley.

  50. Jennifer, Raymond MD on

    Was the point of this entire post for what ranting about what you believe, getting everyone arguing? Couldn’t you just have kept it to yourself? It’s kind of unnecessary. If a parent or person want to go to the hospital for a temperature or 1. Higher or lower temperature than average let them. Mind your dang business. If you want to complain about people coming in to get help, or seek information because they don’t know what’s going on your in the wrong profession. People also don’t need the added stress to anyone who is seeking help. Instead just inform people, not list your pet peeves. Why argue about which thermometer is best? It’s pointless because even if the thermometer is broke and giving you a false temperature, you still have a right to go to the doctor whenever and for whatever you want. You could have a a splinter, who cares, if the doctor complains, then who cares. You pay for insurance, or government pays, and doctor’s are paid so there is no need for this ranting post!! IF YOU WANT TO GO TO THE DOCTORS FOR A 99.1 OR A 89.9 GO, WHO CARES, if you think it’s right go. That’s what these people get paid for.

    Pointless post! Why get everyone fighting.?

    • Much respect to you Dr. Raymond happy to read positive and caring thoughts from you. Truth be told every E.R. Blog I’ve been reading lately strongly suggest we people shouldn’t show up for any reason what so ever, I guess we’re all annoying and one physicians comment was (you guys don’t want to piss us off!!!) NO WE DONT…maybe… That’s a threat we should take seriously, just behave yourselves, okay. One guy probably harmless, and I’m sure the rest don’t think that way.. There are certain topics that I get that can cause and create anger, but fevers and all the many different reasons why -regardless if it’s a pet peeve or not I’m surprised. To the Medicaid mom and the parents of the special needs kids sorry those things were said to you. Someone will respond with helpful thoughts, you’ll see.

      • To all of the families whether using private insurance or Medicaid, you have a RIGHT to be treated. You do not need to settle for SUB PAR medical care or attitudes, biases and unethical judging of yourself or family for going to the ER.

        I was feeling great, until I woke up with a terrible pain in my throat without fever. Turns out it was a double inner ear infection as well as sinusitis that is moving into my lungs (infection) UTI.
        I didn’t go to the ER, but my doctor almost didn’t have time to get me in THAT day. Had she not, then by god I’d have gone to the ER & guess what? Had one miserable nurse, doctor or rude office personnel had an issue with it, I’d have REPORTED THEM.


        Consumers of healthcare, we have to start DEMANDING good treatment. With all the financial cuts these doctors are angry and resentful. They have school loans and debt like the rest of us and some days, well their attitudes just SUCK.

        Little advice for all the doctors with a bad attitude, if you can’t have compassion for other’s well being, perhaps it’s time to think of a new career. A career where people always have bad attitudes, poor service and a chip on their shoulder. Do you JOB, you should feel blessed, filled with pride about your job, not have an attitude and treat others with contempt.

        I’m going to pray that you doctors with bad attitudes get therapy.

        • You’re mistaken about the “right” to be treated. If you walk into a doctor’s office, you have no right to anything. You can demand all you want and the doctor can ask you to leave. You have a “right” to receive a *screening exam* in an emergency department and if you don’t have an emergency, you have a “right” to nothing else. A double ear infection and sinusitis moving to your lungs isn’t an emergency. If you weren’t triaged out of the emergency department with those complaints, you might have received a decongestant that you could have purchased over the counter, or, if you had a particularly bad doctor, you might have even received a prescription for antibiotics which have been proven to have no effect in sinusitis of less than 10 days’ duration. http://www.motherjones.com/environment/2013/04/sinus-infections-antibiotics-resistance
          The post that you’re responding to is educational. Low grade fevers are a farce. By the way, so are almost all “double ear infections” in adults and any notion of “sinusitis moving to your lungs.”
          A vast majority of doctors aren’t angry and resentful. Often bad attitudes from patients beget bad attitudes from medical providers. When I have someone cop an attitude and threaten to report me to the AMA (an organization to which a vast majority of physicians don’t even belong, anyway) because they don’t get their Z-pack for their magical migrating sinus infection, then I’m not going to be all warm and bubbly inside.
          It’s a two-way street, lady.

          • Good point, Whitecoat. When it comes to sanctimonious, arrogant, callous doctors who endanger patients through a refusal to listen and/or think more deeply about the presenting problem than their mental flow-chart would indicate, we should be reporting them to their state licensing boards And hospital administrators until they either face professional repercussions or are given mandatory empathy training. Clearly they need it.

  51. Jennifer, Raymond MD on

    If your are seriously arguing this case, your mistaken.,and loosing. The ER is for any MEDICAL EMERGENCY, including a fever. Please don’t make people feel guilty for caring enough to seek help. Seeking help/information about what’s going on is always the better option. Especially if you are unsure and feel you or your child needs to be seen just in case.

    I’ve had a patient with a 99.1, ongoing up to about 99.4, although not highly elevated, and would normally be the bodies way of fighting off a infection, this patient ended up having serious brain problems, i’m glad she sought out help. This was an extremely rare case, miniscule.

    The point is, it is never a waste of time or money, to seek help/information, if you feel you need to.

    • @ Dr. Raymond, thank you so much! I’ve been fighting a what I call low grade fever for few days. Guarantee if I call my PCP he will tell me to go so ER so labs can be ran & results will be immediate. I’m a cystectomy patient that still suffers w/resistant utis, some I’m not even aware & also w/open wound (which looks great) from a knee replacement where incision dehisced and I contracted MRSA. So now for 3 days I’m feeling very lethargic, calf is very hard, little bit of pelvic pain, severe headaches @ times and slight cough only when I lay down though. So now I feel like if I go to my ER and say fever has been high 99’s through 100.6 off and on, I will be judged….So thanks for sorta making me little paranoid to seek treatment based on the original post.

    • If only you could be in all e.r.’s at all times, please reply often your opinions are a breath of fresh air.

    • Med Student on

      If your are seriously arguing this case, your mistaken.,and loosing.

      If you are indeed a medical doctor, you’re the first functionally illiterate one I’ve ever met.

      • Whitecoat & Med Student are both indeed nothing but wanna-be doctors on the internet.
        I’d suggest any one who deems it necessary to be treated at an ER, just go.

        Why are we even entertaining these pimply faced kids who claim to be a doctor “online”. Likely they are tweens or teens with an itch to go to medical school, or medical school drop-outs.
        The extent of whitecoat’s education is using “.com” resources: (Exhibit A quote from whitecoat)” if you had a particularly bad doctor, you might have even received a prescription for antibiotics which have been proven to have no effect in sinusitis of less than 10 days’ duration. http://www.motherjones.com/environment/2013/04/sinus-infections-antibiotics-resistance

        And this little erroneous git’s opinion which is obviously a microassault based in his deep rooted misogyny because his mommy didn’t hold him enough! He resorts to insults on a typo–epic failure.

        As Carole said a breath of fresh air.

        • Before you are blocked from the site, I’m approving this comment to show everyone else a glowing example of why some doctors get bad attitudes.
          First you publish a bunch of tripe about double ear infections and sinusitis going to your lungs (because that must happen all the time in invertebrates). That was under “VERA’s” name, though.
          Then, when I expose pretty much everything in your comment as being absolutely untrue, you get your panties in a wad, put on a big pouty face and change your name to “Luther” so you could make it appear that someone else actually sympathizes with you. Gasp! How did I know that?!? Both comments came from the same IP address, brainiac. Notice how your avatar didn’t change between the comments?
          Your comment provides no cogent response … I’ll wait while you look up that term … but instead you respond with a bunch of non-sequiturs … go ahead, I’ll wait while you look that one up, too … and create a bunch of ad hominem attacks (I provided the link for that one to speed things up a little).
          Now, because I’ve exposed your whacked out idea about having a “right” to medical treatment as being, well, whacked out; because I’ve apparently exposed your doctor as prescribing antibiotics for inappropriate reasons; and because you can no longer garner sympathy from the people in the studio audience with you at the Jerry Springer Show by telling them your doctor snatched you from the throes of death by prescribing a ZeePack to save you from a case of magical migrating sinusitis and DOUBLE EAR INFECTIONS TO BOOT … now you have decided to expose me for what I am: a farce with acne vulgaris who can’t form an understandable sentence and who dropped out of medical school because my mommy didn’t suckle me enough while I obtained my graduate equivalency diploma. Damn, you’re good. With those logic skills and your keen knowledge of the migration patterns of sinus mucous, we should create another medical TV show. We won’t call it “House,” instead, we’ll call it “VERA-Luther”!
          Of course, if you were my patient, you could now go complain to the AMA (see prior comment from your alter-ego Vera for the link) or maybe the surgeon general, telling them that I was mean and rude. Then you could give me all “1”s on my satisfaction scores, writing in crayon in the margins that you’d give me all “zeroes” if there was any way to do so. You might even be able to copy the satisfaction surveys and write “Vera” on one and “Luther” on the other to give me “double” bad scores like your “double” ear infections, you sneaky devil, you.
          But unfortunately, you’re not in the emergency department. So go float back down to your mommy’s basement, Little Snowflake, so you can wail and moan to the other snowflakes on whatever chat room you came from about how all doctors are mean because one just got fed up with your whininess and deceit.

          • Well, we know you’re an American doctor, because effectively every other nation on the planet recognizes health care as a basic human right or citizenship right rather than as a simple consumer good. I hear you can make Quite a good living selling cars, though. Have you considered that? Bonus, no pesky professional ethics to have to studiously ignore!

      • Are you serious? WHY…you can learn something from her med student. Can tell already by that stupid comment your going to fail. You’ll only cost patients their lives and hospitals malpractice lawsuits due to your lack of following excellence in your profession. And DONT DISRESPECT her again..if you do, well we’ll just go back and forth all day everyday, because I will not back down defending her. Whitecoat you should of had her back, she did not say anything that deserved negative feedback from anyone. And please don’t block anyone, your blog is one of the best to read, because of our differences. Maybe this blog should not be open to the public so you guys can have a private place to vent about patients, I can understand and appreciate that. But meanwhile since we are welcomed let us all vent.

    • Thank you for being a doctor who shows compassion and cares about patients. I was beginning to think they didn’t exist. Please keep doing what you do.

  52. Well looks like I’m one of those “crazy” parents who are concerned about their toddler’s recent ongoing fever. It’s been going on for 4 weeks. The first week it peaked at 104.9 and went down within two days. Two weeks later, it peaked again at 104.8, and went down to about 101 after 3 days. But my point is… it has never gone back down to 98. It has remained at 99 or higher. My ped checked for bladder infection, but came back negative. My child is very active and happy and has no other symptoms, so I am of course confused. I keep looking for other symptoms. She’s mentioned a few times her knees hurt and her eyes hurt- I told my doc- he doesn’t seem concerned. So I guess my biggest q is- the joint pain. how in god’s name am I supposed to know whether my two year old has joint pain?? She has just started telling me what she wants to eat, I doubt she’d complain about (or even know how to complain about) joint pain. Any suggestions on HOW I am supposed to flag this symptom?

    • My knee doctor had me lie on my back and took my leg bending it at the knee over and over. If your 2 yr old starts crying or says hurt, then you will know. Kids are pretty flexible, and you wont hurt her by bending her leg as long as you can get her to relax it and not stiffen up. If she stiffens up, then dont force it. Basically you are bending her knee for her. An eye doctor will know after doing an eye exam. Hope that helps:)

    • Young kids won’t be able to tell you. In general, though, if their joints hurt, they won’t use them. They’ll limp or they won’t walk if a knee or hip hurts. They’ll reach across their body instead of using a painful arm. If a joint is causing fever, chances are that it will be warm and swollen.
      As I mentioned in another comment, fever isn’t always due to an infection. May need to dig a little deeper for the cause. http://en.diagnosispro.com/differential_diagnosis-for/infectious-disorders-specific-agent-fever-of-unknown-origin-chronic/35606-154-170.html

  53. Whitecoat… Super professional. You’re blatantly disrespectful and narcissistic. Why do you hold such contempt for the people who pay your bills?
    If you don’t enjoy helping others heal, go work for ComCast.. with your snipey attitude I’m absolutely positive you’d fit right in.

    Now onto the comment I was going to post before being side tracked by a pseudo doctor.
    Yes in some cases a 99.0 temp signals something is wrong. Your body does not run a higher than normal temperature for no reason. This is your warning sign.
    Now if it only lasts a day or so, you would be safe assuming it is probably just a viral infection or something similar that resolved itself..
    A fever is meant to fight pathogens of all types invading the body.

    It is your body, you know it better than any doctor or nurse. Listen to yourself, if something doesn’t feel right, go to the doctor. Or better yet, a homeopathic doctor, these docs are amazingly compassionate. Most Western Medicine doctors become narcissistic as soon as their residency is completed.

    In my case, I ran a 99.5-100.0 degree temp for SIX MONTHS. Six horrible months, my normal body temp is around 97.6.. it took six months of doctor’s visits claiming nothing was wrong with me for me to take matters into my own hands.

    I found toxic black mold growth behind the drywall in my master bathroom.. it’s been four months and I’m detoxing and still deal with these “non fevers”.
    Toxic black mold is very dangerous and can have long term health effects from exposure. I have migraines on a daily basis, joint pain, neck pain, panic attacks, developed a heart arrhythmia, trouble sleeping, muscle pain and a slew of oter terrible health problems, and I am only 27 and had perfect health before exposure.

    Bottom line.. my “not fever” almost killed me, and probably would have if I had convinced myself nothing was wrong like the doctors wanted me to believe.
    Good luck everyone!!

    • "Toxic Black Mold" Hoax on

      The biggest hoax is the hysteria over the notorious black mold that grows on sheetrock. This black mold is formally known as Stachybotrys chartarum or Stachybotrys atra. The horror stories related to items such as infant deaths in Cleveland in 1993 and 1994 are not true. The statements of CDC related to possible cause have been retracted by that organization. With extremely rare exceptions (possibly only one documented case) there is no association between inhalation of Stachybotrys chartarum and any identifiable disease.

      It is true that Stachybotrys chartarum, as part of its metabolic processes, produces a chemical by-product called a mycotoxin. But there are hundreds, thousands, perhaps even tens of thousands of other molds that produce mycotoxins. Mycotoxins are large molecules that do not easily become airborne, thus the only real possible exposure is ingestion such as eating grains or other foodstuff with a large growth of Stachybotrys or direct infection through an open wound.

      The possibility that a person who is not severely ill, or whose immune system is not compromised from disease or suppressant medicines, exhibiting any reaction to a mycotoxin is practically nonexistent as shown by the total lack of scientific evidence showing a direct link between a specific mycotoxin and any disease or symptom.


    • "Toxic Black Mold" Hoax on

      …and let me guess. The “treatment” for your “toxic black mold poisoning” which “almost killed you”, and which consists of “detoxing”, is being provided by some sort of quack or doctor of woo, not a real doctor.

    • Hi Jessica,

      I ran a temp too of 99.0 for several months and then realized that it was everytime I took a certain medication. Just a thought but could be meds causing it too. Off the med I run my normal 97.6. There are several reasons it can run a little higher.

  54. You can say what you want. However, I know my children’s normal body temperature. So, last year when my 14 year old’s temperature was “elevated” ( is that a better term for you to handle) to 99.9 for a couple of days for no apparent reason other than a slight swelling of his calf due to a wrestling injury, I took him to his doctor. He was diagnosed with cellulitis in his leg. If I would have ignored the “elevated” body temperature he most likely would’ve developed serious complications including sepsis and possibly lost his leg, if not his life. So, don’t tell me that an elevated body temperature is nothing. Thankful you are not treating MY children.

    • So what you are saying is he had some symptom other than a fever?
      If so, than this blog entry wasn’t about your child.

  55. So…how about prolonged sub-febrile temperature as first (and for some time ONLY) manifestation of childhood cancers?
    Sometimes ER visit could be life-saving even when symptoms are subtle. Especially when your regular doctor is a moron who can’t tell his ass from a whole in the ground and brushes you off with ‘it’s viral, your child is fine’
    Doctors’ smugness bother me. It could actually cost lives.

    • A “prolonged sub-febrile temperature” is rarely an emergency. The emergency department is not the best place to take a child suffering from such.

      If you’re unhappy with your regular paediatrician, find another one. But it’s still the case that non-fevers are usually non-emergencies. The emergency department is for accidents and emergencies. It shouldn’t be a substitute for primary care.

  56. This sounded like it came from the snarky female doctor that has since been let go from my clinic… must be cut from the same cloth. She cut me off in middle of sentence that my temp had been running higher than normal between 99.4 to 99.9 since Emergency Room visit for flank pain instead of my normal 96.9 to 97.1. She actually sneered and said for your information fevers don’t start until 100.1. Sorry to disagree but I’m multiple medications include intravenous biologic infusions, methotrexate injections, etc to suppress my immune system for my conditions and an increase of several degrees is in fact a fever. My 99.9 is more than someone with a basal temp of 98.6 reaching the same temp. Even the Mayo Clinic’s information site informs: You have a fever when your temperature rises above its normal range. What’s normal for you may be a little higher or lower than the average normal temperature of 98.6 F (37 C). I think more so, you should be teaching the importance of treating each patient as an individual case not just a rigid scale of numbers. Ask what their temps normally run. Emergency rooms have changed drastically over the past few years and not for the better in many cases. I was recently discharged from the ER in the middle of actually vomiting in a pan a few months ago. They had me sign during heaving up bile. Years prior I would not be leaving until I kept down a juice or soft solid and was able to produce an urine sample without quick draw on my own. Nope.. shove you out the door.

  57. This is hilarious. When you take your temp daily for a month and average 97.8, are super sick and have a temp of 99.6, feel like you have a severe flu and end up gram stain positive, your opinions, sir, are moronic.

  58. Patients should be treated on a per patient basis if little Johnny’s temp is 99.4 and he’s racing through the waiting room, maybe it’s not a warranted visit….however when my daughter was 6 months old she cried like she was colic and her temp would rise to 99.1- 100.4 and no one took it serious until one night (no offices open) she was crying like she was in pain and her temp was only 99.6 when I got to the ER after Tylenol and motrin it continued to rise to 102.7,they sent me home. Within an hour 103.1 I returned at that time they did a spinal tap to check for meningitis and called for transport to children’s. She had kidney reflux and one kidney was stage 3-4 they other stage 2 they started with IV ATB to tx, which thank God worked because this could have resulted in my baby having to undergo dialysis possibly for the rest of her life. So the broad statement about parents overreacting is a little brash, because if you yourself are a mother you know when something is different with your child. God willing if you are a mother your child’s early prognosis does not rest on a prolonged supposive low grade temp. And yeah I already know my kid was presenting with pain and this post wasn’t meant for me but again it was assumed to be colic. Maybe you should look up the burn out % for nurses and explore another area of the field, maybe surgical I mean handing a dumass doctor a Scapel doesn’t require too much TLC, maybe you should become a doctor, so you have less pt. contact period. It’s nurses like you that have people in hysteria diagnosing and self treating themselves off webmd because they don’t want to inconvenience health care workers that treat them like peons.

  59. 98.6° is based on an average. To be considered a fever, you must be one standard deviation away from the mean. Therefore, 100.4°is one standard deviation away from the mean. Think of a bell curve. Your body temp fluctuates through out the day in response to many factors. It must increase above the normal fluctuation to a significant degree to be considered a “fever”. Kind of like weight, your weight can fluctuate a pound or two from day to day, but you don’t consider yourself gaining weight until you packed on at least 3 or 4 lbs.

  60. Your post is kind of all over the place.

    I have worked in pediatric health care for years, and have a child of my own, and I never hear about a parent taking their kid to the ER for low grade fevers. Sounds to me like it’s a few peds in your area who keep advising patients to do that so it keeps occurring/you keep seeing it.

    Anyway, I know my kid and if he started getting low grade fevers and I wasn’t getting a diagnosis or my ped told me to take him to ER, I would. I don’t know you so I wouldn’t take any of your advice but I know my ped and I trust him.

  61. I really can’t blame you for being annoyed, some time it over worried parents just worried about their child’s wellbeing or it could be a true problem, in any case it depends on the doctor on what they think is the right thing to do..
    Some times even with a fever it’s hard for them to work out what is going on.
    I had some trouble a few years back that started as a normal not to worry problem and then had gotten worse
    I had started to feel unwell and gone to the doctor before it had gotten this bad with a temp 37.8C (100.0F) with was high for me as my normal is between 36.7C (98.0F) and 37.5 (99.5F). The doctor said that the temp may be high as it was a 37C (98.6F) that day with is a very normal reasoning so I trusted my doctor.
    Three days past where I had become ill with temp ranging between 39.7C (103.4 F) and 40.7C (105.2 F) and a pain under my left arm at that point it had come to the point where I was not able it lift it above my head, lower my arm flush to my body or stretch it out in front of me, and feeling cold with shivers, I had come home from work 1pm ish taken some Paracetamol and gone to sleep. Waking up about 5pm with shivers and uncontrollable shaking. At that time I took my temp to find it at 39.7C (103.4F) taking some more paracetamol and waiting a hour to find it had not gone down but up, at that point I consulted my mum seen as I still live at home, and I was taken to the hospital.
    Long story shorter, I was in there for 6 full days, mostly coz my temp was hovering in the highs I had mentioned before, but only between 1pm and 4am then I would be pretty much normal other then the pain under the arm, with had made both my pulse and blood pressure go up so they where just keeping me in to monitor them.
    In my time there I had allot of doctor question why I was in because I “didn’t look sick” something I heard over and over, I was happy joking and trying to chat with people that come into see me, even with the pain under my arm which they had told me was from a gland in my arm or glands, I really can’t remember welling becoming twice the normal size.
    The after non of the 6th day had come with no temp but sill they wanted to keep mento be shore, After the morning if the 7th day I was given the all clear and discharged at 11am.
    The only thing I was told was that there may have been a bacteria in my bloodstream but they could not say why or what type it was. After all the blood tests and cultures that did, as well as some other scans all over my body they still didn’t know that much just that I had something and had gotten better with their care and help.

    So to the doctors, it’s not always by the book, some times the books can’t tell you what it is.
    And to the patients, your doctor only knows that they have learnt in their study’s teachings and experiences so if you fall out of the normal you can’t blame them for not “knowing you” but most good doctors will learn from new experiences.

  62. I know this old. Hopefully parents will seek advice from their pediatrician and not a blog. Just an example..my son was 2.5 years old when he had a nagging 99.something fever. It kept coming and going. We were gearing up for a Disney trip. I was afraid the 99.something might be indicative of a bigger problem to come so we visited the pediatrician. Long story short…my son had no symptoms other than a belly ache and we finally found out he had pneumonia in a lower lobe. Antibiotics and a few days of coughing up his lung and he was good to go. I agree this wouldn’t warrant an emergency room visit but I’m glad I was persistent that his “low grade fever” was a problem that needed his pediatricians attention.

  63. Look, I get it. People freak out about the smallest thing. A tiny rise in temperature, some people take their kids to the ER. But to act as if a small change in body temperature is no big deal is fucking moronic. There’s so much more to it than that. Just 6 weeks ago I notice my 3 year old daughter is hot to the touch. I know what warmer feels like, so I take her temperature. 99.1. No big deal, right? I let it go. Two days later, same temperature. Wakes up screaming in the middle of the night that her ear hurts. Next morning she says it feels fine. That night she says her throat hurts. I look and can tell it’s red. Temperature of 99.3. So I take her to the doctor. She’s got strep. So much for that not being a fever. That’s a fucking tell-tale sign of strep. A round of antibiotics, and she’s back to normal. Just 15 days after the doctor visit, another 99.1 temperature. No way she’s sick again, so I let it go. Now her throat hurts, so I take her to the doctor. Strep again. More antibiotics. 10 days later I get a 99.0 temperature, and my throat starts to swell. I let it go thinking there’s no way I’ve got strep. 5 days later and my temperature is just barely 88.9 at the highest, but I still feel chilled. Just 5 days away. From a trip to Europe, I decide to bite the bullet and go to the doctor. Now I’ve got strep for the first time since I was 5. Antibiotics for me. 3 days later, another temperature of 99.3 in my daughter. Doctor again, but this time she’s got a rash on her chest that looks strangely like scarlet fever. Even has that sand papery feel. Well what do you know, she’s got strep, so different antibiotics.

    I get that you are trying to get people to stop freaking out about small changes, but you are going about it the wrong way. Even small changes in temperature signal something. You are certainly not a douche, as they are clean and sanitary. More like you’re just wearing blinders and affected by your own arrogance. You should see a doctor for that.

  64. I’m not a doctor but am married to a pharmacist and we own a pharmacy — we have dozens of doctor friends and this topic comes up a lot. Anything under 101 is absolutely not a fever. Period. No matter what your pediatrician does — they are making sure you don’t come back 2 days later thinking they did nothing. Body temperatures run 97-99.5 easily and mean nothing. Even my own family doc who is a very well respected doctor at a major U.S. medical center has told me several times my temp is 99.3 or so on a normal visit and doesn’t even question it. I have asked…and he said – “oh that’s normal” — so I’m with the writer!

  65. It’s a few years late but I thought I’d leave my 2 cents. I get it that your beef is with the term “low grade fever” which is fine. And I certainly would be just as pissed if someone was sent to the ER (a pet peeve of mine too but in the opposite way … funny how no one complained about the term ER until the TV show “ER” came around) because of a 99–a temp that is highly unlikely to lead to imminent death.

    However, to claim that a temperature in this range cannot be pathological is a thought based on ignorance and a lack of understanding about body temperatures. Note the nurse who came down with Ebola was told by the CDC it was okay to fly to OH because she did not have a “fever.” Yeah, she had Ebola at 99.5. Sure, this story is after your post but the principles of medicine do not change–people and infections are all different and context is what matters.

    It’s just as dangerous as saying you are not tachycardic unless the HR is over 100. Or you are not hypertensive unless your SBP is over 140. These are all ARBITRARY cutoffs if you haven’t realized it. It’s funny that you bring up the 100/60 low grade hypertension example but you misapplied it–people actually do talk about prehypertension and stage 1 hypertension and prediabetes. Maybe we should just change the term to prefever and you might be happier.

    By the way, citing one study of 26 nursing home patients is hardly robust data to support your assertion of fever part B of a 2.4 degree change. Ironic you blast your critics for failing to cite science and this is what you produce to support your claims. And since no one is really checking their temps all the time, all people can go by is the isolated value. It should also be obvious that you don’t go from 98.1 to 103 without going through 99. And it should be painfully obvious that unless you are doing continuous temperatures, patients can be having fevers without you knowing how high they are if you catch them at 99 or 100. As an aside, look up feverprints, a new venture by Boston Children’s to get a better handle on fevers.

    Perhaps you will read back years from now and realize the tone of your post is the kind of thing that makes this world a worse place and a reason some people are fed up with doctors.

  66. I completely agree with the previous poster. And I hope I never have you as a dr. (Or maybe you are a nurse?). There are many studies disproving your claim. Here’s an interesting article http://well.blogs.nytimes.com/2009/12/28/whats-your-temperature-rethinking-986/?_r=0

    Here’s a great study: http://jama.jamanetwork.com/mobile/article.aspx?articleid=400116

    And here is the study to which the previous commenter refers:

    98.6 was an average (mean) temperature…hopefully you understand that means some people are above and some people are below that number.


    Try the old, ‘shoe on the other foot’. This article makes you sound arrogant(my pet peeve). Take some time to watch ‘the bucket list’. It’s all fun, games, and jokes until you’re the one sick, being treated like dirt, and no one will listen.

  68. Aussierules on

    When my son was around 18 months old, and in the middle of the night, I could hear him whimpering. His body was burning up. Took his temp axillary as he could not tolerate the thermometer in his mouth. It was 38.5c I, being a non-panicky mother did the old cool face cloth, strip down to the nappy and dose with Panadol trick. Of course it was a long night. However, after time his fever only rose not reduce. After 6 hours of this and my dozing off in the chair by his cot, I could suddenly hear a whooping kind of choking sound. I shot out of the chair and saw he was now turning a shade of blue. Temp was now over 41c. Time for the Casualty department.
    It was a freezing cold night, in June. The heater in our car had failed a few days before and we had not got around to fixing it, which was probably a blessing for my son. He felt cooler to the touch when I took him into the rather empty casualty triage. The doctor felt him, and stated, “You brought him in for a temperature he doesn’t have, right?” whilst rolling his eyes. No, I brought him in as he is failing to breathe well and the ambulance officers told me to drive him in, and keep an eye on his breathing, as we live semi-rural and the ambulance was out on another case. Sure, he stated. I was breathing calmly, and yet my mind was racing. My son had been in a cold environment, I told him, which obviously had reduced his body temperature, I don’t want to argue with you, I just need to figure out if he has whooping cough.

    Again I got the rolled eyes. I understand he was probably thinking I was another panicky mother, I get that. I am sure I would too, if the role were reversed. I told him I would sit for a while, as my son was becoming distressed at being held and feeling poorly. An hour or so later, a nurse came by and stated, “He seems to be struggling to breathe, and he sure does look awful, have the doctors come yet?” She took his temperature tympanic, and it was now 41c again. She very smartly informed the doctor of this and he, I could hear him from the other area stated, “Oh of COURSE it is!” and stomped to me. By now son was gasping solidly for air and indeed threw up as his poor little body couldn’t get air enough and the temperature caused his body to vomit to try to cool itself down. THIS I told the doctor as he examined him. He looked up at me and said, “Are you a nurse, or a doctor?” I knew he meant in my working life, as his tone was more respectful. I told him no, but I do have some medical training. He then admitted my child to ward and he was given antibiotics for a severe chest infection. He was there for 4 days with his temperature failing to drop for 3 of them.

    My point? Many parents do not understand the human body, and to attend an ER as you call them in US, is only putting a child at risk for contracting something else. Often a child’s temperature will be minor, spike then it will pass. I knew this. So, I did the best I could at home. His presentation of a minor temperature was due to the fact our winter was upon us and his body had cooled to the touch. Had he not had the breathing difficulty I would have kept driving him around till he slept and his cooler temperature stayed down.

    The doctor in this case may well have seen dozens of mums and dads freaking out that their child has a minor temperature, but a little empathy each time, and a little education to those parents may well go on to educate others to avoid the Casualty ward and stop clogging them up with ‘low grade fevers’ of a very common cause.
    My own body temperature is relatively low at 35.9C I tend to have doctor’s go get a new thermometer as they think it has failed. (I have many medical conditions so it is usually checked at an appointment) I chuckle at that. Yet when I am truly ill it is difficult to be believed. I will go to 37c and still be told that is normal. Every human being is not a statistical average. The mean body temperature is 36.3c according to taking this statistic of several hundred well people, and doctors are taught that.
    It was only the past 4 times when I have been in hospital after surgeries that the nurses have got doctors to come to realise my basal body temperature is the lower normal type. Once after a major surgery the nurses had been taking my temp from the get go and several days later cam to see how ill I had become, as the original temp was 35.9c and now ‘only’ 37c, yet my symptoms were of Clostridium Difficule, which was proven by testing. Interesting dilemma being a doctor I should think. Always expect the unexpected is my motto. Oh and keep out of the ER unless you really are dying, or can’t breathe. Simple.
    Disclaimer; I live in Australia, we haven’t used Fahrenheit since some time in the 1970’s. I use the Queen’s English. If you didn’t get my point then find another webpage to troll. Thank you that is all.

  69. I’m not a mom or a doctor but I do know of doctor’s stupidity. I don’t know if mom had a fever or not when this happened. However due to a doctor being stupid my mom lost her hearing. She had ear pain and went to a doctor and they perscribed decongestant. It turned out much much worse as my mom woke up not being able to hear in one of her ears. She told this to another doctor who said she should have came to him and he would have got her steroids to keep her hearing. I myself have a fever it started yesterday I had a light feever( no other term my skin burned my dad and I felt weak) with a sinus infection the temperature when I checked then was a lovly 99.7 I woke up today it was 99.6 I then take a nap 99.2 then I take it again and it rose .1 degrees. Fevers suck no mater how low grade it is especally in summer. I havn’t went to the ER or doctor yet I’ll do so if it persists for three days.

  70. As a person relegated to the patient role (too often – autoimmune condition) I wish I hadn’t read the post. It really is offensive, and potentially hurtful. Perhaps this level of sarcasm belongs somewhere else. Anger management class? Psychotherapy?

  71. Tell It Like It Is on

    I need a doctor like you! I’ve had issues for years with no answers. I don’t need any fluffy talk, I want answers. Doc tells me I have “low-lying cerebral tonsils.” No, I have my brain falling out of my skull!! I had a blood pressure so low they couldn’t take it but hey, nothing is wrong right? Now I’ve had a temp of between 99.4-100.2 for a few months, fatigue, unreal sweating and terrible headaches but hey, that’s all normal…. Nevermind that my d-dimer test was abnormal because hey. more testing isn’t needed. Maybe if there were more doctors like you I would have results. Oh and when my kids get a fever, I don’t treat it because it’s doing it’s job. I’m also the mom that fills my kids full of water after they throw up so they throw up again. They get better quicker though so in the end they’re happier.

  72. I wish sociopaths were banned from practicing medicine. For someone with autoimmune a low grade fever means that their bodies are stoked up–and there is normally a lot of pain that goes along with it. You just aren’t good enough of a doctor to know what’s going on with the patient.

  73. Wow. I can understand some of this anger over bad Healthcare. I’ve been there, done that. For my children as well as myself. What I am confused about is the misdirected anger at the individual who originally wrote this. They were very clearly saying that it was a personal pet peeve. They also said it was a generalization referring to or regarding folks that use an Emergency Department as a doctors office. No one said that anyone could NOT use an Emergency department. They simply wished folks would stop treating sniffles, sneezes, low grade fevers, etc as emergencies that spend time, money, and resources that could be utilized far more effectively and productively on true health crisis issues. You know, heart attacks, strokes, car accidents, broken bones, burns? Those kind of issues? They even said multiple times that if the person has anything else symptom wise that the remarks were not intended for those folks nor were they intended for the rare or unusual patient in whom the fever is the only presentation of illness. It was pretty clear the person was venting their peeve in a nonharmful manner, wishing to spew some all too normal disgust at the way SOME folks, and only SOME folks, use the Emergency department as a substitute for a standard g.p. or pediatrician. Some folks cannot be bothered to go to a regular doctor due to work, money, time or other constraints. The original post was a standard ranting and then for some reason, a lot of people started getting nasty to them. Why? Are they not allowed the right to feel something? Are they not allowed to express their opinion? At what point did this human lose the right to have emotions? Was it when they took the hippocratic oath? Perhaps when they saw their first patient? When they lost their first patient? I am curious. Folks seem to feel free to bash this person when they expressed an opinion, which I might add they NEVER said they addressed patients with their frustrations, and expect the original poster to not have likes and dislikes even though that is something all humans have- the right to think and feel any darn way they want. The original post was a pet peeve rant. Not once did they ever say a patient was presented with a statement of “You are an idiot for bugging this emergency department for a low grade fever.” or any other remarks of such a nature. You people need to stop assuming you have the right to dictate how another human thinks and feels. If you ever want to go to an emergency department then do so. If you or your loved one wait a long time and or get the bums rush, then that’s the crapshoot you were dealt. Get on with things. Go to another doctor or emergency department. Perhaps you got treated badly, perhaps the care was substandard. Again, it’s a crapshoot. All of life is. Just because they are medical professionals of some sort does NOT mean they cannot think things just like every other human on the planet does. You know the things we all think. Stuff like “oh my lord, can this r-tard take any longer?” or “what a moron. I could have been on my way by now!” and so forth. They were venting on a personal pet peeve on a blog created for just such a reason- to vent! Not so anyone could get snarky and assume the aforesaid “rant” was what they convey to patients, nor were they giving advice, nor were they advocating that folks no longer use emergency departments. Mind you, they probably hope and wish and maybe even pray that folks will think carefully about it but they seemed more interested in expressing their disgust or dismay at the lack of thought SOME people put into an emergency department visit. People jumped this person for having an opinion, not for any actual DEED performed or not performed. All those who commented nastily, and you know who you are, should take a look in the mirror and see if there was any substance in the opinion that applies to them. If it doesn’t, well perhaps then you should get off your soapbox and stop denying another human the right to THEIR Own opinion because if it doesn’t describe you then why get pissy and snarky and say this man or woman has no right to an opinion? Who died and left you in charge? No one. Just my opinion though and clearly a lot of folks don’t believe any opinion matters but their own. Again, no one said you couldn’t go and avail yourself to the services provided at an emergency department, it was a PET PEEVE! So if anyone is still checking this page, let the games begin anew. I just stirred the hornets nest, I poked the tiger or bear, I wrassled me a wild mustang! Yeee haw!

    • I pay taxes and those taxes fund emergency rooms. I am free to use it as often as I wish or see fit as a parent. Any time you are concerned as a mother you should use them. Doctors get paid a healthy sum to do this day in and day out.

  74. Alessio Ventura on

    I had right total shoulder arthroplasty on 8/23/16, and needed emergency surgery on 9/29/16 due to an infection that had developed in the shoulder.

    They inserted a PICC line and I am now on broad-spectrum IV antibiotics and it is a 6 week regimen. They are also running cultures to identify the specific bug but so far nothing has grown (Cultures from the pus-fluid they aspirated from the shoulder).

    Now, based on my medical history, I know my “normal” temperature hovers in the 97-99 range with most measurements spot on at 98.6.

    Since I have been wearing the PICC line, I have periods of 2-3 days length where my temperature is between 99.5 and 100.8, and its associated with significant chills, and painful eyeballs. I also have burning pain in my right shoulder in addition to the normal post op pain. The burning pain is not subsiding but tbe post-op pain is.

    So, if we go by the “technical” definition of fever, then I have not achieved a fever, which would be 101. However, as you can surmize, these temps are outside my average and at least 1-alpha (1 standard deviation).

    My infectious disease doctors are saying the same thing, there is no fever, but as you can clearly see just by Process Theory, there is an underlying process that is showing signs of being “out of control”, and at the very least it is raising its hand and saying “something is wrong”, yet the physicians ignore these numbers as though there is nothing there.

    Clearly, I get ill during these 2-3 day periods, and clearly the increased body temp is a marker for illness. So the definition of “fever” in the medical community gets in tbe way of looking at actual facts, and illnesses are ignored and perhaps not treated.

  75. In order to treat patients, you should first have patience. The medical field is not one that you should get into for financial gain. Reading this, as well as the awful comments from various healthcare ‘professionals’, is disheartening. After a low grade fever between 99.8-100.4, severe cough and burning in my chest for 2 weeks, I finally went to get medical attention at an urgent care. I put it off because of doctors like you, however, I was fortunate to be seen by someone that not only cared about my well being but recognized my fever as just that- a fever. I left after being diagnosed with pneumonia. I sincerely fear for those that come in contact with a majority of the healthcare workers on this thread and strongly suggest seeking a different profession.

  76. YouShouldBeAshamed on

    You write: “Most patients don’t and shouldn’t know about medical definitions.” This is Just the kind of paternalistic bullshit that tries to keep patients in the dark about their own health and unable to judge the quality of medical care they are being given. It also helps protect medical professionals from accusations of negligence or malpractice.

    An informed patient is a patient who has a greater chance of receiving appropriate care and having their rights as a patient respected.

    Shame upon you for suggesting otherwise

  77. momoflgfeverboy on

    As a parent, the main issue is that a child can’t go to school with a 99.9 “fever”. My son regularly has those and if I send him to school he will be sent home again. My options are to keep him home far too often or to teach him to lie if someone notices that he is warm. To answer your next question (how would they notice), when his temperature goes up he feels cold and if he’s the only one that is cold that is an alarm bell for teachers to feel his forehead. So even if it isn’t and accurate scientific term it is an accurate term within the social confines that we have to operate.

  78. I use an oral thermometer. I’m 55. My normal body temperature is 97.2-97.4. And yes, nurses have gotten that reading also. My sister same way. Healthcare professionals REFUSED to believe she was “running a fever at 99°”. It cost my sister her kidney function & almost her life, twice. My sister was fortunately diagnosed with Goodpastures & Wegener’s in time to save her life. And that 99° non fever? That finally broke in the hospital. Sheets & hospital gown drenched in sweat after given appropriate antibiotic. Her temperature? Back to normal at 97.2.

  79. I was severely ill, with shivers, in extreme pain, could hardly walk, scan showed a huge, badly infected Ovarian cyst and they had to operate. My orally taken temperature was 37.6.
    Please go back to a proper medical school to get training, before shedding wisdom on the Internet.

  80. Amanda Sullivan on

    Wow. This is simply amazing! I’ve never been so entertained. I. just. read. the. whole. damned. thing.
    Here I was, just checking the old reliable ‘interwebs’ to see if my kiddo’s symptoms might require a trip to urgent care, or if I should continue to wait out what I’m pretty sure is just a REALLY bad cold. Because you know, the interwebs may be full of BS, but I like to think I’m intelligent enough to weed past the ‘you DEFINITELY HAVE CANCER!’ Or ‘go the the ER STAT!!!!’ posts.

    Who knew I’d come across this 10 year old gem? Beautiful. It sums up everything. It hits every stereotype and every paranoid/delusional idea I can imagine. Well, relative to “low grade” fevers and whatever side of the hospital bed you may be on.

    Here’s the best part! I’m still going to give a ring to the doc tomorrow. I just know better to avoid some terminology that may irk someone’s pet peeve.

  81. A normal body temp that is 97.4 that goes to 99.6 for a good length of time is a bit of a flag. Add joint pain, etc., and you might have Lupus. Like me. SO glad my most excellent doctor wasn’t an arrogant know it all and actually listened.

    • I was going to say the same thing my 5yr old is normally at 97.6 when she is having a flare her temp is at 99-100.2

  82. I understand that 99 isnt considered a “fever”, but my normal temperature is usually in the 97’s. So having a temperature ranging from 99-100.4 for five days now is enough to make me feel like crap. But of course it’s not considered a fever so no one believes I need help. It’s quite frustrating.

  83. I don’t “care what bullshit” is your opinion. 99.0 can be a fever depending on the person. If a person’s baseline temp is 97.8 (which mine is) he/she can feel very very bad at even 99.5 or 100! At 99 my cheeks can be flushed and I am extremely fatigued and can become dehydrated quickly. Infectious disease doctors as well as doctors who are triple board certified in pulmonary medicine, critical care, and internal medicine have held up transfers due to 99 fever. So it is medically irresponsible to say 99 can not be a fever. It is entirely based on someone’s base temp. Arrogance is a scary thing in the medical field. Clinical manifestations should ALWAYS and considered along WITH vital signs. To say 99 is never a fever is just ignorance.

  84. Ok so my son had this “fever” for 2 weeks. No symptoms like sniffles or stuffy nose and only occasional coughing at night. Not a big deal and I don’t use Tylenol or ibuprofen until a fever is 103. I go to the doctor and he opts for chest X-rays because he wanted to rule out chest infection. He thought he heard a slight crackling in his chest but wanted to be sure. My son had pneumonia in early stages and had mono. This isn’t any regular kid. He goes into anaphylactic shock with mosquito bites. Doesn’t go out much in the summer because of that. He was also rushed to the hospital when he spiked a fever of 107 and was convulsing at the age of 2 and has a rare condition where he can’t go long without carbs. You are also forgetting the average body temp is 98.6 but not every body is average or the same. It’s a little presumptuous to assume every person is the same. My normal body temp is 97. At 99-100 I feel like a bag of crap. I just developed a new pet peeve myself. People who think they’re doctors and attempt to give faulty advice.

  85. Barbara Fakoury on

    If my temperature hits 99, I feel like absolute garbage. In fact, when I start feeling that awful, feverish, sweaty, headachy, stiff neck, sore throat / swollen glands feeling, that will prompt me to take my temperature, and it will be in the low 99s. I’ve had this on and off ever since I had lyme disease. Some of my fevers have lasted 10 days or more, during which time I could not work or do anything except just lay there and try to ride it out.

    My normal temperature runs between 96.6 and 97. You can’t make a rigid rule out of what is and what isn’t a fever. Because when I have one, I feel it, and am debilitated by it.

    If it really bugs the hell out of you that people call what they’re dealing with a fever, and if you really must have a rigid definition of what a fever is, then let’s not use the word “fever”. Instead, let’s just say when my temperature is over 99, I’m SICK. Sick as a dog, can’t work. Call it fever, don’t call it fever. It’s not normal. I’m not well, I’m sick. Take that seriously, and try your best to forget about getting wrapped up in semantics.

  86. I have an autoimmune disease and I take prednisone and immunosuppressants daily. If I’m feeling like I have a fever and my temperature is 99 or above I’m told to go to the ER. Sometimes it’s a signal of an autoimmune flare (which attacks my organs). Other times it means I have a bad infection. All of the time it is something that needs to be evaluated.

  87. The ONE thing EVERYBODY seems to be forgetting in these posts….is we are all not created equally. What might be a low grade fever in you, might be normal for me.Sure…you can create a standard, but that doesn’t mean everyone is going to fit neatly inside of it. I have NO doubt that there are a ton of people who panic and rush to the er over nothing, but on the flip side I also know there are a fair amount of people for which “nothing” turns out to be “something”. Which is WHY people panic and run to the er. You never know, and this whole post is pointless

  88. P.S – My father went to the ER for a sore back…and the dr, doing an eye roll, tried to send him away saying it was “probably just” a pulled muscle or even irritable bowel. My father had a distended abdomen as well fyi. Before I sent my father to the er (because I was afraid he was very sick due to the abdomen) I told him to insist on a scan… which he did…and this annoyed the ER dr greatly because he was SURE it was “probably just” something mild. Against his will, he gave my father the scan….he had Cancer in his lungs, stomach, liver, etc, and 2 months later he was dead. So if you have to go to the ER for something that is “probably just” something silly….GO. THAT IS WHY THE HOSPITAL IS THERE PEOPLE. Honestly…..if the doctors don’t like it…..never too late to make a career change.

  89. This was a great post- I was dying laughing. Perhaps I shouldn’t use that pun. Anyway… I just found this post even though it’s a few years old… I was sent to the ER by my family physician as I was 4 months pregnant with twins and had severe abdominal pain and a “fever” of 100.3. The ER doctors and nurses kept telling me that did not qualify as a fever, but kept me due to the pain. It turns out I had chorioamnionitis, and my white cell count was 30+. My water broke due to the infection the next morning and we lost the babies in a still birth. Needless to say the infection was rampant. Is it a fluke that my temp was not higher? Or is it just perhaps that this qualifies as a “fever” for me (as you indicated above, perhaps this is 2.4+ my normal temp)- I don’t chart my bt so I’m not sure of what my baseline is. I only ask so that I can have an intelligent answer should a similar event occur.

  90. Not sure you can or will reply, but curious about one thing you mentioned. All ,y life, my regular temp has been 97.3 to 97.7. On average, one degree below the ‘normal’ temp. After 55 years, I am aware this is my normal. How do people like myself get an ER doctor to believe us? I even had one tell me I was not in thryoid storms 2 days after I was diagnosed and they sent me home after a cardiac without blood work or ekg. Only proven the next day by ekg at my own doctors office. She was freaked they let me go home and the doctor told me I was not in thryoid storms. It was the only reason i rushed to ER in the middle of the night, because my doctor said I needed to be extra careful til they got my tyhroid back to normal. So….what is a person to do when ER doctors tell US we are wrong? How do I get them to understand I am not making up the 97.3? It does suggest, from your own writing, that a doctor SHOULD use it to measure against the temp they get in the hospital and not insist I am lying. Not for nothing…but as a medical anomly, i’ve been gas lighted by too many doctors telling me I don’t have what I have. This situation has lead to many surgeries, years after being told I it was in my head. I finally know what to say about drugs…cause with all my ortho issues, they assume I just want pills. However, I’ve had everything from major allergic to major adverse, or the top 5-6 side efects and ended up sicker than I went in. i used to tell them what I was allergic too. I learned to say, I don’t take any pills unless it is saving me from death, other than my synthroid. They stopped treating me like a drug seeker. This temp article really brought back memories, not good ones. It would mean a lot if you could tell me what key words or phrases I need to use to prove I’m not making it up for fun, and really do have a low temp naturally. It’s my normal. How do I convince an ER doc now?

  91. William Stevenson on

    Assuming there is no such thing as a “low grade fever,” and assuming that a patient has a rock-steady baseline temperature of 98.6F measured with the most accurate medical-grade thermometer; what would you recommend to a patient that has had a consistent temperature of 99.5F for over 2 months that frequently spikes above 102F for short durations accompanied by joint pain, headaches, frequent urination, body aches, shortness of breath, and fatigue?

  92. Well I stumbled here because I was kind of panicking about my “low grade fever” and you successfully convinced me not to (I didn’t used to be so health phobic, but I had a few rounds of freak-medical situation blood transfusions and hospital stays last year that made me a little panicky about what the f might be going on in my body.)

    Though as someone who had to go to the ER a lot in the past year, the whole “I can tell when you’re full of BS,” thing is annoying. Once they figured out what was wrong with me, a blood test would back me up, but it was a coin flip whether the triage nurse would initially take me seriously and rush me to the back or roll their eyes and send me to the waiting room until blood work came back. And some who would look at my gums or the whites of my eyes because “they read that was a way to check for anemia.” Jesus Christ, do the damn blood test. If you’re gonna rail about trusting studies over your gut, apply the same to your practice.

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