Fever without other symptoms in children: what parents should know

The most important facts in brief:
Fever is not an illness, but a defense reaction of the body. If a child has a fever without any other symptoms, this is often a sign of an incipient infection (such as three-day fever) or a reaction of the immune system. In most cases, this is harmless, but parents should monitor the progression closely.

When a child’s forehead is burning up but they are not coughing or complaining of abdominal pain, parents are often confused. Fever without other symptoms in children medically describes a condition in which the rectally measured body temperature rises to 38.0 °C or higher without any immediately recognizable accompanying symptoms such as a cold, rash or pain. This phenomenon is not uncommon in young children in particular, as the young immune system must first learn to react to various environmental stimuli.

Possible causes: Why does my child suddenly have a fever?

If the fever occurs in isolation, it can be difficult to identify the cause immediately. Other symptoms often only develop over the course of 24 to 48 hours. Common triggers for isolated fever are:

• Three-day fever (exanthema subitum): A classic in small children. It begins with a sudden, high fever that lasts for around three to four days. When the fever subsides, it is often followed by a pale pink skin rash.
• Urinary tract infections: Treacherous, as they are often painless or young children cannot localize the pain. A child who suddenly has a fever and then goes away again (or has a fluctuating fever) could be suffering from cystitis.
• Viral infections in the early stages: Many viral infections start exclusively with a rise in temperature before a cough or cold sets in.
• Overheating: Clothing that is too warm or intensive play in the sun can temporarily increase body temperature.
• Teething: Although high fever during teething is controversial, a slightly elevated temperature can occur.

Fever at different ages

The assessment of fever depends heavily on age. While infants should be seen by a doctor sooner, older children often tolerate fever better.

• Infants (under 3 months): Fever is always an alarm sign. Please consult a doctor immediately.
• Fever without other symptoms Child 2 to 3 years: Infections such as three-day fever are most common here. Pay attention to drinking behavior.
• Fever without other symptoms Child 4 to 7 years: At this age, the child is often better able to communicate how it feels. If the child complains of a constant fever without any other symptoms, a thorough examination (e.g. blood count, urine) should be carried out to rule out hidden inflammation.

What to do if you have a fever without accompanying symptoms?

The top priority is rest and observation. Fever helps the body to fight pathogens. As long as the child is still playing and drinking enough, the fever does not necessarily have to be brought down immediately.

Home remedies and medication

If the fever rises above 39 °C or the child feels very unwell, fever-reducing measures can help. These include

• Sufficient fluids: water, diluted juices or tea to compensate for fluid loss.
• Medication: Antipyretic agents can be given as suppositories or juice after consultation with doctors or pharmacists. Please note that the dosage depends on age and weight.

When to see a doctor? Red Flags

Although isolated fevers are often harmless, there are warning signs that you should seek medical advice:

• The fever lasts longer than 3 days.
• The fever cannot be reduced despite medication.
• The child no longer drinks or appears apathetic/ apathetic.
• Febrile convulsions occur.
• There is also a skin rash (except in the case of a subsiding three-day fever).

How TeleClinic can help

If you are unsure whether a visit to the doctor is necessary or you need a specialist assessment of your child’s condition, doctors are available to you via TeleClinic. You can use the app to obtain a medical consultation from the comfort of your own home.

If a child sickness certificate is required for the employer to care for your sick child, you can request this during digital consultation hours. Certificates and prescriptions are always issued at the doctor’s discretion. This often saves you and your weakened child the stressful journey and waiting time in a full practice.

Conclusion

A child with a fever without any other symptoms is usually no reason to panic. It is a natural reaction of the body. It is important to keep a close eye on the child’s general condition. If this deteriorates or the fever persists, professional advice is essential.

Sources/evidence

• RKI Guide – Information on infectious diseases
• German Society for Pediatrics and Adolescent Medicine (DGkJ) – Parent information on fever
• Berufsverband der Kinder- und Jugendärzte e.V. – Fever in children