Guide for Fever Diagnosis and Treatment

Temperature Rising

The minute my hands touched her skin, I knew it was going to be a long night. The thermometer confirmed my suspicions: 101 degrees, and my 8-month-old, Mira, was in pain and miserable. I gave her acetaminophen, used a nasal aspirator to clear her stuffy nose (which she fought), and rocked her back to sleep. But the minute her head hit the sheets, she screamed. I picked her up and repeated the routine throughout the night.

By morning, the fever was climbing, despite the fever reducer. I called the doctor. Suspecting she would need antibiotics for an infection, and because it was a Saturday, he told us to go to the emergency room. Her fever was now close to 105 degrees. After several tests and hours of waiting, we had a prescription and a diagnosis: sinus infection. As a frequent victim myself, I instantly understood why Mira cried every time we put her down, and why she fought the aspirator -- the pressure in her head must have been unbearable.

That night I learned my first lesson in childhood triage: the fever is just a symptom, not a disease. I thought that because her temperature was 101 degrees, she had only a cold, but Mira's out-of-character cries and misery were more telling symptoms than the thermometer's number.

You have to ask yourself, "What else is going on?" says David Krol, MD, chair of the department of pediatrics at the University of Toledo College of Medicine, in Ohio. "Has his behavior changed? Is there vomiting, diarrhea, or a rash? Does he seem to be in pain?"