Recurrent Fever

What is a recurrent fever?

A fever is a part of your body’s natural defense system. Your immune system is the part of your body that works to fight off illnesses. When this system is triggered, your body’s temperature heats up. Typically, your average body temperature should be around 98.6° Fahrenheit (or 37° Celsius). A fever is a temperature of 100.4° Fahrenheit or higher. If you take a child’s temperature orally or axillary (armpit), you might get a reading that’s up to one degree off. To get the most accurate temperature reading, take the child’s temperature rectally.

A recurring fever is a fever that happens multiple times over a period of time. These fevers can sometimes be described as episodic, meaning that they come and go. A recurrent fever is one that comes back in a pattern. For example, your young child or toddler could have a fever every month.

This type of fever is typically seen in young children, usually under age 5 (infants and toddlers in particular). The increased temperature lasts for a few days and then goes away for a stretch of time. The child is healthy and acts normally in between fevers.

Recurrent fever is one of the main symptoms of a collection of conditions called periodic fever syndromes. These are diseases that cause a person — typically a child — to have a fever in a spaced out pattern over time, without having a virus or bacterial infection.

What’s the difference between a recurrent fever and a classic fever?

The main difference between a classic fever and a recurrent fever is how often it happens. If you have a recurrent fever, it lasts for a few days, gets better, goes away and then comes back after a period of time when you felt healthy. Recurrent fevers keep happening and coming back over time. A classic fever is also usually linked to an infection or virus. With a recurrent fever, you may have a higher body temperature without any virus or bacterial infection.

What causes a recurrent fever?

A fever can happen for many different reasons. These causes can include:

• A virus.
• A bacterial infection.
• Vaccination.

You can also have a higher body temperature at different times of the day or after exercising. These are usually only a few degrees higher than your normal body temperature and go back down after a short period of time.

However, a recurrent fever isn’t caused by a virus or bacterial infection. Recurring fevers seem to happen without a cause and in a pattern. It’s often listed as a main symptom of different periodic fever syndromes. These syndromes are sometimes caused by a genetic defect. When the recurrent fever is linked to a periodic fever syndrome, the higher body temperature could be a result of one of these genetic issues.

What medical conditions are linked to recurrent fevers?

A recurring fever is one of the main symptom of a group of diseases called periodic fever syndrome. There are several types of periodic fever syndromes, including:

• Familial Mediterranean fever (FMF).
• Tumor necrosis factor receptor associated periodic syndrome (TRAPS).
• Hyperimmunoglobulin D syndrome (HIDA), also called mevalonate kinase associated periodic fever syndrome.
• Neonatal onset multisystem inflammatory disease (NOMID).
• Muckle-Wells syndrome and familial cold auto inflammatory syndrome.
• Periodic fever, Aphthous-stomatitis, Pharyngitis, Adenitis (PFAPA) syndrome.

What are the symptoms of a recurrent fever?

The symptoms of a recurrent fever are very similar to a typical fever. These symptoms can include:

• Having a temperature above 100.4° Fahrenheit (37° Celsius).
• Experiencing body chills and hot skin.
• Feeling tired (fatigue).

In children with a fever, you may notice that your child is acting a little more tired than normal. Other signs of a fever in a young child may include:

• Being irritated or fussy.
• Not wanting to eat or drink as much as usual.
• Crying (typically it’s high-pitched).
• Pulling at the ears.
• Being less responsive than normal.

Each child is different and while some may show many of these symptoms, others may show few or even no signs of discomfort. Some children with a low-grade fever may not show any of these signs. They may act normally, playing and staying in a generally good mood.

How do I treat a recurrent fever?

A recurrent fever is treated just like a typical fever. Taking acetaminophen (Tylenol®) is one way to manage any uncomfortable symptoms of the fever and reduce the temperature. This is particularly useful in children. However, make sure you talk to your healthcare provider before giving your child acetaminophen. The amount of medicine (dosage) you give your child can vary based on the child’s weight and age. Be sure to double check the correct dosage before giving anything to your child. You can usually give your child acetaminophen from birth on. After 6 months of age, you can also give your child ibuprofen (Motrin®).

Speaking of medicine, make sure to avoid aspirin. This particular medicine can lead to a serious medical condition called Reye’s syndrome. It’s very dangerous, so do not give your child aspirin until your healthcare provider tells you it is safe to do so.

Rest is another important part of recovering from a fever. If you notice that your child is more tired than normal, let them rest.

Drink plenty of fluids (especially water) is important when you have a fever. Make sure your child continues to drink water and other fluids during a fever to avoid dehydration.

It’s important to monitor your child throughout the fever. If your child is acting fine for a few days, you can usually give acetaminophen to help with any discomforts and just keep track of the fever. During this time, monitor how much your child is drinking (hydration) and urinating. Also, keep track of any changes in breathing patterns — particularly if your child is working harder to breath. If the fever continues for five days, your child will need to be seen by the healthcare provider.

Tracking the fever can also be helpful. Take notes of what temperatures happened when and how long the fever lasted. This information can help your healthcare provider with a diagnosis if you child keeps getting fevers on and off. These recurrent fevers can be a sign of a bigger medical condition.

Do recurrent fevers last into adulthood?

Most recurrent fevers go away as the child ages. They are much more common in younger children than in adults.

When should I call my healthcare provider about my child’s fever?

In most cases, a low fever is not something you should worry about. This is a sign that the body is doing what it should do to fight off an illness. Most fevers usually go away within a few days. However, it’s always good to call your healthcare provider if you’re child has a high fever (104° Fahrenheit or higher) or if the fever lasts more than a few days. If your child gets a fever on and off over a long period of time, make an appointment with your child’s pediatrician. This is the first appointment. If your pediatrician thinks these recurring fevers could be periodic fever syndrome, you will be connected to a specialist to diagnose your child and work on a treatment plan.

A note from Cleveland Clinic

It can be scary when your child has a fever. Remember that you can always call your healthcare provider to ask questions about your child’s fever and get direction on your next steps. Often, fevers during childhood are monitored and treated with Tylenol® at home. It’s also a good idea to keep track of fevers so that you can give your provider all the information needed for a diagnosis later.