KOCHI: There’s little that frightens parents more than a spike of fever in a child. This is compounded by the degree of discomfort shared by the child. The whole home is in disarray because the kid’s got a temperature! The most common cause of temperatures in children is infections, particularly viral ones. Try as hard as you might, it’s impossible to prevent these. There could be an older child who brings in a steady supply of germs from school, it could be the office going parents, or in my case, the occupational hazard of being a paediatrician.
Babies put all their power and might into reacting to infections. Colds tend to make them miserable for a day or two and then they just go away in a week — until the next one. The only thing that works is Paracetamol, TLC and patiently waiting for the cold to pass. Some children between the six months and six years are prone to developing fits with high temperatures. But with medical support, the children can recover with hardly any ill effects.
Children get other infections too — bacterial, especially pneumonia, tummy bugs, skin infections, urinary infections, and serious ones like meningitis. These are very significant and often merit hospitalisation and antibiotics administered intravenously. There are also infections like dengue, typhoid, Covid, TB etc.
Then, there are some unusual infections — often tongue twister bugs and if these occur, the doctor might check whether the child has issues in their immune system. There are also fevers which are not caused by an infection. Particularly if the fever stays long with newer symptoms coming up. About 25% of prolonged fevers in childhood come in this category. These fevers could even be the warning of childhood cancer or they could be the pointer to rheumatological disease.
These are also disorders of the immune system. Many are acquired or evolved in response to a trigger like infection, unrecognised environmental stimulus and changes wrought by pubertal hormones. Children can get arthritis, connective tissue diseases, vasculitis and inflammatory bowel disease too. These diseases are treated predominantly by immunosuppression.
They can also get fever due to an ever-expanding list of Autoinflammatory syndromes — these are inborn genetic errors and cannot be picked up on standard pregnancy scans. These will present as periodic or continuous fevers with other distinctive features. If detected early, they can be treated with specific medications, which will help prevent many long-term complications.