Stories about: fever

Four things you might not know about fever

4 things to know about fever in children.

Of everything we pediatricians get called about, I think that fever is the most common. Which isn’t surprising, given that fever can be a sign of illness. But despite the fact that it is so common, fever is often misunderstood — and often frightens people more than it should. Here are four things all parents should know about fever.

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Is that fever a problem? Ask Thermia

shutterstock_124303936Your child has a fever. Do you call her caregiver? Treat it with acetaminophen? Wait and see?

Thermia, an online fever calculator developed by the HealthMap team at Boston Children’s Hospital, can provide puzzled parents some guidance.

HealthMap co-founder John Brownstein, PhD, explains how Thermia works and details possible next steps.

Read about Thermia on Boston Children’s Vector blog.

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Say what? An iPhone tool to diagnose ear infection?

shutterstock_195954584If you’re the parent of a child plagued with frequent ear infections, an iPhone otoscope that lets you peek into her ears to capture a video of her eardrum and share the images with her doctor may sound like just the gadget you need.

The CellScope, the iPhone otoscope mentioned above, and the Pacif-i, a Bluetooth pacifier that takes a baby’s temperature, were on display at the Consumer Electronics Show (CES) earlier this month. The Las Vegas-based annual trade fair, a weeklong playdate for gadgetphiles, included a host of devices designed to make it easier for parents to track their kids’ health.

Do you need an iPhone otoscope? Will a sneak peek at your daughter’s eardrum translate into better or faster care for your toddler? Is your child’s pediatrician ready to view home video of your daughter’s eardrum? Probably not, at least for now.

There is some value in the devices, especially if your child has a chronic issue, according to Michael Docktor, MD, Boston Children’s Hospital’s clinical director of innovation and director of clinical mobile solutions. Docktor was on hand at CES to check out the hundreds of health and biotech gadgets on display at this year’s show. “For me, it was a chance to see where medicine and health care are headed,” Docktor wrote on BetaBoston.

But the gadget fest offers more of a sneak peek at the future of care, rather than a new way to diagnose and treat sick kids.

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Five important things you might not know about strep throat

Boston Children's pediatrician offers tips on strep throat, fevers and other common illnesses.On the Richter Scale of childhood illness, strep throat ranks pretty low, but its little tremors can wreak a fair bit of havoc on the day-to-day lives of parents and children. It’s also one of those illnesses that’s so common that people often think they know everything there is to know about it. But as a pediatrician I’ve discovered that parents really don’t know everything about this pesky and painful illness.

Here are five important things you might not know about strep — but should:

Not all sore throats are strep.

In fact, at most 30 percent of sore throats are caused by group A streptococcus, the bacteria that causes strep throat. The vast majority of sore throats are caused by viruses. And while you may think you know it’s strep from how it looks or your past experience, studies have shown that it simply isn’t as easy as it might seem; viruses and strep can look remarkably similar. To make the diagnosis, we need to do a rapid strep test or a throat culture. So if your pediatrician insists on seeing your child instead of calling in a prescription, they are doing the right thing.

Not all strep throats are sore.

Kids with strep throat can have headaches, stomachaches, vomiting and rash, or some combination of these symptoms — and sometimes these symptoms can bother them more than their throat does. I’ve seen lot of kids in the office with vomiting or headache and no sore throat who turned out to have strep, much to the surprise of their parents.

Strep usually gets better without antibiotics, but we treat it anyway.

This one often surprises people. Our immune system is actually pretty good at fighting group A streptococcus, and will generally get rid of it in a few days. But we give antibiotics, for three reasons:

  • To make kids feel better faster. If you’ve ever had strep, you know how miserable it can feel.
  • To prevent complications. Although it’s rare, strep throat can lead to problems in the heart, kidney and even the brain. By treating the infection, we make those complications far less likely.
  • To prevent spread of the infection. Strep is very contagious, as many parents and teachers will tell you. Once someone has been treated with antibiotics for 24 hours, the chances that they will give it to someone else go way down.

Having a positive culture doesn’t necessarily mean you have an infection.

Strep can live in our noses, mouths and throats and not make us sick. This is called being a carrier, and it’s more common than people realize. Sometimes it’s hard to tell whether someone actually has strep throat or whether they are sick with a virus and happen to be a carrier! Because of this, we don’t recommend doing another test after treatment unless the person is still feeling sick. Most of the time being a carrier doesn’t cause trouble. If it seems to be causing recurrent infections, stronger antibiotics can be used, and sometimes a tonsillectomy is recommended.

Even though you may feel better after a day or two, it’s important to take the full course of antibiotics.

It really can be tempting to stop once that fever is gone and your child is happy and eating again — after all, they look completely better, and most kids don’t like taking medicine — but if you do, there’s a good chance the infection won’t really be gone and in a few days you’ll be right back where you started.

Read more popular posts from Dr. Claire McCarthy.


About the blogger: Dr. Claire McCarthy is a primary care pediatrician at Boston Children’s Hospital, an assistant professor of pediatrics at Harvard Medical School, a senior editor for Harvard Health Publications and an official spokesperson for the American Academy of Pediatrics.

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