Common Causes of Fever in Children: Differentiating Viral from Bacterial Infections

boy lying in bed with fever

Medically Reviewed by Dr Welras Long (M.B.B.S, Singapore. MRCS, England)

Fever in children is a common concern for parents, often signaling an underlying infection. While fevers are typically the body’s natural response to infections, differentiating between viral and bacterial causes is crucial for appropriate treatment. In this article, we explore the common causes of fever in children, emphasizing the importance of recognizing patterns that aid in distinguishing between viral and bacterial infections.

Understanding Fever in Children

Fever is the body’s defense mechanism in response to an infection or other inflammatory processes. In children, the normal body temperature can vary, but a fever is generally considered when the temperature rises above 100.4°F (38°C). Fever itself is not an illness but a symptom indicating an underlying issue.

Common Causes of Fever: Viral Infections

Respiratory Viruses

  • Common Cold. Rhinoviruses and other respiratory viruses can cause a mild to moderate fever along with symptoms like a runny nose, cough, and congestion.
  • Influenza (Flu). Influenza viruses often induce sudden-onset fever, body aches, and respiratory symptoms.

Gastrointestinal Viruses

  • Rotavirus. This common cause of gastroenteritis can lead to fever, vomiting, and diarrhea in children.
  • Norovirus.  Another gastrointestinal virus that can cause fever and severe vomiting.

Childhood Viral Infections

  • Chickenpox (Varicella). Characterized by an itchy rash, chickenpox is often accompanied by a moderate fever.
  • Hand, Foot, and Mouth Disease. Caused by enteroviruses, this viral infection may lead to fever, mouth sores, and a skin rash.

Common Causes of Fever: Bacterial Infections

  • Ear Infections. Bacterial infections of the middle ear (Otitis Media) can cause fever, ear pain, and sometimes, fluid drainage.
  • Strep Throat (Group A Streptococcus). Strep throat is a bacterial infection that typically causes a sore throat, fever, and swollen tonsils.
  • Urinary Tract Infections (UTIs). Bacterial infections of the urinary tract may lead to fever, frequent urination, and discomfort.
  • Sinus Infections (Sinusitis). Bacterial sinus infections can cause facial pain, nasal congestion, and fever.
  • Pneumonia. Bacterial pneumonia may result in high fever, cough, and difficulty breathing.

Differentiating Viral from Bacterial Fever: Key Factors

Onset of Symptoms

  • Viral: Symptoms often develop gradually, and the fever may be preceded by other signs like cough, runny nose, or rash.
  • Bacterial: Symptoms may appear more abruptly, with a rapid onset of fever and localized symptoms corresponding to the infected area.

Duration of Fever

  • Viral: Fever associated with viral infections typically resolves within a few days to a week.
  • Bacterial: Fever due to bacterial infections may persist for a more extended period, requiring medical attention.

Nature of Fever

  • Viral: Fever tends to be moderate and may fluctuate.
  • Bacterial: Fever may be higher, and persistent high fever could indicate a more serious bacterial infection.

Associated Symptoms

  • Viral: Often accompanied by symptoms specific to the type of virus, such as respiratory or gastrointestinal symptoms.
  • Bacterial: May present with localized symptoms corresponding to the affected area, such as ear pain, throat discomfort, or difficulty breathing.

When to Seek Medical Attention

While many fevers in children are caused by viral infections and can be managed at home with rest and fluids, certain circumstances warrant prompt medical attention:

  • High Fever. A fever of 38°C or higher requires medical evaluation.
  • Persistent Fever. If the fever persists for more than a week without improvement, medical advice is essential.
  • Difficulty Breathing. Respiratory distress, rapid breathing, or persistent coughing may indicate a more severe respiratory infection.
  • Seizures. Febrile seizures can occur in young children with rapid rises in temperature and require immediate medical attention.
  • Unexplained Rash. A fever accompanied by an unexplained rash may suggest a more serious condition and necessitates medical evaluation.
  • Reduced oral intake. A child with fever may have reduced appetite and reject food/fluids. If oral intake is persistently reduced, there is a risk of dehydration and clinical deterioration.

Prioritize Your Child’s Health with Keystone Clinic & Surgery

Recognizing the common causes of fever in children and understanding the nuances of viral and bacterial infections are essential for effective management. Keystone Clinic & Surgery offers comprehensive pediatric services, ensuring that your child receives the care they need. For professional medical guidance and support, visit Keystone Clinic & Surgery. 

References 2019. Fever in Common Infectious Diseases. 2022. Fever in Infants and Children. 2023. Repeated Infections in Children.,RV)%2C%20and%20influenza%20virus. 2023. Viral Fever and Bacterial Fever: How are They Different from Each Other?.

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