Fever or Chills, Age 12 and Older

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

• Your age. Babies and older adults tend to get sicker quicker.
• Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
• Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
• Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
• Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

You can get dehydrated when you lose a lot of fluids because of problems like vomiting or fever.

Symptoms of dehydration can range from mild to severe. For example:

• You may feel tired and edgy (mild dehydration), or you may feel weak, not alert, and not able to think clearly (severe dehydration).
• You may pass less urine than usual (mild dehydration), or you may not be passing urine at all (severe dehydration).

Severe dehydration means:

• Your mouth and eyes may be extremely dry.
• You may pass little or no urine for 12 or more hours.
• You may not feel alert or be able to think clearly.
• You may be too weak or dizzy to stand.
• You may pass out.

Moderate dehydration means:

• You may be a lot more thirsty than usual.
• Your mouth and eyes may be drier than usual.
• You may pass little or no urine for 8 or more hours.
• You may feel dizzy when you stand or sit up.

Mild dehydration means:

• You may be more thirsty than usual.
• You may pass less urine than usual.

Symptoms of difficulty breathing can range from mild to severe. For example:

• You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
• It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you're at rest (severe difficulty breathing).

Severe trouble breathing means:

• You cannot talk at all.
• You have to work very hard to breathe.
• You feel like you can't get enough air.
• You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

• It's hard to talk in full sentences.
• It's hard to breathe with activity.

Mild trouble breathing means:

• You feel a little out of breath but can still talk.
• It's becoming hard to breathe with activity.

Severe trouble breathing means:

• The child cannot eat or talk because he or she is breathing so hard.
• The child's nostrils are flaring and the belly is moving in and out with every breath.
• The child seems to be tiring out.
• The child seems very sleepy or confused.

Moderate trouble breathing means:

• The child is breathing a lot faster than usual.
• The child has to take breaks from eating or talking to breathe.
• The nostrils flare or the belly moves in and out at times when the child breathes.

Mild trouble breathing means:

• The child is breathing a little faster than usual.
• The child seems a little out of breath but can still eat or talk.

Sudden drooling and trouble swallowing can be signs of a serious problem called epiglottitis. This problem can happen at any age.

The epiglottis is a flap of tissue at the back of the throat that you can't see when you look in the mouth. When you swallow, it closes to keep food and fluids out of the tube (trachea) that leads to the lungs. If the epiglottis becomes inflamed or infected, it can swell and quickly block the airway. This makes it very hard to breathe.

The symptoms start suddenly. A person with epiglottitis is likely to seem very sick, have a fever, drool, and have trouble breathing, swallowing, and making sounds. In the case of a child, you may notice the child trying to sit up and lean forward with his or her jaw forward, because it's easier to breathe in this position.

Many prescription and nonprescription medicines can trigger an allergic reaction and cause a fever. A few examples are:

• Antibiotics.
• Barbiturates, such as phenobarbital.
• Aspirin, if you take too much.

If you're not sure if a fever is high, moderate, or mild, think about these issues:

With a high fever:

• You feel very hot.
• It is likely one of the highest fevers you've ever had. High fevers are not that common, especially in adults.

With a moderate fever:

• You feel warm or hot.
• You know you have a fever.

With a mild fever:

• You may feel a little warm.
• You think you might have a fever, but you're not sure.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

• Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
• Long-term alcohol and drug problems.
• Steroid medicines, which may be used to treat a variety of conditions.
• Chemotherapy and radiation therapy for cancer.
• Other medicines used to treat autoimmune disease.
• Medicines taken after organ transplant.
• Not having a spleen.

Temperature varies a little depending on how you measure it. For adults and children age 12 and older, these are the ranges for high, moderate, and mild, according to how you took the temperature.

Oral (by mouth) temperature

• High: 104°F (40°C) and higher
• Moderate: 100.4°F (38°C) to 103.9°F (39.9°C)
• Mild: 100.3°F (37.9°C) and lower

A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature.

Ear temperature

• High: 105°F (40.6°C) and higher
• Moderate: 101.4°F (38.6°C) to 104.9°F (40.5°C)
• Mild: 101.3°F (38.5°C) and lower

Armpit (axillary) temperature

• High: 103°F (39.5°C) and higher
• Moderate: 99.4°F (37.4°C) to 102.9°F (39.4°C)
• Mild: 99.3°F (37.3°C) and lower

Sudden tiny red or purple spots or sudden bruising may be early symptoms of a serious illness or bleeding problem. There are two types.

Petechiae (say "puh-TEE-kee-eye"):

• Are tiny, flat red or purple spots in the skin or the lining of the mouth.
• Do not turn white when you press on them.
• Range from the size of a pinpoint to the size of a small pea and do not itch or cause pain.
• May spread over a large area of the body within a few hours.
• Are different than tiny, flat red spots or birthmarks that are present all the time.

Purpura (say "PURR-pyuh-ruh" or "PURR-puh-ruh"):

• Is sudden, severe bruising that occurs for no clear reason.
• May be in one area or all over.
• Is different than the bruising that happens after you bump into something.

Symptoms of serious illness may include:

• A severe headache.
• A stiff neck.
• Mental changes, such as feeling confused or much less alert.
• Extreme fatigue (to the point where it's hard for you to function).
• Shaking chills.

Pain in adults and older children

• Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
• Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
• Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

• Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
• Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
• Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Fever can be a symptom of almost any type of infection. Symptoms of a more serious infection may include the following:

• Skin infection: Pain, redness, or pus
• Joint infection: Severe pain, redness, or warmth in or around a joint
• Bladder infection: Burning when you urinate, and a frequent need to urinate without being able to pass much urine
• Kidney infection: Pain in the flank, which is either side of the back just below the rib cage
• Abdominal infection: Belly pain

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Adults and older children often have several symptoms of shock. These include:

• Passing out (losing consciousness).
• Feeling very dizzy or lightheaded, like you may pass out.
• Feeling very weak or having trouble standing.
• Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Babies and young children often have several symptoms of shock. These include:

• Passing out (losing consciousness).
• Being very sleepy or hard to wake up.
• Not responding when being touched or talked to.
• Breathing much faster than usual.
• Acting confused. The child may not know where he or she is.