Hyperpyrexia: What to know about a high fever

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Kiti Rismania 13 Feb 2024

Hyperpyrexia is another term for a very high fever. It usually refers to a body temperature of more than 106.7°F or 41.5°C. Treatment may depend on the underlying cause.

Some doctors lower the measure for hyperpyrexia to include anyone with a body temperature of 106.1°F or 41.1°C and above.

Fevers, including very high fevers, are never illnesses in themselves, or the causes of illnesses. Instead, they are symptoms of other problems, such as an infection or injury. Viral or bacterial infections cause most fevers. However, in hyperpyrexia, that is not always the case.

Hyperpyrexia is an emergency that needs immediate attention from a medical professional.

In hyperpyrexia and most other cases of fever, the brain tells the body to raise its baseline temperature above normal. The body responds to the brain’s messages and raises its temperature to a new baseline. This reaction normally happens as a result of an infection or trauma.

Hyperpyrexia differs from hyperthermia, a medical term for the uncontrolled rise in body temperature due to excess amounts of body heat generated.

In hyperthermia, the brain is not regulating the rise in temperature the way it does with other fevers. Rather, the body cannot handle the heat from environmental causes, and so it overheats.

Cases of heat stroke are due to hyperthermia, and not to hyperpyrexia.

Causes of hyperpyrexia

Usually, instances of hyperpyrexia are associated with viral or bacterial infections. Some other causes include the following:

Intracranial hemorrhage

In some cases, bleeding in the brain known as intracranial hemorrhage causes hyperpyrexia. Accidents or other traumas and strokes are the most likely cause of intracranial hemorrhage. The bleeding in the brain can affect an area of the brain called the hypothalamus, which is responsible for regulating the body’s temperature.

Sepsis

In rare cases, hyperpyrexia may result from sepsis. Sepsis is a potentially life-threatening response to an infection caused by the immune system. The overwhelming immune system response gets into the blood, which may cause organ damage or failure.

Anesthesia

People may experience hyperpyrexia due to a direct side effect of general anesthesia, occurring when there is an underlying disease of muscleTrusted Source. In these cases, a person’s temperature rises rapidly while under anesthesia, requiring doctors to make adjustments to lower the body’s temperature again.

Hyperpyrexia in children

Kawasaki syndrome or disease is a potential cause of hyperpyrexia, especially in children. Kawasaki syndrome causes inflammation to the medium-sized arteries throughout the body. One sign of Kawasaki disease is high fever, which can result in hyperpyrexia if left untreated.

What are the symptoms?

Symptoms of hyperpyrexia vary from person to person, depending on how long the condition lasts and if it worsens. Early symptoms may include:

increased thirst
extreme sweating
dizziness
muscle cramps
fatigue and weakness
nausea
light-headedness

As the high temperature persists or gets worse, the severity of the symptoms can increase. This situation can lead to:

headache
contracted pupils
mild confusion
pale, moist, and cool skin
vomiting or upset stomach
decreased urination or inability to urinate

In prolonged periods of a temperature of more than 106.1°F, the following symptoms may occur:

extreme confusion
loss of consciousness
rapid, shallow breathing
dry, hot, and red skin
weak, fast pulse
widened pupils
seizures

It is essential to seek treatment for fevers over 106.1°F to help prevent serious long-term complications or death.

Treatment and management

As hyperpyrexia is caused by another disease, treating the latter will usually cause the body’s temperature to go down.

When the body temperature starts reaching 106.1°F and higher, it may be necessary to treat the fever itself, as well as the underlying cause. Direct treatment of hyperpyrexia may include:

a cool bath or cold, wet sponges put on the skin
liquid hydration through IV or from drinking
fever-reducing medications, such as dantrolene

In cases of malignant hyperpyrexia caused from general anesthesia, doctors will need to take steps to reduce the patient’s fever.

How is hyperpyrexia diagnosed?

Diagnosing hyperpyrexia is done using a thermometer. If the reading is over 106.1°F, then the person has the symptoms of hyperpyrexia.

Since hyperpyrexia itself is not a diagnosis and only a symptom of a larger problem, finding the underlying cause of the high fever is more important and often more challenging.

A doctor will assess the person’s physical state and run tests to rule out the more common causes of high fever. These test may include the following:

blood work, to check for signs of infection
image studies of the brain to check for intracranial hemorrhage

Further tests will largely depend on any other symptoms the person has.

Outlook

If the fever is not treated and a person’s temperature brought down to a safe level, hyperpyrexia can cause permanent brain damage or death.

However, in most circumstances, correct treatments can lower the fever safely, giving doctors time to diagnose and treat the underlying cause of the hyperpyrexia.

What to know about a fever in toddlers

A fever can occur in toddlers for a variety of reasons. While not all fevers are serious, certain conditions that cause high temperatures in toddlers need urgent medical attention.

Is a fever dangerous?

According to the American Academy of Pediatrics, a child’s normal body temperature should be between 97ºF (36ºC) and 100.4ºF (38ºC).

Children and babies can have higher temperaturesTrusted Source than adults, as they have a larger surface area compared to their body weight. Toddlers also sweat less and have a faster metabolism, which can cause them to have a higher body temperature.

According to a 2019 articleTrusted Source, a fever alone is rarely harmful and does not typically exceed 105.8ºF (41ºC). While fevers higher than this temperature can be dangerous, they are rare.

Febrile seizures

A febrile seizure is a seizure that occurs when a toddler has a fever. Although they may seem alarming, they are not dangerous and typically last a few minutesTrusted Source.

The National Institute of Neurological Disorders and Stroke notes that these types of seizures occur in 2⁠–5%Trusted Source of children below 5 years old.

Symptoms of a febrile seizure include:

loss of consciousness
uncontrollable shaking of legs and arms
eye rolling
stiff limbs
twitching in one area of the body

If a toddler’s febrile seizure lasts more than 5 minutes, or the child does not seem to be getting better, seek immediate medical attention.

When to contact a doctor

The Food and Drug Administration (FDA) recommends contacting a doctor if a toddler experiences a fever of 102ºF (38.8ºC) or moreTrusted Source.

A parent of caregiver should also contact a doctor if the toddler has:

other signs of illness, such as rash
a fever that lasts for 5 days or more
a fever that does not reduce with acetaminophen
a cough that lasts for more than 3 weeks
persistent ear pain
signs of dehydration

When to seek emergency care

A review from 2019 noted that only 1 in 100 childrenTrusted Source with a fever will require urgent medical attention. However, an individual should seek urgent care if the toddler experiencesTrusted Source:

difficulty breathing, including nostrils widening with each breath
wheezing
fast breathing
shortness of breath
ribs showing with each breath
excessive crankiness or sleepiness
symptoms seeming to be getting worse
excessive crying
fever that comes and goes
blue or grey lips

Additionally, meningitis is a serious condition that can causeTrusted Source fever in toddlers. A person should take the child to the emergency room immediately if they experience fever along with any of the following symptoms:

headache
stiff neck
dislike of bright lights
sleepiness
trouble waking up
nausea
irritability
vomiting
lack of appetite
lack of energy
a rash that does not fade under pressure — use a glass to test for this

Should a caregiver try to reduce a fever?

A caregiver does not always need to reduce a fever. A fever lower than 101ºF (38ºC) does not require treatment unless the toddler is uncomfortable.

Fever occurs due to the body reacting to contracting a viral or bacterial infection. Bacteria and viruses can thrive at the body’s normal temperature — by increasing its internal temperature, the body can help kill the infection.

While certain drugs can help lower a child’s fever, they do not treat its underlying cause.

Treatment

To help make the toddler feel more comfortable, a person can:

ensure the child drinks plenty of water
put cool, damp cloths on the foreheads, wrists, and calves
dress them in loose, light clothes
give them medication, such as ibuprofen or paracetamol

When giving a toddler medication to treat their fever, a person should ensure they give the correct dose. The FDA recommends that an individual speaks with a doctor before giving medication to a toddler below the age of 2 yearsTrusted Source.

Nationwide Children’s Hospital says that a person can also give the child a sponge bath if they have a fever over 104ºF (40ºC) and are vomiting and unable to keep the medicine down. To do this, a caregiver should place the child in a bath with lukewarm water of approximately 85–90ºF (29–32ºC) and sponge the water over the skin.

If the child is unable to sit in the bath, a person can lay a lukewarm, wet washcloth:

on the stomach
on the groin
under the armpits
behind the neck

What to avoid

Parents and caregivers should be aware of the following when treating a toddler’s fever:

do not rub a toddler down with alcohol, as the skin may absorb it, leading to coma
do not put a toddler in a cold or ice bath, as this can cause shivering and increase their temperature
do not undress the toddler
do not delay seeking medical attention for a toddler who appears very ill
do not give a toddler any medication not meant for a child

Tips on taking a child’s temperature

A person can take a child’s temperature in a variety of ways, including:

Forehead temperature: Although this is appropriate for children of any age, using it in direct sunlight can affect temperature readings.
Mouth temperature: This is suitable for those above the age of 4 years. A person places the tip of the thermometer under the tongue and waits until they hear a beep. To get an accurate reading, individuals should wait for 30 minutes after the child has had anything hot or cold to drink.
Ear temperature: This is appropriate for those older than 6 months. When using an ear thermometer, aim the tip slightly diagonally toward the face.

Potential causes

There are many reasons why a toddler might have a fever. Possible causes include illness due to viruses or bacteria, such as:

the common cold
urinary tract infections
ear infections
rubella
mumps
measles
scarlet fever
chickenpox
gastroenteritis

Other causes include:

having a vaccination
sunburn
dehydration

Summary

There are many reasons why a toddler might have a fever. This symptom is a byproduct of a child healing from acquiring an infection, and it does not necessarily need treating. However, a caregiver can provide home care to help the infant feel more comfortable.

Seek medical help if a toddler has a fever of 102ºF (38.8ºC)Trusted Source or more.

Many conditions can lead to a toddler experiencing a fever. If a parent or caregiver has concerns about the toddler’s temperature, they should speak with a doctor.