A fever can be confusing. Sometimes it’s just your body fighting off a common cold, and other times it signals something more serious. The number on the thermometer matters, but it’s not the only thing to watch. Confusion, a stiff neck, breathing difficulties or a seizure can all be signs that you need emergency care.
This guide covers adult fever thresholds, signs of infection in adults that should not be ignored and how to decide between home care and the emergency department, as well as the services that Baylor Scott & White Emergency Hospitals offer in the Dallas-Fort Worth Metroplex to support fever patients.
What Temperature Counts as a Fever in Adults?
For adults, a fever is generally an oral temperature of 100.4 degrees Fahrenheit or higher. Normal body temperature isn’t the same for everyone, and it fluctuates with the time of day, your age and your activity level. A fever is a symptom, not a diagnosis. Your body temperature rises as part of a normal immune response, and a mild fever isn’t necessarily a cause for concern.
When Is Fever Dangerous in Adults?
If your fever is mild, you feel well, your symptoms are improving and you’re alert and breathing normally, you should be able to manage the situation at home. Contact a healthcare provider if your fever remains around 103 degrees Fahrenheit, lasts longer than three days, doesn’t respond to medication or keeps returning over a week. You should also seek medical advice if you have a chronic condition or weakened immune system.
Knowing when to go to the ER for a fever can be lifesaving. Call 911 or get to the nearest ER if you also experience confusion, breathing difficulties, a seizure, a stiff neck, a severe headache, a new rash or extreme drowsiness. Very high fever, generally above 104 degrees Fahrenheit, can affect the liver, kidneys or other organs.
When Home Care May Be Safe for Adult Fever
Home care is often a reasonable place to start if you’re otherwise healthy and your symptoms are mild. You should be able to manage your fever at home if you have no problem staying alert, can breathe normally and are improving constantly, with none of the warning signs above.
Try taking a lukewarm bath, resting, drinking fluids and wearing light clothing. Fever-reducing medicine can help when appropriate and safe for you. Most mild fevers ease up within a few days. If yours lingers, climbs higher or returns after seeming to go away, call a provider rather than wait it out.
Special Considerations for Older and High-Risk Adults
Some adults need to take fever more seriously and seek care sooner. This includes people aged 65 or older, those receiving chemotherapy or on immunosuppressant medication, transplant recipients and those living with HIV or AIDS, chronic heart disease, COPD, cystic fibrosis, diabetes or sickle cell disease. Recent surgery or international travel are also reasons for caution. If you fall into one of these groups and develop a fever along with confusion, difficulty breathing, pain when urinating or a rash, don’t wait to see if it passes.
Older adults, in particular, don’t always show the classic signs of infection. A serious infection can show up as confusion, weakness or sudden dehydration rather than a high reading on the thermometer. If your loved one seems off or unusually tired, it can be just as concerning as a high fever.
Recovery and Monitoring After Fever Treatment
Recovery time depends on what’s causing the fever. Viral illnesses may last for several days or, in some cases, a few weeks, whereas bacterial infections can start improving within two days of taking antibiotics.
Keep monitoring your temperature with the same thermometer and method so the numbers stay comparable. Stay hydrated, take medication as directed and watch for a trend in your fever. If a fever that was improving climbs back up or you start to feel noticeably worse, reach out to a provider.
When To Visit the ER for Fever and What To Expect
In most healthy adults, a fever on its own isn’t an emergency. But if your temperature exceeds 104 degrees Fahrenheit or is paired with confusion, difficulty breathing, loss of consciousness, painful or foul-smelling urination, a seizure or severe pain in your abdomen, head or muscles, seek immediate medical attention.
After you arrive at the ER, the medical team will check your temperature and vital signs, including your oxygen level if needed. Then, a physician will examine you and ask about your medications, immune status, recent travel or surgeries and symptoms such as urinary changes, rash, vomiting or diarrhea.
The physician may check specific areas for signs of infection. This can include your skin for rash, lymph nodes for swelling, eyes for redness or jaundice, mouth and throat for soreness and abdomen for pain. Depending on the suspected cause, the team may order blood work, a urine test or screening for flu, COVID-19, RSV or another infection. Imaging, such as a chest X-ray or CT scan, may be needed for suspected pneumonia, abdominal infection or a neurological concern.
Treatment depends on the outcome of the diagnosis. It may include fever-reducing medication, IV fluids for dehydration or antibiotics if an infection is identified. Some patients are discharged upon improvement, while others are moved to the inpatient care unit for further observation.
Get Emergency Care for Fever in the Dallas-Fort Worth Metroplex
When deciding between home care and the ER, it’s vital to pay attention to your body’s signs. Mild fevers in otherwise healthy adults can usually be managed at home with rest, fluids and monitoring. Fevers paired with confusion, breathing trouble, a stiff neck or a seizure call for emergency attention. Older or immune-compromised adults should also seek medical care.
If you or someone nearby has a fever along with trouble breathing, confusion, extreme sleepiness, a seizure, a stiff neck, a severe headache, a new rash, bluish lips or nails, severe dehydration or chest pain, call 911 or go to the nearest ER. Baylor Scott & White Emergency Hospitals provide emergency care across the Dallas-Fort Worth Metroplex, with board-certified, emergency-trained physicians and on-site diagnostic services. Our emergency care services are available 24/7 and most of our patients are seen by an emergency physician in less than 10 minutes. Contact your nearest location for directions when you need care.