Fever with chills

Overview

Fever with chills is a condition where your body temperature rises above normal (usually over 38°C or 100.4°F) and you feel cold, shivery, or shaky. The chills are your body's way of generating heat to fight off an infection.

Yes, it is very common. Almost everyone experiences a fever with chills at some point, often due to a cold, flu, or other infection.

It can affect people of any age, but young children, older adults, and those with weakened immune systems are more likely to get fevers and may need closer attention.

Symptoms

Common symptoms

• A temperature reading of 38°C (100.4°F) or higher
• Shivering or shaking chills
• Sweating when the fever breaks
• Muscle aches and fatigue
• Headache or feeling generally unwell

Symptoms in children

• Fussiness or irritability
• Flushed cheeks
• Refusing to drink or eat
• Clammy skin or sweating
• Febrile seizures (rare but serious)

Symptoms in older adults

• A lower fever than younger adults (may not feel hot)
• Confusion or changes in thinking
• Weakness or fatigue
• Loss of appetite
• Less obvious shivering

Causes

Main causes

• Viral infections: common cold, flu, COVID-19, other respiratory viruses
• Bacterial infections: urinary tract infection, pneumonia, strep throat
• Inflammatory conditions: rheumatoid arthritis, some autoimmune diseases
• Heatstroke or overheating
• Side effects of some medications or vaccines

Risk factors

• Being very young or very old
• Weakened immune system (due to illness or treatment)
• Recent surgery or hospital stay
• Travel to areas with infectious diseases
• Not being up-to-date on vaccinations

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above
• If fever persists more than 3 days without improvement
• If you have a chronic health condition and develop a fever
• If you are pregnant and have a fever

Book a routine appointment if:

• If the fever is mild and you feel well enough to manage at home
• If you have had fevers off and on for more than a week
• If you need advice on managing symptoms

Diagnosis

A doctor will ask about your symptoms, check your temperature, and perform a physical exam. They will look for signs of infection and ask about recent travel, contacts, and medical history.

Tests that may be done

• Blood tests: to check for infection or inflammation
• Urine tests: to look for a urinary tract infection
• Throat or nasal swabs: for flu, strep, or COVID-19
• Chest X-ray: if pneumonia is suspected
• Lumbar puncture (spinal tap): only if meningitis is possible

What to expect at your appointment

The doctor will likely check your vitals (heart rate, blood pressure, oxygen levels) and may test a sample of blood or urine. They might ask you to wait for results or prescribe treatment based on your symptoms.

Treatment

Treatment focuses on making you comfortable while your body fights the underlying cause. Most fevers are handled at home with rest and fluids. If a bacterial infection is found, antibiotics may be prescribed.

Self-care at home

• Rest as much as possible to help your body recover.
• Drink plenty of fluids: water, clear soups, or oral rehydration drinks.
• Dress lightly and keep the room at a comfortable temperature.
• Use a damp cloth on your forehead or neck if you feel too hot.
• Monitor your temperature regularly but avoid overchecking.

Medical treatments

If the fever is very high or uncomfortable, a doctor may recommend a fever-reducing medicine (antipyretic) such as paracetamol or ibuprofen — but always follow the dosage instructions on the label or as advised by a healthcare professional. For bacterial infections, antibiotics may be prescribed; it is important to take them exactly as directed. Never take antibiotics for a viral infection like the common cold.

When is surgery considered?

Surgery is rarely needed for a fever with chills. It may be necessary only if an abscess (a pocket of pus) forms and needs draining, or for certain serious infections that require surgical removal of infected tissue.

Living with this condition

During a fever episode, plan to stay home from work or school. Rest in bed, stay hydrated, and avoid strenuous activities. Use a thermometer to track your temperature, and note any other symptoms like cough or pain.

Lifestyle tips

• Wash your hands frequently to avoid spreading germs to others.
• Avoid alcohol and caffeine, as they can dehydrate you.
• Get plenty of sleep to help your immune system fight the infection.
• If you smoke, try to stop or cut down, as smoking can make infections worse.

Diet and exercise

While you have a fever, you might not feel like eating. That's okay — focus on drinking fluids. When your fever breaks, you can slowly introduce light foods like toast, rice, bananas, or broth. Avoid heavy, greasy meals. Do not exercise until you are fully recovered, as it can raise your body temperature further.

Mental health and emotional wellbeing

Having a fever with chills can be frightening, especially if you feel very ill. It is normal to feel anxious, restless, or down while you are unwell. Being isolated from others can also affect your mood. Remember that this is temporary, and taking care of your body will help you feel better.

Prevention

You cannot prevent all fevers, but you can reduce your risk of infections that cause them. Good hygiene and staying up-to-date on vaccines are the best ways.

Vaccines

Vaccines such as the flu shot, pneumococcal vaccine, and COVID-19 vaccine can prevent some infections that commonly cause fever with chills. Ask your doctor which vaccines are recommended for you.

Screening programmes

There are no routine screening tests for fever itself. However, if you have a condition that weakens your immune system, your doctor may suggest regular check-ups to catch infections early.

Complications

If left untreated

• Dehydration from fluid loss due to sweating and not drinking enough
• Febrile seizures in children (usually not harmful but frightening)
• Rarely, very high fever can lead to confusion, delirium, or organ damage
• If caused by an untreated bacterial infection, the infection may spread and become more serious.

Long-term outlook

For most people, fever with chills is a short-lived sign that the body is fighting an infection. With rest and fluids, it usually goes away in a few days. Even when it looks serious, modern medicine can treat most causes. The key is to listen to your body and seek medical help if things don't improve or get worse.

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