A fever that “comes and goes” describes a fluctuating pattern in body temperature. This means the body’s temperature rises above its normal range, then falls back to normal or near-normal levels, only to rise again. This pattern is a symptom, indicating an underlying process rather than a specific illness. Normal body temperature typically hovers around 98.6°F (37°C), though minor variations can occur throughout the day.
Common Reasons for a Fluctuating Fever
Fluctuating fevers often signal the body’s immune system responding to various challenges. One common cause involves viral infections, where the body produces pyrogens that reset the brain’s “thermostat” to a higher temperature. Common viruses, such as those for the common cold, influenza, or viral gastroenteritis, can lead to these cyclical fever patterns as the body fights off the infection. The fever may rise, temporarily subside as the immune response progresses, and then reappear as the body continues to clear the viral load.
Bacterial infections can also trigger fevers that fluctuate. Conditions like urinary tract infections (UTIs), pneumonia, or certain respiratory infections can cause the body temperature to rise, fall, and then spike again. The body elevates its temperature to create an unfavorable environment for bacterial growth and enhance immune cell activity, leading to periodic temperature changes.
Beyond infections, the body’s inflammatory responses to non-infectious conditions can manifest as a fluctuating fever. Inflammation is a protective response to injury or irritation, characterized by heat, redness, swelling, and pain. The immune system releases pro-inflammatory chemicals, including cytokines, which can influence the hypothalamus and lead to a systemic increase in body temperature. Autoimmune disorders, such as rheumatoid arthritis or lupus, can also result in recurring fevers, especially during flare-ups. Certain chronic illnesses like inflammatory bowel disease (IBD) or some cancers, like lymphoma, may present with intermittent fevers due to ongoing inflammatory processes.
When a Fluctuating Fever Needs Medical Attention
While many fluctuating fevers are part of the body’s normal defense, certain signs indicate the need for medical evaluation. A temperature exceeding 103°F (39.4°C) in adults warrants medical attention. For infants, especially those under three months of age, any fever above 100.4°F (38°C) should prompt an immediate call to a pediatrician, as even a low fever can signal a serious infection in this age group.
The duration of the fever is another important factor. If a fluctuating fever persists for more than 2-3 days in adults or more than 24 hours in infants and young children, medical consultation is advisable. Accompanying symptoms can also be concerning, including a severe headache, a stiff neck, difficulty breathing, persistent vomiting or diarrhea, a new rash, confusion, seizures, or unexplained localized pain. These symptoms suggest a more serious underlying condition requiring prompt diagnosis and treatment.
Individuals with specific health profiles should seek medical attention sooner for a fluctuating fever. This includes the elderly, who may not exhibit typical fever symptoms but can still have serious infections, and those with chronic health conditions such as diabetes, heart disease, or lung disease. People with weakened immune systems due to HIV/AIDS, cancer treatment, or organ transplantation also require prompt medical evaluation for any fever, as their bodies may struggle to fight off infections.
Home Care for Intermittent Fevers
When a fluctuating fever does not meet the criteria for immediate medical attention, several home care measures can help manage discomfort and support recovery. Staying well-hydrated is important, as fever can lead to fluid loss through sweating. Drinking plenty of clear fluids like water, clear broths, or electrolyte solutions helps prevent dehydration.
Adequate rest allows the body to conserve energy and focus its resources on fighting off the underlying cause of the fever. Resting comfortably in a cool environment can also help manage discomfort. Wearing light clothing and taking lukewarm baths can provide relief by helping to lower body temperature gradually.
Over-the-counter medications like acetaminophen or ibuprofen can help reduce fever and alleviate associated discomforts such as headaches or muscle aches. It is important to follow dosage instructions carefully and consult a healthcare professional or pharmacist regarding the appropriate medication and dosage, especially when administering to children. Throughout the period of fluctuating fever, monitoring temperature readings and noting any new or worsening symptoms is advisable, as this information can be helpful if medical attention becomes necessary.