Health Decision Guides

Welcome to this symptom guide about fever. Sorry to hear you have a fever!

This guide is intended for adults who have an abnormally elevated temperature. Although we think of normal body temperature as 98.6 degrees F, body temperature varies -- and so does the definition of fever. Since body temperature rarely climbs above 99.9 degrees without a reason, this guide will consider a fever to be present when the body temperature is 100.0 F (38 degrees C) or higher. While temperatures between 98.6 and 99.9 degrees might be high for you, minor elevations in temperature are less likely to be a true indication of illness and are often within the range of normal variation.

There are many causes of fever. This guide will cover some of the most common, but it is not exhaustive; rarer causes will not be covered.

This guide is not intended to replace a face-to-face meeting with your doctor about your symptoms. Many causes of fever require an in-person examination and testing to diagnose. However, this guide may be particularly helpful while awaiting a visit to your doctor or after your initial evaluation.

Okay. To begin, here's a two-part question:

1. Is your temperature greater than 104 degrees F?

2. Along with fever, do you have any of the following?

- Severe headache

- Shortness of breath

- Lethargy or confusion

- A rapidly spreading rash

- An inability to drink fluids

Yes, one or more of those is true for me.

No, none of those is true for me.

Good. That makes a serious or dangerous cause of fever less likely.

Along with fever, do you have a significant cough?

Yes, I do have a bad cough.

Nope, no cough.

Fevers are very common in children. They are usually a sign that the body is trying to fight an infection.

The normal temperature of the body is 98.6F, or 37C. Your child's temperature may vary during the day and may increase a little when he's bundled up or very active. Generally, doctors say that there is a fever when the temperature is greater than or equal to 100.4F, or 38C.

Use a digital thermometer to take your child's temperature; never use a glass mercury thermometer. Most children aged  three years and older can hold a thermometer under their tongue. If your child is younger than that, or you're having difficulty with the oral method, talk to your doctor about the best way to take his temperature.

Use this guide if your child is over a year old. If he or she is younger than 12 months of age, visit our Fever in Infants guide.

The guide is designed to help you understand what may be the cause of your child's fever and the actions you should consider. Remember -- this guide is not meant to take the place of a call to or visit with your doctor. If your child has a chronic medical problem, such as sickle cell anemia, or is being treated for cancer or any other serious disease, you should absolutely call the doctor rather than using this guide.

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While most fevers are not a sign of a serious infection, sometimes they can be.

Is any of the following happening with your child?

• His neck is stiff.

• He has a very bad headache.

• Light bothers his eyes.

• He is so sleepy it's hard to arouse him, or is very weak.

• He seems confused.

• He has dark red spots on his skin that don't get paler when you press on them.

• He is breathing very quickly or having trouble breathing.

• He is drooling a lot or won't drink.

• His skin color is very pale or bluish.

• He has a severe stomachache or other severe pain.

• He is having shaking chills.

• He is having repetitive jerking movements of his arms or legs and doesn't seem conscious during them.

Yes, one or more of these describe my child.

No, none of these describe my child.

Fever is very common in children under 12 months of age, and is usually a sign that the body is fighting an infection.

The normal body temperature is 98.6F, or 37C. Doctors generally say that there is a fever when the temperature is 100.4F (38C) or higher.

The best way to take an infant's temperature is rectally with a digital thermometer (never use a glass mercury thermometer). Taking the temperature under the arm, or using an ear thermometer, is less exact.

If your baby has a fever, this guide can help you think about what might be causing it and help you decide if and when you should call the doctor. Please note that this is not meant to take the place of calling or visiting your doctor. If your child has a chronic illness such as sickle cell anemia, or is being treated for any serious illness, you should not use this guide but instead call your doctor immediately.

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Fever can sometimes be a sign of a dangerous illness.

Does any of the following describe your baby?

• He has a high fever (greater than 102 F or 39C).

• He is very irritable.

• He is very weak or much sleepier than usual.

• He has dark red spots on his skin that don't get paler when you press on them.

• He is having trouble breathing (breathing very quickly, labored breathing, sucking in around his ribs).

• His skin looks pale or bluish.

• He is vomiting bloody, black, or green liquid.

• His stool is bloody or black.

• He has gone more than six hours without a wet diaper.

• He is drooling excessively and having a lot of trouble swallowing.

Yes, one of these describes my baby.

No, none of those describe my baby.

We're sorry to hear you have foot pain!

Please keep in mind that this guide is not intended to replace a face-to-face evaluation with your doctor. The goal of this guide is to provide information while awaiting evaluation with your doctor or additional information after you have seen him or her.

Foot pain may develop for a number of reasons -- fracture and infection are among the most serious while sprains and arthritis are among the most common. There are rare causes of symptoms that will not be included here and would require more detailed evaluation than this guide can provide.

Severe pain, swelling, bruising, or inability to bear weight are "alert" symptoms that could indicate serious injury to a bone or ligaments. When accompanied by fever, an infection becomes a major concern. However, most people with foot pain have no serious or dangerous cause. In fact, many have pain due to poorly fitting or tight shoes; for women, high heels only make a tight shoe more uncomfortable. Try changing your footwear to something with more cushion, support and room for your feet -- and read on to learn more about the causes of foot pain.

Certain symptoms suggest a serious cause of foot pain that requires prompt attention. It's important to ask questions about these symptoms first.

Did your pain begin after a significant injury, such as a fall or car accident?

Yes, my pain began just after a significant injury.

No, my pain did not occur after a severe blow or injury.

Along with foot pain, have you noticed swelling or redness in your foot (or feet)?

Yes, I have noticed swelling and/or redness.

No, I have no swelling or redness, thank goodness!

Welcome to our Health Decision Guide on frequent urination.

There can be many reasons why women may find themselves needing to urinate more often than usual.

By answering a short series of questions, you will gain a quick understanding of the likely causes of your urinary frequency.

Please keep in mind that this guide is a learning tool and not a substitute for consultation with your own doctor.

Let's get started.

There are two main reasons why you need to urinate frequently -- either your kidneys are making a lot of urine and your bladder fills up quickly, or you might have an urge to go to the bathroom often even though there is only a small amount in your bladder.

Do you have to urinate often but when you go, only a little comes out?

Yes, I urinate only a little each time.

No, I urinate a lot each time.

Welcome to our guide on hair loss in men.

Most men can expect some thinning or change in their hair pattern as they age. Usually hair loss is gradual, but sometimes it can occur in a sudden, dramatic, or otherwise abnormal way. This type of hair loss can sometimes signal an underlying condition or medical problem.

Hair loss may result in diffuse hair thinning or cause one or more areas of the scalp to become bald (the medical term for baldness is alopecia).

This guide is intended to help you figure out why you are losing hair and to point you in the right direction for evaluation and treatment. Please keep in mind that this information cannot replace a face-to-face evaluation with your own health care provider.

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Some types of hair loss can be caused by damage to the skin of the scalp.

With your hair loss, have you noticed any of the following changes of the skin on your scalp?

- Redness

- Flaking

- Irritation or itching

- Scarring

- Open sores

Yes, I am experiencing one or more of these skin changes.

No, the skin on my scalp is normal.

Welcome to our guide on Hair Loss.

You might be surprised at how common women experience hair loss. While most women can expect some thinning or change in their hair pattern as they age, hair loss can sometimes occur in a sudden, dramatic, or otherwise abnormal way. This type of hair loss can sometimes signal an underlying condition or medical problem.

Hair loss may result in diffuse hair thinning or cause one or more areas of the scalp to become bald (the medical term for baldness is alopecia). This guide is intended to help you figure out why you are losing hair and to point you in the right direction for evaluation and treatment.

Please keep in mind that this information cannot replace a face-to-face evaluation with your own health care provider.

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Some types of hair loss can be caused by damage to the skin of the scalp.

With your hair loss, have you noticed any of the following changes of the skin on your scalp?

- Redness

- Flaking

- Irritation or itching

- Scarring

- Open sores

Yes, I am experiencing one or more of these skin changes.

No, the skin on my scalp is normal.

Sorry to hear that your head hurts.

This health decision guide is designed for pregnant women who experience a headache that is either new or different from prior headaches. However, a pregnant woman with persistent headaches may also find some helpful information in the guide.

There are many possible reasons why you have a headache. By answering this series of questions, you will learn about the cause or causes likely to be most relevant to you.

This guide is a learning tool and not a substitute for consultation with your own doctor.

Let's get started.

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Most headaches, even very severe ones, are not associated with a serious medical problem; however, it is important to first identify a headache that needs immediate medical attention.

Sudden onset severe pain that is different from any type of headache that you have ever experienced before always requires medical evaluation.

Is this the worst headache of your life?

Yes, this is the worst headache ever.

No, this is not the worst one.

Children hit their heads frequently. Most of the time, the injury is minor, usually involving only the scalp, and nothing needs to be done. Sometimes, the injury is more serious, involving the skull and/or brain inside, and medical attention is required.

Answering the questions below will help you understand the difference between minor and serious head injuries and will help you decide what to do if your child has a head injury.

Remember, this guide is not meant to take the place of a consultation with your doctor.

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When a child has a head injury, certain symptoms are the most worrisome.

Did your child hit his or her head and have any of the following symptoms?

• loss of consciousness (was not responding to you or was "knocked out")

• seizure (convulsion)

• extreme persistent crying.

Yes, my child had one or more of these symptoms.

No, my child did not have any of these symptoms.

Many women feel that their periods are heavy. Doctors consider a woman's menstrual periods to be genuinely "heavy" when they meet any one of three criteria:

• periods last eight days or longer

• the blood flow causes you to change your sanitary napkin or tampon more than once an hour for six hours in a row or longer

• there is a significant increase in the amount or number of days of your usual flow, compared with your own usual periods.

It's normal for menstrual flow and duration to vary somewhat from period to period. If you have a repeated, long-lasting increase in monthly flow then you should be evaluated by a doctor. About ten percent of women have heavy periods, also called "menorrhagia." Some of the more common causes include hormone changes, thyroid problems, growths or other changes in the uterus, problems with your blood's ability to clot, or a pelvic infection.

Heavy periods usually keep to the monthly cycle pattern. Sometimes bleeding can last or recur throughout the month and it may be hard to know when one period ends and another begins, a problem known as "menometrorrhagia." If your bleeding is not occurring in a clear monthly cycle, please visit our health guide on Bleeding Between Menstrual Periods.

The Heavy Menstrual Periods Decision Guide is designed to give you some information about what may cause monthly periods to be heavy and what steps you can take to get help. This guide is not meant to substitute for a doctor's evaluation.

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Very heavy bleeding can be an emergency. You might need an urgent evaluation by your doctor.

Are your menstrual periods lasting eight or more days, or are you bleeding so much that you change pads or tampons more than once an hour?

Yes, one or both of these is true for me.

No, neither of these is true for me.