LAS VEGAS—It’s an adage as old as Hippocrates: The higher a febrile child’s fever climbs, the more dangerous the cause must be.

“There’s a concept that the higher the fever, the sicker you must be,” Al Sacchetti, MD, FACEP, said at the rapid-fire session, “Staying Cool with Pediatric Fever.” “The reality of it is: not really. In fact, over 38 [degrees Celsius] or over 39, it really doesn’t matter how high the fever is…the last meningitis case I saw, the kid’s temperature was 100.8 –[degrees Fahrenheit].”

Now, of course, over 106 degrees, more than 50 percent of cases are viral. But Dr. Sacchetti’s overarching point: most fevers without source (FWS) are just that. And, for his part, emergency physician Glenn Hornstein, MD, of Salisbury, Maryland, was perfectly glad to hear the news.

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