Chills
Rigors; ShiveringChills refers to feeling cold after being in a cold environment. The word can also refer to an episode of shivering along with paleness and feeling cold.
Considerations
Chills (shivering) may occur at the start of an infection. They are most often associated with a fever. Chills are caused by rapid muscle contraction and relaxation. They are the body's way of producing heat when it feels cold. Chills often predict the coming of a fever or an increase in the body's core temperature.
Fever
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...
Chills are an important symptom with certain diseases such as malaria.
Malaria
Malaria is a parasitic disease that involves high fevers, shaking chills, flu-like symptoms, and anemia.
Chills are common in young children. Children tend to develop higher fevers than adults. Even minor illness can produce high fevers in young children.
Infants tend not to develop obvious chills. However, call your health care provider about any fever in an infant 6 months or younger. Also call for fevers in infants 6 months to 1 year unless you are sure of the cause.
"Goose bumps" are not the same as chills. Goose bumps occur due to cold air. They can also be caused by strong emotions such as shock or fear. With goose bumps, the hair on the body stick up from the skin to form a layer of insulation. When you have chills, you may or may not have goose bumps.
Causes
Causes may include:
- Exposure to a cold environment
- Viral and bacterial infections
Home Care
Fever (which can accompany chills) is the body's natural response to a variety of conditions, such as infections. If the fever is mild, 102°F (38.8°C) or less, with no side effects, you do not need to see a provider for treatment. You can treat the problem at home by drinking lots of fluids and getting plenty of rest.
Evaporation cools the skin and reduces body temperature. Sponging with lukewarm water, about 70°F (21.1°C), may help reduce a fever. Cold water may increase the fever as it can trigger chills.
Medicines such as acetaminophen, aspirin, or ibuprofen are helpful in fighting a fever and chills.
DO NOT bundle up in blankets if you have a high temperature. DO NOT use fans or air conditioners either. These measures will only make the chills worse and may even cause the fever to rise.
HOME CARE FOR A CHILD
If the child's temperature is causing the child to be uncomfortable, give pain-relieving tablets or liquid. Non-aspirin pain-relievers such as acetaminophen are recommended. Ibuprofen may also be used. Follow the dosage guidelines on the package label.
Note: DO NOT give aspirin to treat fever in a child younger than 19 years old because of the risk for Reye syndrome.
Reye syndrome
Reye syndrome is characterized by sudden (acute) brain damage and liver function problems. This condition does not have a known cause. This syndrome...
Other things to help the child feel more comfortable include:
- Dress the child in light clothing, provide liquids, and keep the room cool but not uncomfortable.
- DO NOT use ice water or rubbing alcohol baths to reduce a child's temperature. These can cause shivering and even shock.
Shock
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...
Read Article Now Book Mark Article - DO NOT bundle a child with a fever in blankets.
- DO NOT wake a sleeping child to give medicine or take a temperature. Rest is more important.
When to Contact a Medical Professional
Call the provider if:
- Symptoms such as stiffness of the neck, confusion, irritability, or sluggishness are present.
Confusion
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...
Read Article Now Book Mark Article - Chills are accompanied by a bad cough, shortness of breath, abdominal pain or burning, or frequent urination.
- A child younger than 3 months has a temperature of 101°F (38.3°C) or more.
- A child 3 months to 1 year has a fever that lasts more than 24 hours.
- The fever remains above 103°F (39.4°C) after 1 to 2 hours of home treatment.
- The fever does not improve after 3 days, or has lasted more than 5 days.
What to Expect at Your Office Visit
The provider will take your medical history and perform a physical exam.
You may be asked questions such as:
- Is it only a cold feeling? Are you actually shaking?
- What has been the highest body temperature connected with the chills?
- Did the chills happen only once, or are there many separate episodes?
- How long does each attack last (for how many hours)?
- Did chills occur within 4 to 6 hours after exposure to something that you or your child is allergic to?
- Did chills begin suddenly? Do they occur repeatedly? How often (how many days between episodes of chills)?
- What other symptoms are present?
The physical exam will include the skin, eyes, ears, nose, throat, neck, chest, and abdomen. Body temperature will likely be checked.
Tests that may be ordered include:
- Blood (CBC or blood differential) and urine tests (such as urinalysis)
CBC
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
Read Article Now Book Mark ArticleBlood differential
The blood differential test measures the percentage of each type of white blood cell (WBC) that you have in your blood. It also reveals if there are...
Read Article Now Book Mark ArticleUrinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
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Blood culture
Blood culture
A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.
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Sputum culture
Sputum culture
Routine sputum culture is a laboratory test that looks for germs that cause infection. Sputum is the material that comes up from air passages when y...
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Urine culture
Urine culture
A urine culture is a lab test to check for bacteria or other germs in a urine sample. It can be used to check for a urinary tract infection in adults...
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X-ray of the chest
X-ray of the chest
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
Treatment depends on how long the chills and accompanying symptoms (especially fever) have lasted.
References
American Academy of Pediatrics website. Fever. www.healthychildren.org/English/health-issues/conditions/fever/Pages/default.aspx. Accessed February 6, 2023.
Hall JE, Hall ME. Body temperature regulation and fever. In: Hall JE, Hall ME, eds. Guyton and Hall Textbook of Medical Physiology. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 74.
Leggett JE. Approach to fever or suspected infection in the normal host. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 264.
Nield LS, Kamat D. Fever. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 201.
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Thermometer temperature - illustration
Fever is an important part of the body's defense against infection. Most bacteria and viruses that cause infections in humans thrive best at 98.6 degrees F (37 degrees C). Raising the body temperature a few degrees can help the body fight the infection. In addition, a fever activates the body's immune system to make more white blood cells, antibodies, and other infection-fighting agents.
Thermometer temperature
illustration
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Thermometer temperature - illustration
Fever is an important part of the body's defense against infection. Most bacteria and viruses that cause infections in humans thrive best at 98.6 degrees F (37 degrees C). Raising the body temperature a few degrees can help the body fight the infection. In addition, a fever activates the body's immune system to make more white blood cells, antibodies, and other infection-fighting agents.
Thermometer temperature
illustration
Review Date: 2/2/2023
Reviewed By: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.