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 is a feeling of coldness occurring during a high fever, but sometimes is also a common symptom which occurs alone in specific people. It occurs during fever due to the release of cytokines and prostaglandins as part of the inflammatory response, which increases the set point for body temperature in the hypothalamus. The increased set point causes the body temperature to rise (pyrexia), but also makes the patient feel cold or chills until the new set point is reached. Shivering also occurs along with chills because the patient's body produces heat during muscle contraction in a physiological attempt to increase body temperature to the new set point. When it does not accompany a high fever, it is normally a light chill. Sometimes a chill of medium power and short duration may occur during a scare, especially in scares of fear, commonly interpreted like or confused by trembling.

Severe chills with violent shivering are called rigors.

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Chills are commonly caused by inflammatory diseases, such as the flu. Malaria is one of the common reasons for chills and rigors. In malaria, the parasites enters the liver, grow there and then attack the red blood cells which causes rupture of these cells and release of a toxic substance hemozoin which causes chills recurring every 3 to 4 days. Sometimes they happen in specific people almost all the time, in a slight power, or it less commonly happens in a generally healthy person.

Some chills occur after exposure to a cold environment. They can also occur as a response to a bacterial or viral infection that causes a fever. Chills are commonly associated with the following conditions:

  • bacterial or viral gastroenteritis
  • flu
  • meningitis
  • sinusitis
  • pneumonia
  • strep throat
  • urinary tract infections (UTIs)
  • malaria

Evaluation of the degree of chills is important for estimating risk of bacteremia in patients with acute febrile illness. The more severe degree of chills suggests the higher risk of bacteremia.

  • stiff neck.
  • wheezing.
  • severe coughing.
  • shortness of breath.
  • confusion.
  • sluggishness.
  • irritability.
  • abdominal pain.

Your doctor will perform a physical examination and possibly run diagnostic tests to see if a bacterial or viral infection is causing your fever. Diagnostic tests may include a: blood test, including a blood culture to detect bacteria or fungi in the blood

If you or your child has a fever with chills, there are some things you can do at home for comfort and relief. Keep reading to learn how to treat a fever with chills and when you should call a doctor.

Home care for adults

Treatment is usually based on whether your chills are accompanied by a fever and the severity of the fever. If your fever is mild and you have no other serious symptoms, you don’t have to see a doctor. Get plenty of rest and drink plenty of liquids. A mild fever is 101.4°F (38.6°C) or less.

Cover yourself with a light sheet and avoid heavy blankets or clothing, which can raise your body temperature. Sponging your body with lukewarm water or taking a cool shower may help reduce a fever. Cold water, however, may trigger an episode of chills.

Over-the-counter (OTC) medications can lower a fever and fight chills, such as:

  • aspirin (Bayer)
  • acetaminophen (Tylenol)
  • ibuprofen (Advil)

As with any medication, carefully follow the instructions and take them as directed. Aspirin and ibuprofen will lower your fever and reduce inflammation. Acetaminophen will bring down a fever, but it won’t reduce inflammation. Acetaminophen can be toxic to your liver if it isn’t taken as directed and long-term use of ibuprofen can cause kidney and stomach damage.

Call your doctor if your fever and chills don’t improve after 48 hours of home care or if you have any of the following symptoms:

  • stiff neck
  • wheezing
  • severe coughing
  • shortness of breath
  • confusion
  • sluggishness
  • irritability
  • abdominal pain
  • painful urination
  • frequent urination or lack of urination
  • forceful vomiting
  • unusual sensitivity to bright light

Home care for children

Treating a child with chills and fever depends on the child’s age, temperature, and any accompanying symptoms. In general, if your child’s fever is between 100ºF (37.8°C) and 102ºF (38.9°C) and they’re uncomfortable, you can give them acetaminophen in tablet or liquid form. It’s important to follow the dosing instructions on the package.

Never bundle feverish children in heavy blankets or layers of clothing. Dress them in lightweight clothing and give them water or other liquids to keep them hydrated.

Never give aspirin to children under the age of 18 because of the risk of Reye’s syndrome. Reye’s syndrome is a rare but serious disorder that can develop in children who are given aspirin while fighting a viral infection.

You should call a doctor in the case of any of the following:

  • a fever in a child younger than 3 months old
  • a fever in a child age 3 to 6 months, and the child is lethargic or irritable
  • a fever in a child age 6 to 24 months that lasts longer than one day
  • a fever in a child age 24 months to 17 years that lasts longer than three days and doesn’t respond to treatment

Medical treatment for chills

Your doctor will ask questions about your chills and fever, including:

  • Do the chills make you shake, or do you only feel cold?
  • What was your highest body temperature that was accompanied by chills?
  • Have you had chills just once or have you had repeated episodes of chills?
  • How long did each episode of chills last?
  • Did the chills begin after exposure to an allergen, or did they begin suddenly?
  • Do you have any other symptoms?

Your doctor will perform a physical examination and possibly run diagnostic tests to see if a bacterial or viral infection is causing your fever. Diagnostic tests may include a:

  • blood test, including a blood culture to detect bacteria or fungi in the blood
  • sputum culture of secretions from the lungs and bronchi
  • urinalysis
  • chest X-ray to detect pneumonia, tuberculosis, or other infections

Your doctor may prescribe an antibiotic if you’re diagnosed with a bacterial infection, such as strep throat or pneumonia.

Hot water bath.

Hot water half a cup.


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