Discussions By Condition: I cannot get a diagnosis.

Why does underarm show fever but oral temp doesn't?

Posted In: I cannot get a diagnosis. 3 Replies
  • Posted By: knoxmom
  • December 1, 2008
  • 04:44 PM

Your Open Question

Why is my son's underarm temperature always several degrees more than if I take it orally?
My 13 yr old son gets frequent fevers (he is being observed for possibly having Still's disease.) He can typically tell when he has a fever, and he's always right. However...the majority of the time, his oral temperature will show normal but his underarm temp will show a fever. Sometimes it is 3-4 degrees higher than the oral reading. I have always had this problem with his temp. Does anyone know why this could be or what could cause this? I'm very confused. I've asked drs but they all just look at me like I'm crazy, but yet they never take his temp under his arm. They always take orally or in the ear. Any input would be helpful! Thanks
(Also, when his underarm reflects a fever, he also shows other symptoms: Warm to touch, glassy eyes, general ill feeling, etc)

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3 Replies:

  • Actually, an axillary temperature will typically read about one-half to one degree lower than an oral temperature and a rectal temperature will typically read a degree higher than an oral temperature. Tympanic temperature is about equivalent to oral temperature. The reason for a rather paradoxical presentation in your son might have to do with factors associated with taking his temperature. Axillary temperature is the least reliable from an accuracy standpoint and in order to obtain the actual reading, the armpit should be dry and the person free from any activity or exercise for at least 20 minutes or so. Oral temperatures can be affected by taking in liquids within the period proximal to testing the temperature. As for any consideration being given to Still's disease, are the fevers spiking to high levels around 104? Do you observe any rash that appears extremely red-pink in origin, commonly called a salmon rash, and have any imaging studies been performed to examine the patency of your son's joints and any evidence of deterioration or does he have any arthritic complaints? If these symptoms are not occurring, then AOSD or Still's disease would not likely be the underlying cause for the fevers. A reliable marker of AOSD is measure of glycosylated ferritin: the percentage of this form of the protein is often below the 50% of the total during the flare-up of the disease. The white count and CRP are both typically elevated in AOSD as well. If all of these tests have been performed with negative results and none of the symptoms I've discussed are evident, then the likelihood of Still's disease would be remote at best. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • December 2, 2008
    • 01:12 AM
    • 0
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  • You didn't really answer her question. My responses to anyone on this forum are not for your scrutiny or judgment. I have stated repeatedly that you need to be under psychiatric care and it would be important for you to center your efforts upon discovering why you are fixated upon the notion that unseen forces are invading your body and causing you to be ill. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • December 2, 2008
    • 01:24 AM
    • 0
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  • My responses to anyone on this forum are not for your scrutiny or judgment. I have stated repeatedly that you need to be under psychiatric care and it would be important for you to center your efforts upon discovering why you are fixated upon the notion that unseen forces are invading your body and causing you to be ill. Best regards, J Cottle, MDI cant believe that this comment is called for please show some maturity here...That is just below the belt amazing.....:mad:This is the kind of behaviour that gives your profession a sad reputation.:(You add the words MD to the end of your name and quiet frankly anyone on these boards can do so...We dont know if you are or not...However I always thought that neuros had different letters after there name I could be wrong please let me know if I am...........We really dont know how you are so why would we take your word over anyone elses on this forum....
    Rainbows End 227 Replies
    • December 2, 2008
    • 02:42 AM
    • 0
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