Chills without a fever: what to know

Shivering is the body's way of producing heat, so a cool room, wet clothing, or exhaustion can trigger it. Anxiety and an adrenaline surge may also cause trembling. A thermometer reading can be normal early in an illness, after fever medicine, or when the infection is limited to one area. Chills with cough or breathing symptoms may occur with influenza or pneumonia; burning urine or side pain may point toward a urinary tract or kidney infection. Travel history matters for malaria or dengue fever.

Move to a warm, dry place, change damp clothes, rest, and drink fluids if you can. Recheck your temperature after resting and record associated symptoms, recent travel, medicines, and when the episodes happen. Eat a regular snack if you may have missed meals, unless you have been told to restrict food. Avoid heavy blankets if you later develop a high temperature. Arrange medical advice if chills keep returning, last beyond a short episode, or come with urinary, respiratory, abdominal, or neurological symptoms.

Get emergency help for confusion, severe weakness, fainting, blue lips, difficulty breathing, severe pain, a stiff neck, or skin that is unusually cold and mottled. Seek prompt assessment after recent travel to a malaria area, especially with sweats, headache, or worsening illness. Do not wait for a fever if you feel seriously unwell; sepsis can develop with an abnormal temperature or no fever.

When did the chills begin, and do they happen after meals or exposure to cold? Have you travelled recently, started a medicine, or noticed cough, painful urination, rash, or unusual fatigue?