Cold hands and feet during a fever: what to know

During chills, the body can narrow blood vessels near the skin while the core temperature rises. This may make hands and feet feel cold even when the forehead or chest feels hot. Shivering, tiredness and muscle aches can accompany an infection. The fever itself does not identify the infection; common cold, COVID-19, acute bronchitis and other illnesses can have overlapping symptoms.

Cold extremities are more concerning when they occur with unusual sleepiness, confusion, breathing difficulty, severe pain, a rash that does not fade with pressure, or skin that is blue, grey, very pale or mottled. In a child, feeding difficulty, reduced responsiveness or fewer wet nappies also matters.

Check the temperature with a reliable thermometer and observe alertness, breathing and fluid intake. Offer frequent drinks; for a child, use age-appropriate fluids and continue feeds if tolerated. Dress comfortably and use light layers during chills, avoiding ice baths, very hot water bottles or heavy wrapping. Use fever medicine only as directed for the person’s age and health, and never give a child aspirin unless a clinician has advised it.

Seek emergency help for difficult breathing, blue or mottled skin, confusion, collapse, a seizure, severe dehydration, or a person who is hard to wake. Get prompt medical advice for a fever with a concerning rash, severe headache, stiff neck, persistent vomiting, worsening pain, or a very young infant. Trust a clear deterioration even if the measured temperature is not high.

Ask what temperature and symptom changes should prompt review, which fever medicine is safe, and how much fluid is suitable. Tell the clinician when the fever began, the highest reading, recent travel or exposure, medicines taken, and whether urine, breathing or alertness has changed.