Vomiting and shivering without fever

Shivering can occur when the body is cold, stressed or losing fluid, and a temperature reading may be normal early in an illness. Vomiting with chills can occur with Influenza, Gastroenteritis or another infection. Urinary symptoms or pain in the side can suggest Kidney Infection or a Urinary Tract Infection. Recent travel or mosquito exposure may be relevant to Malaria or Dengue Fever. Pneumonia can cause marked illness with breathing symptoms, while Sepsis is a dangerous response to infection that may worsen quickly; a single normal temperature does not exclude serious illness.

Rest somewhere comfortably warm and take small sips of water or an oral rehydration drink. Recheck your temperature with a reliable thermometer if shivering returns, and note cough, breathing changes, urinary pain, rash, headache, recent travel and insect exposure. Eat lightly when vomiting settles. Wash your hands and avoid close contact while an infection is possible. Do not take antibiotics left over from a previous illness; treatment depends on the cause.

Get emergency help for confusion, fainting, severe weakness, difficulty breathing, blue or grey lips, a rapidly spreading rash, severe headache with neck stiffness, or inability to keep fluids down. Seek urgent medical advice for severe side or abdominal pain, painful urination, very little urine, persistent shaking, or a recent trip to a malaria-risk area with vomiting or chills. If you feel rapidly worse, do not wait for a fever to appear.

Could dehydration, infection or a recent exposure explain the shivering? Do I need urine or other tests? Which changes in breathing, alertness, pain or urination mean I should seek emergency care?