Fever treatment in Phuket
A temperature in the tropics is a symptom, not a diagnosis, and the list of things it could be is longer here than at home. Fever treatment in Phuket starts with working out which one you have, because dengue, a chest infection and heat illness are managed in completely different ways.
What causes fever here
The differential is wider than most travellers assume, and several items on it need excluding rather than waiting out.
- Dengue, which is common and seasonal
- Ordinary viral illness picked up in transit or on a flight
- Gastrointestinal infection from food or water
- Chest and sinus infections
- Urinary infections, particularly in women and with dehydration
- Skin and wound infections, which start fast in this humidity
- Typhoid, and occasionally chikungunya or Zika
- Heat illness, which produces a raised temperature without any infection at all
The travel history matters too. Somewhere rural, somewhere with malaria, or an animal bite all change the list.
What tells you which it is
Severe aching with pain behind the eyes points at dengue. Cough and chest pain point at a respiratory infection. Burning on passing urine points at the urinary tract.
Vomiting and diarrhoea point at the gut. A hot, red, spreading patch of skin points at a wound infection somebody had stopped thinking about.
Fever with no localising feature at all, lasting more than two or three days, is exactly the situation blood tests exist for — see blood tests.
The features that mean now rather than tomorrow
A rash that does not fade when a glass is pressed over it. Neck stiffness with a headache and dislike of light. Breathing difficulty. Confusion or a struggle to stay awake. A convulsion.
Any of those, at any temperature, is an emergency — see emergency medical care.
So is a fever in anyone with a suppressed immune system, in a baby under three months, or in someone who has become genuinely unable to keep fluid down.
Bringing a temperature down
Paracetamol at the correct dose and interval. Cool fluids in steady amounts. Light clothing and a fan rather than a blast of air conditioning.
Where dengue has not been excluded, paracetamol only. No ibuprofen and no aspirin, because of the effect on platelets — see dengue fever treatment.
Cold baths and alcohol rubs do not help and make people shiver, which raises temperature rather than lowering it.
Antibiotics, and when they are pointless
Most fevers here are viral, and antibiotics for those achieve nothing beyond an upset stomach and a contribution to resistance.
They are given where there is a bacterial source — a chest infection, a urinary infection, an infected wound, a confirmed bacterial gut infection.
Buying them over a counter and taking a guess is common in this region and is a bad idea, not least because it makes any later test harder to interpret.
Half a course left over from a previous illness is worse still. Too short a course at the wrong dose selects for exactly the resistant bacteria you would rather not be carrying, and it treats nothing properly on the way.
Heat, which imitates infection
A body temperature can rise from heat alone, particularly after a long day outdoors with too little water and too much sun.
Heat exhaustion produces a raised temperature, headache, nausea and weakness with no infection anywhere. Cooling and fluid fix it.
Heat stroke — a temperature above forty with confusion or unconsciousness — is a genuine emergency — see heat exhaustion treatment.
Children with a temperature
How the child looks matters far more than what the thermometer says. Alert, drinking and recognisable is reassuring at any reading.
Floppy, breathing fast, not drinking, or a rash that does not blanch is not, and needs seeing immediately.
Any fever in a baby under three months goes to a hospital paediatric department without debate — see paediatric care.
Fever that will not go away
Past five days without a clear cause, investigation rather than more paracetamol is the answer. Typhoid, an abscess and less common tropical infections all present this way.
Blood counts, inflammatory markers, cultures and imaging where needed. Most of it is available the same day.
Where a hospital admission is what is needed, that is arranged with the results attached — see hospital transfer.
Being assessed without going anywhere
Somebody with a high temperature should not be sitting in a car. A doctor attends, examines, takes bloods and starts treatment in the room — see doctor hotel visits.
Where daily monitoring is needed, as with dengue, that continues at your accommodation rather than requiring a journey each day.
All three branches are open continuously for anyone who would rather come in.
Take a photograph of the thermometer readings with the times, if somebody is well enough to be keeping track. A pattern across two days tells a doctor considerably more than one number taken in a waiting room, and it is the sort of detail that occasionally makes the diagnosis on its own.
Documentation and travel
Fever ruining days of a trip is claimable with the right report, stating diagnosis, onset and the period involved — see travel insurance claims.
Flying with a significant fever is inadvisable and airlines occasionally refuse to board someone visibly unwell.
Where travel needs deferring, the certificate that lets a policy cover the change is issued at the same visit — see fit to fly certificates.
Ring the insurer’s assistance line before rebooking anything. Several policies will only pay for changes they authorised in advance, and a flight moved on your own initiative can end up being a flight you paid for twice.
Frequently asked questions
How high is too high?
The number matters less than the person. Confusion, breathlessness, a non-blanching rash or neck stiffness are urgent at any temperature.
Is it dengue?
Sudden high fever with pain behind the eyes and deep aching suggests it. A blood test the same day settles the question.
Can I take ibuprofen?
Not until dengue is excluded. Use paracetamol only, because ibuprofen and aspirin affect platelets.
Do I need antibiotics?
Only with a bacterial source — chest, urine, wound or a confirmed gut infection. Most fevers here are viral.
When should I get tested?
Fever past two or three days with no obvious cause, or any fever with warning features. Results come back the same day.
Could it just be the heat?
Yes. Heat exhaustion raises temperature with no infection at all. A fever over forty with confusion is heat stroke and an emergency.
My child has a fever.
Watch the child rather than the thermometer. Any fever in a baby under three months goes straight to a hospital paediatric department.
Can somebody come to my room?
Yes — examination, blood tests and treatment on the spot, at any hour, with daily review where that is needed.
Three clinics, none of which close
English-speaking doctors, on duty 24 hours a day. Phuket is bigger than visitors expect and the traffic is worse than the map suggests, so Takecare Medical Clinic works from three separate buildings rather than one: Bang Tao on the north-west coast, Kata in the south, and Patong between them. Each is open every hour of every day, takes people without an appointment, and asks nothing about residency or referrals.
Beyond the island, Takecare Medical Clinic is one of the Takecare Clinic group‘s clinics working across Phuket, Krabi and Chon Buri. That matters mainly for what happens afterwards: move on mid-treatment and the next clinic already holds the notes, so a handover is a call between colleagues rather than a folder you carry through an airport.
Getting seen, and how to choose a branch
There is somebody on the end of +66 81 718 9080 or WhatsApp 24 hours, every day. Say what has gone wrong and the reply will be honest about which of three things you are dealing with: come in now, this will keep until the morning, or skip us entirely and go where there is a surgeon. No appointment exists to be made, and there is no hour at which asking is a nuisance.
Pick whichever branch is nearest rather than whichever sounds largest — they run the same hours and carry the same equipment. Patong suits the west-coast beaches and Bangla Road, Kata covers Karon and the south, and Bang Tao serves Layan, Surin and Cherngtalay. Cannot get out to a clinic? Ask for a doctor hotel visit instead and somebody comes to your room. And if what you need turns out to be beyond any clinic, referral and hospital transfer is arranged from the same conversation. You are made stable before anybody moves you, a colleague rings ahead so the team on the other end knows what is arriving, and the transport is organised for you rather than handed over as one more thing to sort out.