What Causes Fever and Headache Together and How It’s Treated

The combination of a fever and a headache may be a sign of a serious infection. Or they may be signs of a run-of-the-mill viral infection that simply needs to run its course.

The article discusses both infectious and non-infectious causes of a headache with a fever. It also covers other possible symptoms and when you should see a doctor.

Meningitis

Meningitis is an inflammation of the meninges, the protective membranes around the brain and spinal cord. Meningitis is usually caused by viruses or bacteria, but it can also be caused by some medicines or non-infectious illnesses.

While any type of meningitis can be serious, viral meningitis tends to be less severe than bacterial meningitis.

Symptoms

In addition to a severe, generalized headache and a high fever, symptoms of meningitis may include:

• Neck stiffness
• Nausea
• Vomiting
• Confusion
• Rash
• Sensitivity to light
• Joint pains
• Seizures

A person who has meningitis typically will not have all of these symptoms. If you think you may have symptoms of meningitis, seek immediate medical care.

Treatment

With viral meningitis, there is no specific treatment. Most people recover on their own from viral meningitis after a week to 10 days. An antiviral medication could help if the meningitis is caused by certain viruses such as influenza or herpes virus.

Bacterial meningitis is treated with antibiotics. Because bacterial meningitis can be a serious, life-threatening infection, it’s important to start treatment as soon as possible.

Encephalitis

Encephalitis is an infection of the central nervous system that may be caused by a virus, bacteria, or fungus.

The key difference between meningitis and encephalitis is that meningitis is inflammation of the lining around the brain and encephalitis is inflammation of the brain itself. Both meningitis and encephalitis can cause abnormalities in brain function leading to confusion and seizures.

Encephalitis is a serious, life-threatening disease that needs immediate medical attention. Severe cases lead to death in about 10% of patients.

Because the two can be so difficult to differentiate, doctors sometimes use the term “meningoencephalitis.”

Symptoms

In addition to fever and headache, symptoms of encephalitis include:

• Joint pain
• Muscle weakness
• Stiff neck
• Nausea

Encephalitis causes symptoms with brain function as well, including:

• Confusion
• Behavior changes
• Sensitivity to light
• Difficulty speaking
• Trouble moving
• Memory issues
• Loss of consciousness
• Seizures

Treatment

Treatment depends on the type of encephalitis you have. If it’s a bacterial infection, antibiotics should be prescribed. For viral infections, antiviral medications may be given.

Other treatments may depend on the severity and effects of the illness. Steroids may be given to reduce swelling and brain pressure.

Cold or Flu

Influenza, commonly known as “the flu,” mononucleosis "mono", and the common cold can cause fever and headache. These illnesses are caused by viruses that spread easily from person to person.

Mono is usually mild, and the flu can cause mild symptoms or severe illness. In some instances, it can be serious enough to be life-threatening, especially for those over 65, people with chronic illnesses, and newborns.

Symptoms

Along with fever and headache, other symptoms of the flu or mono may include:

• Chills
• Cough
• Stuffy or runny nose
• Muscle aches
• Fatigue (tiredness)
• Vomiting or diarrhea are possible (more common in children)

When you have a cold, the symptoms can be similar to the flu. Fever and headache are possible but less common with a cold than with the flu.

Symptoms of a cold include:

• Sneezing
• Runny or stuffy nose
• Sore throat
• Cough

Treatment

Often, the best treatment for a cold, the flu, or mono is to stay home, get lots of rest, and drink lots of fluids. Over-the-counter medications like acetaminophen and ibuprofen may also help with a headache and fever.

If you have the flu, your doctor may be able to prescribe antiviral drugs. These can reduce the amount of time you’re sick by a couple of days and decrease the chance of complications.

Physicians don’t prescribe antibiotics for a cold, the flu, or mono since they’re not effective against viruses. However, if you get a complication from the cold or flu, such as a bacterial sinus infection, you might need an antibiotic.

Brain Abscess

A brain abscess is a rare, but potentially life-threatening condition, in which infected fluid collects in the brain.

A headache from a brain abscess occurs as a result of elevated intracranial pressure as the abscess continues to grow and take up space.

Symptoms

Symptoms of a brain abscess can resemble that of meningitis or encephalitis. In addition to fever and headache, symptoms include:

• Neck stiffness
• Chills
• Vomiting
• Confusion, trouble focusing, or sleepiness
• Weakness
• Language problems
• Loss of muscle function, usually on one side
• Vision changes
• Seizures

Treatment

Medication may be the first step if the abscess is less than 2 centimeters or the abscess is deep in the brain. This can include antibiotics or antifungal medication, depending on what caused the infection. Diuretics, which reduce fluid, may also be used to decrease swelling in the brain.

Surgery may be needed to drain the abscess if it’s larger than 2 centimeters or if it might rupture.

If the abscess is deep, needle aspiration guided by CT or MRI scan may be used to drain the fluid.

Sinus Infection

A sinus infection, or sinusitis, is the swelling or inflammation of the lining in your sinuses. Your sinuses are hollow spaces behind your forehead, eyes, and cheeks that connect to your nasal passages.

The sinuses make thin mucus that drains out of the nose. When they become blocked with fluid, bacteria can grow and cause an infection. This extra mucus could be caused by a cold or allergies.

Symptoms

A bacterial sinus infection can give you a fever and a sinus headache, which you may feel around your eyes and forehead.

Other symptoms include:

• Facial tenderness or swelling
• Ear pain
• Tooth pain
• Thick nasal discharge

Treatment

If you have bacterial sinusitis, a week or so of antibiotics, rest, fluids, and steam should clear it up quickly. Very rarely sinus infections lead to other complications like a brain abscess, meningitis, blood clot, or osteomyelitis—an infection of the facial bones (especially the forehead).

If you are diagnosed with a sinus infection, be sure to follow up with your healthcare provider if your fever persists while taking antibiotics.

Heatstroke

Heatstroke is the most severe form of heat-related illness. It happens when your body overheats to over 104 degrees F and you aren’t able to sweat enough to cool your body down. It can be life-threatening and requires immediate medical attention.

Symptoms

The symptoms of heatstroke include:

• High body temperature (over 104 degrees F)
• Headache
• Hot, dry, and flushed skin
• Lack of sweat
• Muscle cramps
• Nausea
• Vomiting
• Dizziness
• Delirium
• Unconsciousness

Treatment

Heatstroke is a medical emergency. Call 911 if you suspect heatstroke.

While waiting for medical help, try cooling the person’s body as quickly as possible. Get to a shady, cool area. Have them lie down and elevate their feet. Apply cold water to the skin and then use a fan to help cool the body quickly.

In the emergency room, intravenous (IV) fluids will be used to replace fluids lost.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) causes pain, stiffness, and swelling in the joints. It’s an autoimmune disease, which means that it happens when the immune system attacks the body’s own healthy tissues. In some cases, it can cause fever and headaches.

Symptoms

RA can occasionally cause mild fevers. It can also cause headaches, particularly if it affects the cervical spine.

Other symptoms include:

• Neck or back pain
• Swelling of joints
• Warmth around joints
• Weakness
• Fatigue

Treatment

Treatment for RA typically includes disease-modifying antirheumatic drugs (DMARDs). These can slow the progression of RA by modifying your immune system. Biologic agents are sometimes used to control inflammation in rheumatoid arthritis.

HIV or AIDS

HIV (human immunodeficiency virus) damages your immune system by attacking a type of white blood cell that fights infections.

If HIV isn’t treated, it can lead to AIDS (acquired immune deficiency syndrome). AIDS is the final stage of HIV infection in which the immune system is severely damaged.

Early HIV or AIDS can cause many different symptoms. Headache and fever are possible symptoms of both.

Symptoms

Symptoms of early HIV infection can happen two to four weeks after exposure to the virus. These early symptoms are estimated to affect 50% to 90% of those infected.

Early HIV symptoms include:

• Fever (above 100.4 degrees F)
• Headache
• Sore throat
• Muscle and joint pain
• Rash that occurs two to three days after fever

If HIV isn’t treated, it weakens your immune system and can lead to AIDS. At this stage, you’re more likely to develop “opportunistic infections,” severe illnesses that your body can’t fight off. Depending on the infection, symptoms can include fevers, shortness of breath, blurred vision, and weight loss.

Treatment

While there isn’t a cure for HIV, medications are available to control it. Antiretroviral therapy (ART) involves taking a daily combination of HIV medications. This reduces the amount of HIV in the blood and helps protect the immune system.

Lupus

Lupus is an autoimmune disease. It can cause swelling and pain throughout your body. Your symptoms can be minimal at times and flare up at other times, suddenly becoming more severe.

Symptoms

Headaches are a common symptom for people with lupus. In a 2021 study, 54% of patients with lupus reported having primary headaches, with migraines the most common.

Reoccuring low-grade fevers are also common before a lupus flare or oncoming illness.

Other symptoms include:

• Joint stiffness, pain, or swelling
• Fatigue
• Swelling in the hands or feet
• Sensitivity to light
• Chest pain when taking deep breaths
• Hair loss
• Sores in the mouth or nose
• Butterfly-shaped rash on cheeks and nose

Treatment

There is no cure for lupus, but different types of medications are available to treat symptoms and manage the illness. Some medications can help treat swelling and pain. Others help prevent the immune system from attacking tissues in the body.

For mild pain and fevers, your physician may suggest over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen.

Corticosteroids such as prednisone can help reduce pain and calm the immune system. They may be prescribed in either low or high doses, depending on the severity of the illness.

Antimalarial drugs such as hydroxychloroquine and chloroquine phosphate may also be prescribed. In addition to treating malaria, they help treat joint pain, fatigue, and lung inflammation with lupus.

Other Causes

There are also less common causes of the combination of fever and headache. Some of them are rare, and some may cause a headache or fever, but do not usually cause that combination.

Your healthcare provider might consider these causes if your symptoms are unusual or if the initial testing and treatments for more common causes don't provide answers or relief.

Conditions may include:

• Giant cell arteritis: Also called temporal arteritis, this is an inflammatory condition of the arteries that run under the scalp. It can cause pain, vision changes, and a fever.
• Sarcoidosis: This inflammatory condition is not common. Neurosarcoidosis can cause inflammation in or near the brain, potentially causing neurological symptoms, and it may cause a headache. A fever is not a common sign of sarcoidosis.
• Pituitary apoplexy: This is a rare condition that occurs when the blood supply to the pituitary gland is blocked or when there is bleeding of this gland. It can cause a headache, nausea, vomiting, vision changes, fever, and loss of consciousness.
• Brain tumor: A primary brain tumor that starts in the brain or a metastatic brain tumor that spreads to the brain from somewhere else In the body can cause a headache and neurological symptoms (such as vision changes or weakness). This doesn't usually cause a fever.
• Osteomyelitis: Inflammation or an infection of bone may affect the skull or upper spine, causing a headache with a fever. This is not a common condition.
• Subarachnoid hemorrhage: A blood vessel rupture can cause a severe headache, often with changes in consciousness. A fever is not a typical symptom of this life-threatening condition.
  

When to See a Doctor

If you have a fever and headache, you may need to get medical care to determine the cause. Call your doctor to let them know your symptoms.

Go to the doctor right away if you experience any of the following:

• A severe headache
• A headache that doesn’t go away with medication
• Fever and/or headache that are persistent
• Headache and fever that get worse instead of improving
• Headaches and fever that happen more often than usual

Seek immediate medical care if you have fever and headache along with:

• Stiff or painful neck
• Rash
• Vomiting
• Confusion
• Fainting
• Vision changes
• Loss of muscle function
• Difficulty speaking or moving
• Seizures

You should also go to the emergency room for extremely painful headaches that occur suddenly. These are called thunderclap headaches because they can appear suddenly like a crash of thunder.

Some thunderclap headaches can occur because of a problem with blood vessels in the brain. This can include a stroke or a brain aneurysm.

Summary

Having both a fever and headache can be signs of an infectious or non-infectious condition. Some illnesses may be mild, such as the common cold. Others can be serious, or even life-threatening, such as meningitis or a brain abscess.

Call your doctor if you have any questions about what could be causing your headache and fever. Let them know if you have new or concerning symptoms, or if they’re persistent or getting worse. Seek emergency care for any severe symptoms.

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