Does your child’s fever keep coming back? Pediatrician Dr Amita Mahajan explains when it could be a sign of leukaemia

Not every childhood fever is a seasonal infection. An expert explains when persistent fever, bruising and fatigue could be warning signs of leukaemia.

Fever is common among children, especially during changing seasons. While most cases are linked to infections, persistent or unusual symptoms may need attention. As September marks Childhood Cancer Awareness Month and September 4 is observed as World Leukemia Day, Dr Amita Mahajan, Senior Consultant, Pediatric Oncology, Indraprastha Apollo Hospital, Delhi, shares with HT Lifestyle the crucial signs parents should watch for.

“Fever is extremely common in children and, in most cases, is related to an infection. However, when fever keeps returning, lasts longer than expected or occurs along with other unusual symptoms, it is important to have the child evaluated by a paediatrician,” says Dr Mahajan.

Signs parents should notice

Leukaemia is a cancer of the blood and bone marrow that can interfere with the production of healthy blood cells. According to Dr Mahajan, some symptoms parents should be mindful of include:

• Persistent or recurrent fever
• Unusual fatigue, weakness or pale skin
• Unexplained bruising, bleeding or frequent nosebleeds
• Bone or joint pain
• Reduced appetite or unexplained weight loss
• Recurrent or unusually persistent infections

In some cancers, including leukemia in children and adolescents, obesity can negatively affect survival outcomes.

When symptoms need further evaluation

A single episode of fever, tiredness or bruising is rarely a reason to suspect leukaemia. However, parents should seek medical advice when symptoms persist, recur or appear together.

“If a child remains unusually tired after recovering from an infection, develops unexplained bruises, has recurrent fever or repeatedly complains of bone or joint pain, it is better to consult a paediatrician rather than repeatedly assuming it is a seasonal infection,” says Dr Mahajan.

Children can experience frequent infections for several reasons, particularly when they are exposed to other children at school or daycare. However, the pattern and duration of these infections can be important.

“Recurrent infections by themselves are not an indication of leukaemia. But if they are unusually persistent or are accompanied by pallor, weakness, bruising, poor appetite or other concerning symptoms, the child should be medically assessed,” Dr Mahajan says.

A paediatrician may recommend a complete blood count (CBC) as part of the initial evaluation, depending on the child’s symptoms and clinical examination.

Why timely diagnosis matters

If initial blood tests show abnormalities that require further investigation, a child may be referred to a paediatric haematologist-oncologist for specialised evaluation.

“Identifying the specific type of leukaemia is important because treatment is tailored to the disease subtype and the child’s overall clinical profile,” says Dr Mahajan. “Childhood leukaemia can be treated with established protocols. Chemotherapy forms an important part of treatment, while other modalities may be used when clinically appropriate.”

Parents should not assume that a child has leukaemia simply because they develop fever, bruising or fatigue. These symptoms are common and can have many other explanations.

“At the same time, persistent or unusual symptoms should not be dismissed as seasonal infections,” Dr Mahajan emphasises. “Leukaemia is not caused by ordinary childhood infections, routine physical activity or parenting. A diagnosis can only be made through proper medical evaluation and investigations.”

What parents need to remember

The aim is not to make parents anxious about every fever, bruise or bout of tiredness. Instead, it is about recognising when a child’s recovery does not follow the expected pattern.

“Parents should look at the overall picture rather than focusing on a single symptom,” says Dr Mahajan. “Persistent or recurrent fever, unexplained bruising, unusual fatigue, pallor, repeated infections, bone pain or unexplained weight loss should prompt a medical evaluation. Early assessment can help distinguish common childhood illnesses from conditions that may require specialist care.”

Dr. Amita Mahajan is a paediatric oncologist based in South Delhi, with over 31 years of experience. She holds an academic background with qualifications including MBBS, MD, and MRCP.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.