Medically Reviewed By William C. Lloyd III, MD, FACS
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What are chills?

Having chills refers to feeling excessively cold, even when you are wearing warm clothing or are wrapped in blankets. When you have the chills, you may also be shivering or look pale.

Chills are often related to fever, an increase in body temperature above normal (98.6 degrees Fahrenheit). Fever is a sign of inflammation or infection in the body.

Part of your body’s response to infection is to create a fever by raising body temperature. Chills are caused by rapid contraction and relaxation of the muscles to increase body temperature. A fever can help to kill infectious pathogens or prevent their spread because most pathogens that cause infection survive best at a normal body temperature.

Chills and fever can be caused by fairly benign conditions, such as a cold, or by serious conditions, such as influenza, malaria or meningitis. Chills and fever are more common in children than adults because even minor illnesses produce a fever in children. Children also tend to get higher fevers than adults.

Exposure to cold temperatures and a low body temperature (hypothermia, a body temperature at or below 95 degrees) can also cause chills as muscles contract and relax to warm the body. Autoimmune and inflammatory disorders, as well as some cancers, can also cause a fever and chills.

Chills can be a symptom of a serious or life-threatening infection or hypothermia. Seek prompt medical care or talk with a medical professional about your symptoms if they persist more than two days or if they cause you concern.

Fever in infants and very young children can quickly become serious. Infants do not usually develop chills, but seek prompt medical care for a fever in a child less than one year old. Seek immediate medical care (call 911) if you, or someone you are with, have been exposed to cold temperatures or cold water or have other symptoms, such as lethargy, difficulty breathing, stiff neck, or confusion.

What causes chills?

Chills are caused by a wide variety of infectious diseases, some of which are common, such as the flu. In some cases, chills can be due to an inflammatory condition, such as an allergic reaction, or an autoimmune disease, such as lupus. Chills and fever can accompany certain cancers as well.

Chills may also be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting, such as hypothermia, which is an abnormally low body temperature.

Common infectious causes of chills

Chills can be associated with many different types of infections, such as:

Other infectious causes of chills

Other infectious causes of chills include:

Inflammatory causes of chills

Chills can also be caused by inflammatory conditions including:

Malignant causes of chills

Chills can also be caused by malignant conditions including:

Questions for diagnosing the cause of chills

To diagnose the underlying cause of chills, your doctor or licensed health care practitioner will ask you questions about your symptoms. You can best help your health care practitioner in diagnosing the underlying cause of chills by providing complete answers to these questions:

  • How long have you had the chills?

  • Have you had a fever? If so, how high was the fever?

  • Have you been exposed to cold temperatures or cold water without proper protection or clothing?

  • What other symptoms do you have?

What are the potential complications of chills?

Chills are usually a sign of an infectious or inflammatory process. In some cases, chills can be associated with a serious or life-threatening condition, such as meningitis or hypothermia. It is important to contact your health care provider promptly when you experience chills. Once the underlying cause is diagnosed, following the treatment plan you and your health care provider design specifically for you can help reduce potential complications including:

  • Brain damage from an extremely high fever

  • Dehydration due to reduced fluid intake, fever, and increased sweating

  • Dehydration due to diarrhea or vomiting

  • Seizures

  • Shock, coma and organ failure

What other symptoms might occur with chills?

Chills are often a sign of fever, which can be caused by a wide variety of infections. Chills can also be caused by hypothermia and other conditions. Chills often occur with other symptoms, which vary depending on the underlying disease, disorder or condition.

Symptoms may occur along with chills

  • Symptoms that may occur with chills include:

  • Aches and pains

  • Cough

  • Diarrhea

  • Earache

  • Fever

  • General ill feeling

  • Hot, dry skin or sweating

  • Lethargy

  • Nausea

  • Rash

  • Sweating

  • Vomiting

Serious symptoms that might indicate a life-threatening condition

In some cases, chills may occur with other symptoms, and certain combinations of symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms:

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Crying inconsolably

  • High fever (higher than 101 degrees Fahrenheit)

  • Pale or bluish coloration of the skin , lips or nails (cyanosis)

  • Persistent watery diarrhea, possibly with blood

  • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

  • Seizure

  • Stiff neck, possibly with nausea, vomiting and confusion

  • Very bad headache

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Dec 3
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Chills.  Medline Plus, a service of the National Library of Medicine National Institutes of Health.
  2. Patient information. Fever in children (beyond the basics). Wolters Kluwer Health.