Ah, four days is definitely on the longer side, I think most doctors here would say that if the fever is still spiking to 39.5°C by day four or five even with paracetamol, it's worth going back to see someone rather than waiting it out at home. Someone in my mum group mentioned that the general rule of thumb is if fever crosses 39.5°C consistently or your child suddenly becomes very lethargic, develops a rash, or stops drinking fluids, those are the signs to head to the ER rather than the polyclinic. On the other hand, if he's still reasonably alert, eating a little, and the paracetamol is bringing the temperature down within the hour, some parents do monitor one more day, but at five years old and day four, I personally would not wait much longer. Make sure you're dosing the paracetamol by his weight, not just his age, because that makes a real difference in how effective it is. That said, every child is different, so please do check with your paediatrician directly, they can assess properly whether this is viral or something that needs further investigation.
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