Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
167 Doctors are Online

Child has fever and abdominal pain, no diarrhea or tenderness. CBC normal. What could this be?

DOCTOR OF THE MONTH - Sep 2012
Sep 2012
User rating for this question
Excellent
Answered by

General & Family Physician
Practicing since : 2008
Answered : 1416 Questions
Question
my 6 year old daughter has had a high fever with abdominal pain for 3 days centralized around her belly button, no rebound tenderness, no diarrhea, no N/V. just got back from the ER. CBC is within normal limits. her symptoms scream appendicitis to me, but WBC's are within normal limits. the IGE's are WNL as well. what could it be? ER dr just scratched his head, gave her milk of magnesia and sent her home. she has never had a constipation problem and goes 2-3 times daily. plus, constipation doesn't cause fever. any suggestions?
Posted Wed, 20 Mar 2013 in Child Health
 
 
Answered by Dr. Das Arindam 22 minutes later
Hello,

Thank you for posting a query.

Look, her symptoms are really indicative of acute appendicitis. Fever is indicative of an acute inflammation due to any infection. In acute appendicitis, rebound tenderness may not be present. That does not exclude acute appendicitis. In many cases, it is diagnosed just depending upon the clinical suspicion.

Apart from acute appendicitis, typhoid infection may also present with these symptoms.

So, a detailed clinical examination is the basis of diagnosis. You have told that WBCs are within normal limit. Apart from that a routine urine examination is also very important.

Now, irrespective of the test reports, a broad spectrum antibiotic like cefixime group of drug should be considered. For fever a paracetamol group of drug should be considered.

So, it would be better to consult with her regular doctor for a detailed clinical examination and for better management accordingly.

Hope this information suffices. Let me know, if you have any more queries.

Regards.

Above answer was peer-reviewed by
 
Follow-up: Child has fever and abdominal pain, no diarrhea or tenderness. CBC normal. What could this be? 8 minutes later
she did have a urinalysis as well which came back normal. The ER nurse didn't seem convinced either and wasn't very supportive of the dr. she recommended i follow up with my pediatrician in the morning or even bring her back for a CT this afternoon once a new dr. is on shift.

Is it possible that in an acute appendicitis that the WBC's are within normal range?
 
 
Answered by Dr. Das Arindam 10 minutes later
Hello,

Thank you for writing back.

Look, in case of any acute infection WBCs are increased. But in case acute appendicitis, it may be normal. In our clinical experience we have seen such patients.

As the urine analysis is normal, most likely, it is acute appendicitis.

So, it would be better to follow up with your pediatrician in the morning.

Hope you have your answers.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Child has fever and abdominal pain, no diarrhea or tenderness. CBC normal. What could this be? 1 minute later
thank you! i appreciate your fast replies! i'll follow up with my pediatrician in the morning.
 
 
Answered by Dr. Das Arindam 2 minutes later
Hello,

Thank you for writing back.

Yes. You should consult with your pediatrician in morning.

If you do not have any more question then you can close this discussion.

Rating and review given by you will be appreciated.

Regards.
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to

The user accepted the expert's answer

Ask a Pediatrician

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor