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Child Has Fever And Abdominal Pain, No Diarrhea Or Tenderness. CBC Normal. What Could This Be?
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?
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.
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 :
Dr. Chakravarthy Mazumdar
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?
Is it possible that in an acute appendicitis that the WBC's are within normal range?
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.
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 :
Dr. Chakravarthy Mazumdar
thank you! i appreciate your fast replies! i'll follow up with my pediatrician in the morning.
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.
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.
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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