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Child having persistent low grade fever and swollen tonsil. Started cough and runny nose. Worrisome

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ENT Specialist
Practicing since : 2001
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my 4 years' old girl has a persistent low grade fever (37-38 c)since 2 weeks ago. Starting with cough and runny nose, she also has swollen tonsil on 1 side and white patches on the other side. She already taken 2 sets of antibiotic, first with claneksi and cefixime. She's also on honey lemon. loratadine and lapifed dm. Her fever always came in late afternoon around 4-7 pm. Appetite and activities are normal. so worried that her illness may be more serious that we dont know yet.
Posted Tue, 16 Oct 2012 in Child Health
Answered by Dr. Naveen Kumar 1 hour later


Thanks for posting the query

After going through your description, I do feel your daughter is suffering from either poorly treated acute upper respiratory tract infection or infectious mononucleosis.

Do not worry! With appropriate intervention the infection can be controlled.

My advice to you is:
1. To encourage your child to drink plenty of warm water, this helps in reducing the throat congestion and the infection.
2. Get a throat swab done to look for the antibiotic for which the child is sensitive to.
3. Also, she will require blood tests such as complete blood count, ESR and monospot test to rule out infectious mononucleosis.
4. Use saline nasal spray and steroid nasal spray (such as fluticasone or momentasone) to keep the nose moist and to help in clearing of the nasal secretions.
5. Try giving a mucolytic such as bromhexine or ambroxol, this reduces the consistency of the nasal secretions and cough.
6. Correct dosage of paracetamol for controlling the fever and the pain.

With these above measure the infection can be taken care of.

Hope I have answered your queries; I will be available for the follow-up queries.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
Follow-up: Child having persistent low grade fever and swollen tonsil. Started cough and runny nose. Worrisome 21 hours later

Please see attached reports on the blood test. According to our local doctor, my daughter's illness is viral based. He told us to wait for another 3 days to see if the fever will subside by itself. If not then he suspect we may have to do Tuberculosis test on our daughter.

Please study the reports and let me know what you think about it. Even at this point she is still having a mild fever at about 37.5 Celcius (26 September, 10PM local time)
Answered by Dr. Naveen Kumar 17 hours later

Thanks for writing back

According to the blood report it is a viral infection. There is mild elevation of the CRP which indicates active infection and the presence of elevated lymphocytes indicates viral infection. Your doctor is on the right track; get an ESR (erythrocyte sedimentation rate), chest x-ray (to look for upper lobe consolidation in the lungs), Monospot test (to rule out infectious mononucleosis) and Mantoux test (to rule out tuberculosis).

Also, follow the measures discussed in the previous response. Request your doctor to start the antibiotic cefuroxime (10-14 days regimen), this will take care of the respiratory tract infection.

Hope this answers your query; I wish her good health.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
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