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Child is having low grade fever, night sweats and leg pain. Test showed raised ESR level. Worrisome

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Pediatrician, Pulmonology
Practicing since : 2003
Answered : 1710 Questions
My child has been having low grade fever with leg aches and night sweat for nearly 10 days. All tests are normal except a slightly raised Esr 24. What should I do?
Posted Sun, 12 May 2013 in Child Health
Answered by Dr. Arun 25 minutes later

Thanks for writing to XXXXXXX

Your kid has got fever of unknown origin. High ESR can occur in any stress/infection. It is not a specific test. That means, high ESR does not indicate any disease or condition specifically.

You need to get your child examined by a pediatrician to rule out hidden focus of infection including further diagnostic workup. It is important to check why there is a rise in temperature. it could be a hidden infection somewhere in her body. So we need to find it first.

Till then, continue giving paracetamol at the prescribed dosing interval.

Wishing your kid good recovery.
Dr Arun
Above answer was peer-reviewed by
Follow-up: Child is having low grade fever, night sweats and leg pain. Test showed raised ESR level. Worrisome 1 hour later
All test results are normal. Crp is 1.24 but Lft,malaria and typhoid have been ruled out. There was nothing in urine/ blood culture either. Got the mantoux done today but as there is no loss of appetite or weight I'm sure nothing will come from it. Chest x XXXXXXX is normal too! Please advise...
Answered by Dr. Arun 14 hours later

Fever persisting for more than 10 days with night sweats, should be investigated fully. malarial tests may not be positive unless done repeatedly during fever spikes. There are other tests like Ultrasound abdomen, Leptospirosis, typhus fever, dengue, etc....which needs to be done in consultation with pediatrician.

Please note clinical examination is must in this condition.

Appropriate workup and if needed hospitalisation may be needed.

Dr Arun
Above answer was peer-reviewed by
Follow-up: Child is having low grade fever, night sweats and leg pain. Test showed raised ESR level. Worrisome 7 hours later
Thank you so much Dr XXXXXXX I will be taking my daughter for ultrasound of abdomen. Clinically too the local doc has found nothing and today afternoon it's 101.7!
She is otherwise ok except for some frequent nose bleeds. Is that significant? She actually has been getting nosebleeds since she was much smaller just that its become frequent this month as in sometimes even 2-3 times in a day. She puts saline drops to keep the nasal lining lubricated.
Thank you once again for your advice.
Best regards,
Answered by Dr. Arun 33 minutes later

I know its difficult with fever running for so long.

The frequent nose bleeds needs to be investigated too. It may not be linked with the present issue of fever. But, make sure her platelet count and coagulation profile are normal. Also get a peripheral smear examination done. I would suggest to continue treatment as advised by your local doctor. But, if fever doesn't go down, better hospitalise her.

Wishing your kid speedy recovery
Dr Arun
Above answer was peer-reviewed by
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