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Having Fever. Prescribed XUCLOV DUO -DS And Zyrcold Syrup. Developed Ulcers. Suffer Pain. Lower Lips Swollen. What To Do?

Posted on Sun, 6 Oct 2013

Question: My son was having fever since 12th sep. It started with 100°C and then by afternoon it went upto 104°C. That the doc was not there. The next day we took him to a Pediatretian, and he gave the following medicines ( XUCLOV DUO -DS SYRUP - 457 MG and antibiotic alongwith NOZUKA and Zyrcold syrup( a5 days course). after taking for 3 days he developed ulcers in his mouth which is quite painful and he couldnt eat anything. We called up the doctor to ask but he was unavailable , and his asst doc said apply mouth ulcer gel (zytee) and continue with the antibiotics . Is it right to do so as earlier also he was not comfortable with this medicine even though the fever subsided. Pls advise . He is in utter pain and his lower lips has swollen with ulcers spreading .his eyes are also a little bit swollen?

Answered by Dr. Dr. Prasad J (1 hour later)

Brief Answer:
I concur with your doctor's treatment...

Detailed Answer:
Hi,

Bacterial infection unlike common virus present with high grade fever. Though no test was performed, it is definitely better to treat such high grade fever emperically with broad spectrum antibiotic. Your doctors have done the same by starting on Xuclov Duo.

Now, the most common side effect of this drug is allergic response and abdominal problems. The mouth ulcer may not be related to drug.

Oral ulcers is again a common complaint during infection. Infective organisms combined with low nutrition is usually the causative factor and not the medications. I would suggest you to continue ulcer gels. If zytee is not helpful, you can try alternative dologel CT gel. In addition, I also recommend that he takes zincovit syrup - this vitamin supplements will benefit him.

Hope this helps. Let me know if you need clarification.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (1 hour later)

Thanks doctor for your prompt reply,

From your reply I understand that I continue with the medications that he is taking now. Also he had asked us to go for blood test which we had done and seeing the report he said that he has slight infection which should get solved by this medications But my question is he is not ready to eat anything with this ulcer at all, how can he be given such strong antibiotics . From 12th sept onwards he already had 1.1/2 bottles of Meftal P , alternatively with Retherma also. On 13th he was given this XUCLOV... Zyrcold , and Nozuka ( he is not having cold ) and till today ie;17th he is continuing with this medicines. For a little child of 5 yrs so much medications is too much I think so and still he is not getting complete relief . I will attach the blood report tommorrow for your reference also . I will definitely start with Zincovit syrup as you said ,but please advise is it good for the small child to hv so many medications?

Answered by Dr. Dr. Prasad J (59 minutes later)

Brief Answer:
Antibiotic should be taken for 5 days minimum...

Detailed Answer:
Hi,

I understand your concern. But as far as antibiotics are concerned it is classified based on spectrum of action. What you feel is strong is very mild to another child. The tolerance varies between individuals. Moreover as I mentioned in my previous reply, the mouth ulcers is usually the effects of medicine and nutritional deficiency rather than medication alone.
I encourage all my patients with infection whether they are treated with antibiotic or symptomatic drugs to drink plenty of fluids and consume healthy fruits and vegetables.

In your child's case, zincovit should benefit him. You may continue Xuclov as of now untill I review his test reports.. Zyrcold and nuzuka can be withheld if he doesn't have nasal congestion now. Meftal P can be taken as and when he develops fever.

Beside the medications, you can apply Dologel CT to the ulcer. It has pain reducing potentials. Encourage him to eat less spicy semisolid food or a liquid diet.

Hope this helps. Let me know if you need clarifications.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (18 hours later)

Good morning doctor,

I have attached the blood reports of my son XXXXXXX for your reference,
Yesterday he was feeling much better .
Please have a look and give your valuable opinion.

Answered by Dr. Dr. Prasad J (15 minutes later)

Brief Answer:
No attachments...

Detailed Answer:
I am sorry something must have gone wrong while you uploaded. I don't find any reports attached here. You can try and upload the reports again. Alternatively you can mail the reports to attachments@healthcaremagic with subject as "Attn:Dr. Prasad - query 0000"

I am glad that he is better now. Encourage him to drink and eat better.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (57 minutes later)

Hello dr XXXXXXX

I have tried again to upload , and also alternatively send you the report from my official mail id .

Please go through the same and advise.

Answered by Dr. Dr. Prasad J (24 minutes later)

Brief Answer:
Report suggest possible bacterial infection and...

Detailed Answer:
Hi,

I was able to review the report. The test done a day after fever reveals neutrophillia and traces of proteins and ketones in the urine. This suggest possible bacterial infection and that he wasn't eating properly before testing.

Though there are other possible explanations for these changes, in this circumstances the aforementioned possibility is most likely.

Antibacterial treatment with antibiotic use is appropriate in this case. We can stop Xuclov tomorrow once the 5 day course is over and hope he continues to get better.

You can continue zincovit syrup for a few more days say about 7-10 days and encourage him to eat well and drink lots of fluids.

Thank you and regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (2 minutes later)

Hello doctor,

Your answer is incomplete it seems bacterial infection and......???
I am eagerly waiting for your complete answer.

Answered by Dr. Dr. Prasad J (3 minutes later)

Brief Answer:
Apologies...

Detailed Answer:
I have completed my last reply... Please read above...

I will be glad to answer and clarify if you have any more doubts.

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar