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High fever in a child, runny nose. Blood and urine culture test done. Concern regarding what antibiotic dose and other diagnosis?

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Practicing since : 1982
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Hello doctor,
i have a daughter who is 2 n a half yrs old.she is havin high grade fever since today morning and running nose since last one week.investigations wise she is havin high TLC (17,100) with 91% neutrophil count on DLC. her ESR is 23. her CRP is negative and urine routine n microscopy is normal.we have also sent blood n urine culture n their reports shall come after 48 hrs. my concerns r as following :
1. shall i start my daughter on an antibiotic n if yes which one n at wat dose. her weight is 12 kgs.
2. im really worried about Rheumatic fever.i hope n pray my daughter is not suffering from that.
3. any other investigation would u like to suggest.
4. wats d likely diagnosis.
Posted Mon, 21 May 2012 in Child Health
Answered by Dr. Taher Kagalwala 2 hours later

It seems that you are a doctor yourself. Thank you for the query.

Based on the history and investigation, it might be good to start her on antibiotic like co-amoxyclav. The usual dose would be 50-90 mg /kg / day.

This picture is not of a streptococcal infection; those infections generally have more of oral congestion and pain on swallowing and not much of cough and so on. Also, the age is slightly small for a Rheumatic fever to develop from a throat streptococal infection. So don't worry about this.

This looks like a bacterial pharyngitis or it might be accompanied by tonsillitis.

What does her throat and chest show clinically?
Also, I would like to know just how "high" was her high grade fever - Was it above 39C or 102.4F?
Have you tried sponging her with lukewarm water all over her body to bring down the temperature?

Do give paracetamol at least 6 ml/dose (120 mg/5 ml concentration). Use it up to 3-4 times in 24 hours. Do not force her to eat. Use a simple oral decongestant to reduce her misery. Avoid decongestant nose drops.

I think this should help her. Let me know if you have any further concerns.

Take care.

Wishing your daughter quick recovery,

Dr. Taher
Above answer was peer-reviewed by
Follow-up: High fever in a child, runny nose. Blood and urine culture test done. Concern regarding what antibiotic dose and other diagnosis? 12 hours later
Thanks for d reply doc.ya im a dentist myself. my daughters fever was as high as 103 DEG F yesterday n ya we indeed did cold sponging and have already started her on augmentin syrup. clinically her throat is normal as well as her chest.d fever has also come down today n infact since last 3 hrs she is nt havin any fever.i have a oral decongestant by d name of MAXTRA containin phenylephrine n chlorphenermine.can we use it. thanks once again.
Answered by Dr. Taher Kagalwala 8 minutes later

Thank you for your reply.

Never do cold sponging to reduce fever unless it is over 103 F. The reason is that cold water constricts the skin vessels and reduces the heat loss by conduction and convection, which will be easier if the skin vessels are dilated. Use lukewarm water instead.

”Maxtra” is okay, and you may use it. The ideal dose for someone like your daughter would be 3.5 ml thrice a day.

I hope she is all right soon. Let me know if you need any more assistance.
If you're convinced with my response, please close this discussion and rate my answer doctor.

Take care, and good day, Dr!

Above answer was peer-reviewed by
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