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Suggest Treatment For Persistent High Fever In A Child

Posted on Mon, 27 Mar 2017

Question: My son is 9 year old.his gallbladder was removed at the age of 2 year due to gallstone.2 monthago,his LFT test was normal.on 23-2-2017 he has fever measuring 103.5,doctor said that it is viral fever or bactirial and gave antibiotic cefpodoxime and paracetamol and mefenamic acid,but on 27-2-2017 his condition become worse with joint pain,fatigue,loss of apetite and fever.doctor said he should be hospitalized and done some test. Tlc count-1300, hb-14 gm.(rbc,dlc count all are normal) Platelets-99000,crp-negative, dengue-negative,typhoid-negative,vitamin d- 7.7, Bilrubin-0.7 sgot-164,sgpt-174,alkaline phaspotate-215 hepetitis A-negative, hepetitis B-negative. hepetitis C-negative Whole abdomen ultrasound-normal On 1-03-2017 his fever,joint pain,fatigue all are gone,he is felling well another test done TLC count-3500 (improve) hb-14.5 gm(rbc and dlc count normal Platelets count-115000(improve) ,only sgot level-210 and sgpt-215 are increase,so what is the reason of high sgot and sgpt if his all hepetitis test are negative and ultrasound report are normal and no symptoms,Is medication is the cause or vitamin d deficiency is the cause or high fever is the cause

Answered by Dr. T Chandrakant (36 minutes later)

Brief Answer:
Looks to be due to influence.

Detailed Answer:
Hi.
Thanks for your query and an elucidate history about your 9 year old son.
I have read the whole history well and understood the concerns.
As per the information you have provided, the cause looks to be Viral/flu that has caused all the symptoms, affected the bone, marrow, joints as also the liver.
With time the symptoms improved, blood tests show improvement but the SGOT and SGPT are still elevated.
Liver recovery takes more time than other parts of the body hence the reports. These will recover with time of a few weeks.

Hepatitis A/B/C are specific viral disease and hence can be detected only if the person is infected with either of the mentioned viruses.
Since there are many more reasons of hepatitis and when in force all the three tests just mentioned will be negative if the causative factors are different.

With the history you have provided, the cause looks to be influenza virus affecting the whole body hence liver too got affected and thus the tests for liver enzymes are also positive.

It is highly difficult to say whether the medications caused this or not - does not look to be as other symptoms would not have been that severe and the medicines given are not much known to cause hepatitis.

Vitamin D deficiency or high fever are not known to cause hepatitis.

I hope, this answer helps you, please feel free to ask for further relevant queries if you feel that there is a gap of communication

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

Follow up: Dr. T Chandrakant (2 days later)

Hello doctor,thanks for your answer, Today again test done. TLC-9500(normal). Hb-14 gm, platelets-182000(normal),sgot-32,sgpt-80,now only problem is that he sometime felling fatigue,is it due to vitamin d defeciency. Doctor said that he should be given vitamin d injection after 3-4 days but i search on internet that vitamin d supplement is better than injection.what is your opinion doctor

Answered by Dr. T Chandrakant (46 minutes later)

Brief Answer:
Post Vitamins D report along with normal range...

Detailed Answer:
Thanks for your feedback.
Nice to know the blood parameters improved well.
How much is Vitamin D and also give the normal range of that particular lab -, best is to post a scanned report attached to this query.

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

Follow up: Dr. T Chandrakant (45 minutes later)

His vitamin d level is=7.7 (20-50 normal),rickets-negative, symtoms-sound in joint during sleeping and sometime feeling fatigue

Answered by Dr. T Chandrakant (1 hour later)

Brief Answer:
As discussed in details below.

Detailed Answer:
Vitamin D of 7.7 is deficiency hence needs therapeutic dose and the correct dose can be calculated and given by his Pediatrician.
It is available in Oral forms like powder and capsules and since this is fat soluble vitamin, it is unpredictable to know how much will be absorbed by the intestine to reach the blood; hence many Doctors prefer to give in injection form so that it is certain how much will be absorbed.
What is the strength of Vitamin D as advised?

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Prasad