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Suggest Treatment For Fever, Cough And Cold
Question: Hi,
My baby is 1 years and 4 month.we stay in XXXXXXX XXXXXXX and my baby's problem started from october.
October month :
My baby is 1 year and 4 month and since October since she turned 1 after every 1 days she gets fever and symptom are of viral fever ( cold,cough,throat and high fever 103) .
Doctor prescribed medication as Meftal-p 8 hourly but then fever came before 8 hours so he recommended fevago 1.4ml 6 hours which can be give after 4 hours of meftal-p
The fever still continued till 4 days and She was not getting better then a Urin test was done where she was detected with pus cells 5-6
then doctor asked for Urine culture and gaveus Antibiotics.As soon as Anti biotics was given by baby started feeling better and till the end of course she was perfect.( we always finished the course)
November month :
Now this was story of October , again in November she showed same viral symptoms high fever /cold runny nose she was again given meftal-p and fevago and cold cure medication.
again she did not got better and Doctor asked for Urine test then again pus cells came she was given Zifi-50.
Again she got better and fine and started eating well
Dec Month:
In the month of December she again for fever with cold and was disagnosed with same Urine infection and again came on Zifi
XXXXXXX Month :
This month in starting she started vomiting & loose motions .Her stool showed infections and she again got Anti biotics and started curing
in last week of XXXXXXX she again got fever / cold and she was again given meftal-p and fevago and cold cure medication.
again she didnot got better and Doctor asked for Urine test then again pus cells came she was given Zifi-50.
Again she got better and fine and started eating well
Now after so many recurring UTI i insisted doctor to diagnose something more then Urine tests and he asked me to do an ultrasound KUB
Reports of KUB was 100% fine
then doctor prescribed a syrup for INDEFINITE TIME that is Sporidex suspension ( 4ml Bed time daily) and said this will stop after DMSA Scan
Now In feb : this month was worst as she got very high fever and cold cough and her doctor was on leave so
we cosulted a diffrent doctor and told her history of UTI(s) he said to first give her fevago/meftal-p and also asked us to go for X-ray ( chest) , blood test : CBC/ CRP Urine routine.
Below are the reports elemets which we marked as BOLD:
XRAY showed : prominent bronchovascular markings bilaterally in lung field
CBC shows : Monocyttes - 16
absolute neutrophil - 7.2
absolutes lymphocyte - 3.5
RDW 13.3
crp qualitative turbidimetry- 4.3
Urine Routine : Pus cells 2-3
Doctor said reports shows Urine infection the blood infection is not high so we will start antibiotics ZIPREX 100
she got better also he gave one multi vitamins to give her daily ( immueboost) and asked us to start Allegrs 3.5ml daily after she gets better.
My Issue is that what is wrong with my baby that she gets fever with cold ( she catches cold very fast) and then it turns into Urine infection.
we are working and Baby goes to day care but the day care is of very very high quality they have CCTV ( live streaming) and hygiene is high.
other kids too are happy and healthy fit there.( they wash my baby well and maids wear disposable gloves when doing this, for baby girl they wipe front to back)
Please help me as this is really getting crazy
also Is DMSA test really required as Sporidex is going on and On.
Please suggest some thing.
My baby is 1 years and 4 month.we stay in XXXXXXX XXXXXXX and my baby's problem started from october.
October month :
My baby is 1 year and 4 month and since October since she turned 1 after every 1 days she gets fever and symptom are of viral fever ( cold,cough,throat and high fever 103) .
Doctor prescribed medication as Meftal-p 8 hourly but then fever came before 8 hours so he recommended fevago 1.4ml 6 hours which can be give after 4 hours of meftal-p
The fever still continued till 4 days and She was not getting better then a Urin test was done where she was detected with pus cells 5-6
then doctor asked for Urine culture and gaveus Antibiotics.As soon as Anti biotics was given by baby started feeling better and till the end of course she was perfect.( we always finished the course)
November month :
Now this was story of October , again in November she showed same viral symptoms high fever /cold runny nose she was again given meftal-p and fevago and cold cure medication.
again she did not got better and Doctor asked for Urine test then again pus cells came she was given Zifi-50.
Again she got better and fine and started eating well
Dec Month:
In the month of December she again for fever with cold and was disagnosed with same Urine infection and again came on Zifi
XXXXXXX Month :
This month in starting she started vomiting & loose motions .Her stool showed infections and she again got Anti biotics and started curing
in last week of XXXXXXX she again got fever / cold and she was again given meftal-p and fevago and cold cure medication.
again she didnot got better and Doctor asked for Urine test then again pus cells came she was given Zifi-50.
Again she got better and fine and started eating well
Now after so many recurring UTI i insisted doctor to diagnose something more then Urine tests and he asked me to do an ultrasound KUB
Reports of KUB was 100% fine
then doctor prescribed a syrup for INDEFINITE TIME that is Sporidex suspension ( 4ml Bed time daily) and said this will stop after DMSA Scan
Now In feb : this month was worst as she got very high fever and cold cough and her doctor was on leave so
we cosulted a diffrent doctor and told her history of UTI(s) he said to first give her fevago/meftal-p and also asked us to go for X-ray ( chest) , blood test : CBC/ CRP Urine routine.
Below are the reports elemets which we marked as BOLD:
XRAY showed : prominent bronchovascular markings bilaterally in lung field
CBC shows : Monocyttes - 16
absolute neutrophil - 7.2
absolutes lymphocyte - 3.5
RDW 13.3
crp qualitative turbidimetry- 4.3
Urine Routine : Pus cells 2-3
Doctor said reports shows Urine infection the blood infection is not high so we will start antibiotics ZIPREX 100
she got better also he gave one multi vitamins to give her daily ( immueboost) and asked us to start Allegrs 3.5ml daily after she gets better.
My Issue is that what is wrong with my baby that she gets fever with cold ( she catches cold very fast) and then it turns into Urine infection.
we are working and Baby goes to day care but the day care is of very very high quality they have CCTV ( live streaming) and hygiene is high.
other kids too are happy and healthy fit there.( they wash my baby well and maids wear disposable gloves when doing this, for baby girl they wipe front to back)
Please help me as this is really getting crazy
also Is DMSA test really required as Sporidex is going on and On.
Please suggest some thing.
Brief Answer:
Both DMSA and Sporidex medicine are required
Detailed Answer:
Hello Mam
I have gone through the detailed clinical history and reports. Report of urine done on 31 XXXXXXX showing 10-15 pus cells. In the presence of symptoms like fever and this urine report diagnosis of UTI is confirm. Blood report is normal for this age. Even chest Xray of normal child may show increased bronchovascular markings. As there are no symptoms related to respiratory symptom presently this X-ray report seems to be normal. Repeated viral respiratory infections are common in infancy. Even 6-8 episodes per year are normal in this age, but this should be upper respiratory tract infection not lower(pneumonia). Like respiratory infection infants are prone to UTI also. But UTI in infant must be taken seriously and as per guidelines of XXXXXXX Academy of Pediatrics first attack of UTI in this age should be investigated properly. Along with culture of urine micturating cystourethrogram (MCU)and DMSA scan should be done to rule out any anomaly causing the UTI. MCU is done to see if there is any reflux of urine going up and DMSA to see any renal scar that may develop due to renal injury.
Infants with recurrent UTI should be kept on low dose prophylaxis of antibiotic like cephalexin(sporidex) for long term to prevent repeated UTI and thus renal injury.
So the present recommendation by your doctor is right and I would suggest you to follow that.
As you have mentioned that the caretakers are maintaining proper hygiene, this is good. This will prevent the infection but as she has repeated episode of UTI as per recommendation prophylaxis is needed.
I hope this answers your query
If you have any further query I will be glad to answer.
Wish her good health
Regards
Both DMSA and Sporidex medicine are required
Detailed Answer:
Hello Mam
I have gone through the detailed clinical history and reports. Report of urine done on 31 XXXXXXX showing 10-15 pus cells. In the presence of symptoms like fever and this urine report diagnosis of UTI is confirm. Blood report is normal for this age. Even chest Xray of normal child may show increased bronchovascular markings. As there are no symptoms related to respiratory symptom presently this X-ray report seems to be normal. Repeated viral respiratory infections are common in infancy. Even 6-8 episodes per year are normal in this age, but this should be upper respiratory tract infection not lower(pneumonia). Like respiratory infection infants are prone to UTI also. But UTI in infant must be taken seriously and as per guidelines of XXXXXXX Academy of Pediatrics first attack of UTI in this age should be investigated properly. Along with culture of urine micturating cystourethrogram (MCU)and DMSA scan should be done to rule out any anomaly causing the UTI. MCU is done to see if there is any reflux of urine going up and DMSA to see any renal scar that may develop due to renal injury.
Infants with recurrent UTI should be kept on low dose prophylaxis of antibiotic like cephalexin(sporidex) for long term to prevent repeated UTI and thus renal injury.
So the present recommendation by your doctor is right and I would suggest you to follow that.
As you have mentioned that the caretakers are maintaining proper hygiene, this is good. This will prevent the infection but as she has repeated episode of UTI as per recommendation prophylaxis is needed.
I hope this answers your query
If you have any further query I will be glad to answer.
Wish her good health
Regards
Above answer was peer-reviewed by :
Dr. Shanthi.E
Firstly Doctor has Just prescribed for DMSA and not MCU as of Now.
Also, as you said "Infants with recurrent UTI should be kept on low dose prophylaxis of antibiotic like cephalexin(sporidex) for long term to prevent repeated UTI and thus renal injury." BUT even after giving her this Daily she suffered from Urine infection though pus cells were low for which I shared Feb urine report. So why is this when she is already on Sporidex.
Also, If DMSA comes normal is this really normalto suffer twice or atleast ones in every month from UTI?
She is on Antibiotics every month for 10 days. Isn't it harming her Immune.
Also, fever is such that she needs fever medication every 4 hours ( Meftal-p / Fevago) too much paracetamol can harm her liver as what i heard .
I hope for curing one thing we are not harming some thing big.
Please reply sir.
Also, as you said "Infants with recurrent UTI should be kept on low dose prophylaxis of antibiotic like cephalexin(sporidex) for long term to prevent repeated UTI and thus renal injury." BUT even after giving her this Daily she suffered from Urine infection though pus cells were low for which I shared Feb urine report. So why is this when she is already on Sporidex.
Also, If DMSA comes normal is this really normalto suffer twice or atleast ones in every month from UTI?
She is on Antibiotics every month for 10 days. Isn't it harming her Immune.
Also, fever is such that she needs fever medication every 4 hours ( Meftal-p / Fevago) too much paracetamol can harm her liver as what i heard .
I hope for curing one thing we are not harming some thing big.
Please reply sir.
Brief Answer:
Don't worry,Urine report is improved
Detailed Answer:
Hello
I can understand your concern. The urine report of feb is showing 2-3 pus cells,previous report was showing 10-15 pus cells.
This time she has clinical symptoms suggestive of viral upper respiratory infection.Increased monocytes in CBC also suggests that it was viral infection.
This suggests that this time fever was due to viral infection not UTI and her urinary infection has improved(2-3 pus cells in the absence of symptoms is normal).
Viral infection does not need treatment with antibiotics. So it is important to differentiate between viral or bacterial infection. CRP is a good indicator to differentiate between viral and bacterial respiratory infection.
Mam, as per recent recommendation MCU should be done 2-3 weeks after diagnosis of UTI in infants and DMSA 2-3 months after treatment. Early DMSA scan soon after UTI is not recommended in daily practice.
So I would suggest you to continue the Sporidex syrup as advised.Go through the guideline of IAP (http://indianpediatrics.net/sep2011/709.pdf) and discuss with your doctor regarding the management. A carefully done urine culture and CRP will help in proper assessment.Also you can discuss with your physician about the justification of antibiotic in viral infection.
Paracetamol can be used 4 hourly. Acute overdose of paracetamol causes liver injury. Otherwise 4 hourly dose of paracetamol does not effect a normal liver.
You can use tepid water sponging initially to bring down the fever and use antipyratic only when temperature is above 100.
If you have more concerns I am here to answer.
Regards
Don't worry,Urine report is improved
Detailed Answer:
Hello
I can understand your concern. The urine report of feb is showing 2-3 pus cells,previous report was showing 10-15 pus cells.
This time she has clinical symptoms suggestive of viral upper respiratory infection.Increased monocytes in CBC also suggests that it was viral infection.
This suggests that this time fever was due to viral infection not UTI and her urinary infection has improved(2-3 pus cells in the absence of symptoms is normal).
Viral infection does not need treatment with antibiotics. So it is important to differentiate between viral or bacterial infection. CRP is a good indicator to differentiate between viral and bacterial respiratory infection.
Mam, as per recent recommendation MCU should be done 2-3 weeks after diagnosis of UTI in infants and DMSA 2-3 months after treatment. Early DMSA scan soon after UTI is not recommended in daily practice.
So I would suggest you to continue the Sporidex syrup as advised.Go through the guideline of IAP (http://indianpediatrics.net/sep2011/709.pdf) and discuss with your doctor regarding the management. A carefully done urine culture and CRP will help in proper assessment.Also you can discuss with your physician about the justification of antibiotic in viral infection.
Paracetamol can be used 4 hourly. Acute overdose of paracetamol causes liver injury. Otherwise 4 hourly dose of paracetamol does not effect a normal liver.
You can use tepid water sponging initially to bring down the fever and use antipyratic only when temperature is above 100.
If you have more concerns I am here to answer.
Regards
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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