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Suggest Treatment For Recurring High Fever In Children
Question: Hi,
My daughter who is 2 years and 3 months old has been suffering from fever and ear ache from the last two days. What started as mild sneezing and cough 4 days back turned into mild fever and ear ache a couple of days back. The fever was coming upto 101 degrees F and I administered Calpol and the fever would go for 6 hours. But the main problem was my daughter complianing about pain in her ears. We took her to her doctor who tried to check her ears but couldnt confirm ear infection as her ears had ear wax. But since my daughter kept on complaining and crying about ear pain, he prescribed her Azythromycin 200 mg, 3.5 ml a day for the ear infection. For cold he prescribed Relent which Cetrizine Hydrochloride and Ambroxyl Hydrochloride 3ml twice day.
Since then we had given two doses of Azythromycin and 3 doses of Relent. It seems that the pain her ears might have receeded because my daughter has not been crying or complaining about pain in her ears for the last 10 hours. But the fever has gone worse. She now has fever of around 102 every 4 hours. Giving her Calpol 250 mg, 5mL reduces her fever slowly (in about 40 mins) but the fever comes back in 4 hours. At the beginning the fever stayed away for 6 hours with Calpol. What steps should we follow next.
FYI...my daughter had fever like this without ear pain a month back, and it came down after 8 days, with combining Cefropox and Azythromycin anti-biotics.
My daughter who is 2 years and 3 months old has been suffering from fever and ear ache from the last two days. What started as mild sneezing and cough 4 days back turned into mild fever and ear ache a couple of days back. The fever was coming upto 101 degrees F and I administered Calpol and the fever would go for 6 hours. But the main problem was my daughter complianing about pain in her ears. We took her to her doctor who tried to check her ears but couldnt confirm ear infection as her ears had ear wax. But since my daughter kept on complaining and crying about ear pain, he prescribed her Azythromycin 200 mg, 3.5 ml a day for the ear infection. For cold he prescribed Relent which Cetrizine Hydrochloride and Ambroxyl Hydrochloride 3ml twice day.
Since then we had given two doses of Azythromycin and 3 doses of Relent. It seems that the pain her ears might have receeded because my daughter has not been crying or complaining about pain in her ears for the last 10 hours. But the fever has gone worse. She now has fever of around 102 every 4 hours. Giving her Calpol 250 mg, 5mL reduces her fever slowly (in about 40 mins) but the fever comes back in 4 hours. At the beginning the fever stayed away for 6 hours with Calpol. What steps should we follow next.
FYI...my daughter had fever like this without ear pain a month back, and it came down after 8 days, with combining Cefropox and Azythromycin anti-biotics.
Brief Answer:
Acute Otitis Media - wait and watch for 3 days
Detailed Answer:
Hi...By what you quote this seems like a middle ear infection or acute otitis media. You can continue antibiotic Azithromycin for total 10 days.
Regarding fever and pain - Fever of few days without any localizing signs could as well a viral illness too.
Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active.
The old episode of fever could be viral or bacterial. you have used 2 antibiotics for it. Now we have no way of finding out what it was.
Next steps -
1. Wait for another 3 days without changing medications.
2. If fever is still there on 6th day without coming down even slightly - I suggest - do a CBC and Blood culture and urine routine and urine culture.
3. I would even consider hospitalization and Intravenous antibiotics at hat juncture after 6 days based on kid's condition.
Regards - Dr. Sumanth
Acute Otitis Media - wait and watch for 3 days
Detailed Answer:
Hi...By what you quote this seems like a middle ear infection or acute otitis media. You can continue antibiotic Azithromycin for total 10 days.
Regarding fever and pain - Fever of few days without any localizing signs could as well a viral illness too.
Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active.
The old episode of fever could be viral or bacterial. you have used 2 antibiotics for it. Now we have no way of finding out what it was.
Next steps -
1. Wait for another 3 days without changing medications.
2. If fever is still there on 6th day without coming down even slightly - I suggest - do a CBC and Blood culture and urine routine and urine culture.
3. I would even consider hospitalization and Intravenous antibiotics at hat juncture after 6 days based on kid's condition.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much Doctor!!
Yes she is active in between two fever episodes. She plays, and even had a full fledged dinner yesterday night. But the fever just comes at an interval of 4 hours. I dont know how many times I can give her Calpol...6 times a day does look pretty high to me but right now, we are giving her 5 doses of Calpol.
Her Ear pain seems to have reduced just because she has not mentioned it to us in last 10 hours. She was constantly telling us about her ear pain earlier.
We have been prescribed 4 doses of Azythromycin for 4 days. Today evening will be her third dose. Its just that the frequency of her fever episodes have gone up since yesterday evening so that is what has left us worrying.
Could it be the case the bacterial ear infection has resulted viral fever that is still persisting? Even though the ear infection might be treated by the anti-biotic the viral has just gone worse? Do we have any anti-viral medicines available?
Yes she is active in between two fever episodes. She plays, and even had a full fledged dinner yesterday night. But the fever just comes at an interval of 4 hours. I dont know how many times I can give her Calpol...6 times a day does look pretty high to me but right now, we are giving her 5 doses of Calpol.
Her Ear pain seems to have reduced just because she has not mentioned it to us in last 10 hours. She was constantly telling us about her ear pain earlier.
We have been prescribed 4 doses of Azythromycin for 4 days. Today evening will be her third dose. Its just that the frequency of her fever episodes have gone up since yesterday evening so that is what has left us worrying.
Could it be the case the bacterial ear infection has resulted viral fever that is still persisting? Even though the ear infection might be treated by the anti-biotic the viral has just gone worse? Do we have any anti-viral medicines available?
Brief Answer:
No antivirals
Detailed Answer:
Hi..
1. No anti virals are available for trivial viral illness like this.
2. It could be a viral illness initially and got secondarily infected with bacterial in the middle ear.
3. Give Azithromycin for total 10 days.
4. Viral illness with otitis media can have ups and downs in fever for 7 days - Do not worry.
Regards - Dr. Sumanth
No antivirals
Detailed Answer:
Hi..
1. No anti virals are available for trivial viral illness like this.
2. It could be a viral illness initially and got secondarily infected with bacterial in the middle ear.
3. Give Azithromycin for total 10 days.
4. Viral illness with otitis media can have ups and downs in fever for 7 days - Do not worry.
Regards - Dr. Sumanth
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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