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Child has constant fever, elevated WBC, SED rate 98. What does this mean?

My 7 year old daughter presented on the 15th with a fever of 102. We treated her fever, figured she was coming down with a cold. After 3 days with the fever ranging from 100 to 102 with tylenol and motrin being administered in the 4 and 6 hours recommended times, I took her to her ped. They did an exam, took blood, and urine. There was no sign of infection with the exam. She looked perfect minus the fever. They said she probably had a virus and it would have to run its course. 2 days later her blood and urine results came back normal. Her fever continued until the 23 - she was down to 98.9 - 99.2 unmedicated. She was fine and fever free from the 23rd through the 1st in which her fever spiked to 103.7. Called the ped, they said that it was possible she picked up another infection, bring her into the office in the morning and they would take a look. We treated her fever again with tylenol(4hrs)/Motrin(6hrs) Before I could get her in for her appointment her fever spiked to 105.7, she was unresponsive, I put her in a luke warm bath to bring the temp down for 10 minutes, gave her motrin, and immediately drove her to the local Pediatric ER. They gave her tylenol, got her an IV and gave her sodium drip (not sure the exact name). Her fever was down within 3 hours to 98.9. They drew blood, took urine, did a chest X-ray . The ER doc said her white count was elevated, which told them she had an infection, however they could not find where, or what, or what was causing it. They suggested a CAT scan of her brain to look for an abscess and mentioned possibly doing a bone scan to look for a bone infection. The CAT scan came back normal. Her fever was steady at 98.9 from 5ish till 10:30 when it went up to 99.1 (medicated) and they sent us home with instructions to see her ped the next am (we were in the ER from 2pm until midnight (fever still 99.1). I took her into her doc the following morning. She woke up with a fever of 102. - we were medicating at this point per the ER doctors instruction alternating tylenol/motrin every three hours. I gave her motrin at 8 am - by the time we got to the office she was 99.0, they did another exam and we talked about getting infectious diseases involved. The doc told me if her fever went to 102.5 or higher to immediately take her to the ER. Her temp stayed between 98.6 and 99.0 for the rest of the day. This morning we were intstructed to bring her back in for more blood work since her fever seemed to be steady. The doc called and said her white cell count at the hospital on the 3rd was in the 17,ooo s and was now (oct 6th) in the high 6000 s however her SED rate was really high 105, she requested they run the test again saying that it seemed as if they made a mistake. The results of the retest came back with white count in the 7000 s and the SED rate 98. Her fever stayed in the 98-99 range again all day today until 8pm in which it started crawling up and is currently steady at 100.6. What does this mean??? Should I be asking certain questions that I am not. Her history - she is a 29 week preemie (twin A), at birth she presented with a grade 3 bilateral IVH with hydrocephalus , she does NOT have a shunt, it resolved without intervention. She has cerebellar hypoplasia (or that is one term they have given us) basically she has a cerebral filled cyst in the place of her cerebellum, her entire cerebellum is missing, however she has the pons and stem. Another term they have given us is an arachnoid cyst.
Asked On : Tue, 9 Oct 2012
Answers:  1 Views:  497
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Lab Tests
Pediatrician 's  Response

Thanks for your query.

I appreciate the details provided by you. It would have been better had you provided all the reports for us to review. The details of differential white cell count are missing which can provide some leads. Was a culture of the blood and/or urine done? Yes, the sedimentation rate is high which suggests some on-going infection which needs to be worked up. In light of your child's neurological history and the constant fever it is better if you hospitalize her where a complete work-up can be done to find a cause of the fever.

I hope I have answered your query to your satisfaction.

Wishing your daughter an early recovery.


Answered: Wed, 10 Oct 2012
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