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5 year child having fever, sore throat, swollen face, excess saliva and ulcer on tongue. Treatment to be done?

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My son is age 5. Last week he developed a fever, sore throat and mouth, a swollen face, excess saliva, raised neck glands, white plaque on his tongue and ulcers on his tongue. The G.P. said it was either Hand, Foot and Mouth disease (there was just one spot at the side of his mouth and some on his bottom) or Oral Thrush and Tonsillitis (he had a bout of tonsillitis one month ago). We completed the prescribed course of Nystatin and antibiotics and he got better. However two days after completing the course he became unwell again. He went back to G.P. today with a sore on his nose, spots around his mouth, and an inflamed throat. The G.P. said that he had some residual infection in his nose and prescribed fucidic acid cream. This evening he had a temp of 38c (which responded to paracetamol), and in addition to the other symptoms a sore mouth and gums that bled when I brushed them very gently (we changed his toothbrush on completion of antibiotics). The problem is not one of oral hygiene as his teeth are brushed twice a day with a child's electric tooth brush. I am not happy with the G.P.'s course of action and would like advice. Thank you.
Posted Mon, 3 Sep 2012 in Child Health
Answered by Dr. Rajiv K Khandelwal 6 hours later

Thanks for your query on XXXXXXX

At this age children tend to get repeated attacks of upper respiratory tract infection which are usually viral in origin. By your description it appears to be a case of upper respiratory tract infection (which encompasses tonsillitis, pharyngitis and even sinusitis). As he has already received a course of antibiotics and anti-fungal medicines I suggest that you get him investigated which should include haemogram and a throat swab culture and sensitivity. Till the results are awaited he should be prescribed the following by his treating GP / Pediatrician:
1. antibiotic depending on what had been given earlier. He can have either azithromycin or erythromycin, if he has not received it earlier.
2. decongestant
3. vitamins B-complex and C
4. paracetamol or acetimophen in case he has fever
5. good oral hygiene

Once the reports are available the antibiotic can be accordingly changed, if required.

Wishing your son a speedy recovery.

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