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Child felt warm, given Calpol. Blood test suggested. Appreciate a second opinion

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Pediatrician, Pulmonology
Practicing since : 2003
Answered : 1803 Questions

My daughter is 25m old and normally keeps very good health she weighs 11.6kg & her height is 85cms.

Tuesday morning she felt warm and by the evening her temperature shot upto 39.7 despite giving her calpol during the day.

So I rushed her to the doctor who thoroughly checked her and she seemed absolutely fine. Her ears, mouth, chest,eyes, palm & feet all seem ok. I requested the doctor to put in a suppository to bring the temperature down. Since then I have been giving her calpol and the suppository as prescribed by the doctor but the temperature seems to keep climbing back up as soon as the effect of the medication fades away. She seems happy as long as the medication has its effect but starts to get cranky soon after.

She doesn't seem to have a cold/cough/any pain. She occasionally puts her fingers in her mouth and chews on them not sure if she is teething as she already seems to have all her teeth.

The doctor has asked us to come back with a blood test if her temperature doesn't settle by Saturday.

I would appreciate a second opinion.

Posted Thu, 13 Sep 2012 in Growth and Development in Children
Answered by Dr. Arun 34 minutes later

Thanks for the query and I will work to provide some useful recommendations.

I understand that your daughter has been having high fever for last three days.

The fever also seems to be high grade. High grade fever is very common in girls when there is Urinary infection and she may clinically look normal on examination. It can be evident on blood and urine testing.

I am not sure if dengue, malaria and typhoid are common in the place where you live. If yes these should be ruled out. If you had traveled in the past one month along with your daughter let your doctor know about it.

I would suggest you not to panic. Your daughter is active and playful between fevers. This is a good sign.

Since it is been there for few days, a review by the doctor would be helpful. There can be signs now which could be missed during the earlier visit. As your doctor suggested blood and urine tests are necessary at this stage. Let me know the tests and results I may add few possibilities.

Dr Arun
Above answer was peer-reviewed by
Follow-up: Child felt warm, given Calpol. Blood test suggested. Appreciate a second opinion 27 hours later

I have uploaded a PDF copy of the bloodwork that was done, the additional lab request from her GP, and I have also uploaded photos of urine that we have collected from her (not sure if you can tell anything from images alone...) We will be going to another lab today to get the bloodwork re-done, and analysis performed on a fresh sample of urine.

She visited her GP today, who confirmed during the visit she has a haemoglobin count (hence the reason for redoing the bloodwork in case there is an error). Her GP was very surprised at the low count as she is generally a very active child.

We are based in Singapore, so as a tropical country it does have some cases of malaria/dengue. She did have a few mosquito bites on her last Friday (17th Aug), but her fever started on Wed (22nd Aug) - should we also check for malaria/dengue? Should we ask the clinic to review for that as well?

Any other guidance/insight you can provide would be greatly appreciated as we are quite concerned.

Thanks and regards,
Follow-up: Child felt warm, given Calpol. Blood test suggested. Appreciate a second opinion 4 minutes later
I should add that her GP has now prescribed Zinnat (antibiotics) for her to take - 5ml twice a day.

Answered by Dr. Arun 2 hours later
Thank you for writing back and uploading the reports. Your daughter does probably have a urine infection. The most prudent thing here would be to continue the antibiotic. Also, give her plenty of water and some cranberry juice. These things have been shown to hasten recovery.
As of now, the platelets are normal. So while malaria and dengue cannot be ruled out, we should only reserve them as a 2nd line diagnosis. If she does not respond to the antibiotic within 5 days, we would need to check her for that as well. Please keep a watch for other signs of malaria and dengue like small blood spots on the skin ( it would look like a rash), bleeding from any site, and severe body ache/malaise.
In all probability, she should be responding to this drug and should be better very soon.
As far as the low haemoglobin is concerned, it could probably be due to iron deficiency or worm infestation. We would need to give her a deworming regimen ( mainly consisting of the drug mebendazole/albendazole). You will need to get this prescribed from your physician. We should also be including plenty of iron XXXXXXX foods in her diet like red meat, egg yolks, dark, leafy greens (spinach, collards), dried fruit (prunes, raisins), beans, lentils, chick peas and soybeans and liver. In addition, please speak with your physician about adding an iron supplement.
Do not worry. I am sure your daughter would be absolutely fine very soon.
Let me know if you have any other concerns.
Above answer was peer-reviewed by
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