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Child getting fever frequently. Blood test done. Are the prescribed medicine safe and effective?

Answered by
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Dr. Uma Rajah Ananth

Pediatrician, Neonatology

Practicing since :1970

Answered : 891 Questions

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Posted on Fri, 1 Feb 2013 in Child Health
Question: My baby is 2 years and 2 months old. He has been getting fever repeatedly for the last 6 days. Now somewhat stable for the most of hours but fever still strikes back. I have got his blood tested and found MP -ve, Blood Sugar 98mg, HGB 10.2g/dL, ESR 52, WBC 6.50/10^9/L, MID% 17.11%, RDW-CV 24.51%, MPV 15.00 fL, PDW 7.30%, P-LCR 64%, LIST IS LONG AND Scanned copy of blood test can be emailed, if required. He had been prescribed 1st - DOLO-250 (paracetamol 156.25 mg / 5ml. tsp) 4ml twice / thrice a day depending upon fever ALONG
WITH 2nd - Levolin (contains Levosalbutamol & sulphate IP equally) which is 1mg / 5ml, 3rd - Augmentinn (Amoxycillin Trihydrate IP 460mg equivalent to Amoxycillin 400, Potassium Clavulanate IP 68mg - (as Potassium Clavulanate diluted IP equivalent to 57mg) AND 4th - Ambrolite - D (contains Dexthromethorphan Hydrobromite IP 10 mg, Citrizine Hydrochloride IP 5 mg, Phenylephrine Hydrochloride IP 5 mg, Menthol IP 1.5mg).
doctor
Answered by Dr. Uma Rajah Ananth 2 hours later
Hi XXXXXXX,

From what you have written very nicely and in detailed manner,
The possibilites are

Viral infection with wheezing.- viral bronchitis- although augmentin is given ,viruses do not respond to any antibiotics and will take their own course.
He should recover by a week but cough will persist for a week more!


Malaria has been ruled out by blood test.
If fever persists he should be tested for typhoid though unlikely.
Has dengue been ruled out?.

Please give the platelet Count result again in writing ( scan is not clear)

On the whole I think he should start showing improvement by now!
I know you have a bad weather there now!
Avoid exposing him to cold blast and cover the ears when you take him out!

Good luck

Gid bless
Dr Uma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Uma Rajah Ananth 7 hours later
1. This is congestion type of problem which i felt as a layman, which my son is suffering from along with the problem explained to you in the starting. he has less frequent coughs with a sound of phelgum (mucus type of thing) in his chest.

2. Moreover, the complete blood test report of 2 pages enclosed (fresh uploads 1 pdf & 1 jpg file) for your ready reference. IT IS REQUESTED TO YOU PLEASE provide information for the factors Shown as less/more in the blood report. How much fatal each individual factor is in my son JASKARAN's case.
Thanks & Regards,
-XXXXXXX
doctor
Answered by Dr. Uma Rajah Ananth 4 hours later
Hello,
Congestion as you say is a common term. Causes may be many-
Bronchitis,pneumonia,or just lower respiratory infection.
After the fever subsides phlegm will reduce gradually but will take some more time.

Reg the lab tests
1-The child has mild anemia with low mcv ,low mchc which are suggestive of like serum iron,iron binding capacity,ferritin,and blood smear study.
On the other hand we can give him a course of iron for 6-8 weeks and then repeat the simple CBC test which you have done now and look for improvement.
By the way, is there any family history of blood diseases like Thalassemia in your family?
2- he has high ESR which suggests infection anywhere in the body.
This goes with his present chest infection and we have to repeat this test also later after his present Chest infection clears.
If it is persistently high after 6-8 weeks, we have to think of other causes like tuberculosis and inflammatory conditions.

3 platelets are normal. You need not worry about the other platelet parameters .


4 blood sugar is normal

5-Widal test is written in a peculiar way by hand.It is not clear whether it is positive or negative

Take care
Dr Uma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Uma Rajah Ananth 2 days later
Respected Doctor,

1. Regarding Thalassemia - there no such history in the family.
AND Widal test is -ve.

2. As i explained you the course of medicines my son was having, it ends on 6th January which was for 5 days
And now his cough occurance comes down is twice or thrice a day maximum From 6-8 times. Phelgum has also got reduced as it sounds lesser than before when he coughs.

3. At what time should we go for CBC. Should we go now as we ends up with the course of medicines on 6-jan.

4. What type of Course of Iron you give for 2years & months old baby.
Kindly prescribe.

And What will be the right time to start Course of Iron as we ends up with the
five days medicines explained to you on 6-jan only.

5. serum iron,iron binding capacity,ferritin,and blood smear study - Should we go for these tests RIGHT NOW or AFTER that Course of Iron.

PLEASE ENSURE THE TIMINGS I REQUESTED, in 4th and 5th point.
Thanks & Regards,
XXXXXXX


doctor
Answered by Dr. Uma Rajah Ananth 5 hours later
Hi,
Good that there is no family history of thalassemia.

Good that his cough is coming down this is expected.

You nave to do the tests now by XXXXXXX 15th and then start on iron.
This is to confirm the diagnosis.

If you have any problem in doing the tests ,you can start on iron straightaway after XXXXXXX 15th.
Also give him iron XXXXXXX food like, palak,egg yolk twice a week,ragi XXXXXXX etc.

Iron syrups are plenty like Feviron,,Globac -z etc,ferose.etc.
We are not authorised to prescribe as on line doctors- please get it prescribed by your doctor .
Any other good brand is also OK.
take care
Dr Uma




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Uma Rajah Ananth 2 days later
Respected Doctor,

1. Should i go for the same CBC and ESR tests only
OR
Should i also includer serum iron,iron binding capacity,ferritin,and blood smear study.?

Regards,


doctor
Answered by Dr. Uma Rajah Ananth 3 hours later
Hello,
You have to do both CBC, ESR and the other tests of serum iron,iron binding capacity,ferritin and blood smear study ,all at the same time pricking the baby once!
As I said earlier wait for complete clearance of infection and fever of present episode before you do the tests.

God bless
Dr Uma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Uma Rajah Ananth 2 hours later
Respected Doctor, Thanks for your precious opinion.

1. Fever is Ok means normal since 6-jan. We stopped anti-biotics after 5 days course of Augmentin. Dolo-250 was given only upto 4 days, now stopped.

2. We are continued with Ambrolite -D 4ml. twice a day which is De-congestent ALONG WITH Livolin 4ml. twice a day for more 5 days (from 6 to 10 Jan).

3. Now cough is still there arround 3-4 times a day with sound of phelgum from chest approximately same or say 90% of what it sounds on 31st Dec. What much better is the way to treat this cough Specially phelgum which sounds in chest.
I repeat here Fever is normal since 6th of XXXXXXX

4. One More Thing, his toungue is showing some white layer on it for which we are giving Candid Drops 4 drops Thrice a day with some time difference after Ambrolite-D and Livolin

5. Can we take Iron tonic along with the Ambrolite-D and Livolin with some time difference?

Regards,
XXXXXXX
doctor
Answered by Dr. Uma Rajah Ananth 7 hours later
Hello,
1-good !
No need for doll anymore.

2 these two are for cough and wheezing.- follow your doctor's order.

3nothing more you can just ty some steam inhalations carefully
Cough takes more time!

4- Iam surprised !I rather think it is a coated tongue from these illnesses.
Take care of mouth hygiene.
Give some general tonic like A-z syrup once a day (1 tsp)( multi vitamin and multi mineral tonic)

5 yes ,no problems.

Good luck
Dr UA
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Uma Rajah Ananth 26 hours later
Respected Doctor,
Thanks for your learned opinions, Further...

1. Today is the last day of Ambrolite-D and Livolin. Cough is same
with sound of phelgum in chest.

2. New CBC & ESR YET TO BE conducted along with iron tests you advised for.


3. we have got Tonic Ferrobic-XT prescribed as 5ml twice a day - which contains
Ferrous Ascorbate, Folic Acid, Vit B12 & Zinc suspension.

4. My QUESTION is.... Can we carry on A-Z syrum 1tsp a day (multi-vit and Multi-mineral tonic)
ALONG WITH ...Ferrobic-XT -folic/zinc tonic.?????????

Thanks & Regards,
XXXXXXX
doctor
Answered by Dr. Uma Rajah Ananth 19 minutes later
Hi,
1- may be wheezing is still there.
Let some doctor check with steth for wheezing - if there continue levolin alone for another 10 days.
Even other wise with decreasing cough,do not get worried.
2-OK do when advised earlier after a week or so.
.No hurry.
3- give the iron tonic with zinc plus Becosues syrup or visynerol.( other tonics). These contain minimal amount of various vitamins only.

God bless
Dr Uma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Uma Rajah Ananth 45 hours later
Respected Doctor,
Thanks for your learned opinion once again.

1. My 4th point in previous query was-
Can we carry on A-Z syrup 1tsp a day (multi-vit and Multi-mineral tonic)
ALONG WITH ..............Ferrobic-XT -folic/zinc tonic.?

Also please tell a-z syrup for how long.............?
AND fow how many no. of days either of these three Iron tonic like Ferrobic-XT or Fevilon or Globac-z can be given.....?

2. and for a growing child like him, as at this age child don't like to eat all necessary nutritious food. SHOULD the aforesaid course of Tonic / Iron be repeated in the next year too.?
doctor
Answered by Dr. Uma Rajah Ananth 56 minutes later
Nd iron studies Hello,

1 A- z syrup contains only little iron a d has little of everything.
So it can be given for ever as a general tonic/supplement till the age of atleat 5 years.

2- for iron tonic you give any one of the iron tonics for 3 moths along with A-z ,
Then you do the CBC,and blood tests and then decide.

3 meanwhile build up nutritious food mixed with fruits and vegetables.

4-I suggest you do the cbc and iron studies now by 15 the XXXXXXX and let me know.

5 - iron and a-z can be given irrespective of other medicines.
Stop them temporarily f there are loose stools.
Also start iron with one tsp daily after food and the after a week you can increse to 1 tsp twice a day.
Iron can also cause constipation,black stools.- do not worry.
Thanks

Regards

Best wishes to Jaskaran!

Dr UA
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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