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Child has low grade fever and puffy eyes. Mono test negative. What's wrong?

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General & Family Physician
Practicing since : 2009
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my Daughter is 10 she has had a fever for 14 days, some low grade 99-100 some over 103. I have had her at the doctor 3 times in 2 weeks. They thought she had mono. They said her white blood count lands in that area. She has a puffy face and seems to get splotchy on and off. The mono test came back negative today and she still has a fever. We don't know whats wrong and I was wondering if anyone has any ideas?
Posted Wed, 6 Mar 2013 in Infections
Answered by Dr. Luchuo Engelbert Bain 3 hours later
Persistent high-grade fever with a suspicious white blood count in favor of Mono, even if the test came back negative, could still be in some cases, due to Mono. Most tests generally used are not 100% effective in detecting the disease.
Other causes of fever and puffy face especially in this case need to be considered. A complete blood count might need to be re controlled. It could be interesting to know the nature of the puffy face, where it swells only in the mornings and gets to normal during the day or even, or remains swollen all day. Most cases of fever and puffy face are generally due to a kidney infection called acute glomerulonephritis, or rarely at times, a liver lesion.
Kidney function tests and liver function tests could be quite helpful in better evaluating the origin of these symptoms.
A fever evolving for over two weeks with no specific sources of infection could be evaluated to look for causes of fever of unknown origin. Detailed physical examination and other examinations like chest x rays are usually needed.

I propose you to visit a pediatrician for a more critical evaluation and some laboratory examinations for some common infectious diseases and conditions that could be involved with this fever. However, Mono is still one of the options in the diagnostic possibilities, but the addition if puffing of the face needs a more critical and specialist expertise.
Thanks as I hope this helps.
Thanks and best regards,
Luchuo, MD.
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