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Infant with high fever, wet cough and nasal discharge. Need to go to emergency?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
feverMy son has had a on and off again fever of 101.9 since last night. he also has a wet cough and runny nose. my son is 10 months old and i dont know if i should take him to the emergency room or not
Posted Fri, 27 Apr 2012 in Child Health
Answered by Dr. Hema Yadav 3 hours later
Thanks for posting your query.
Fever of 101.9 would be considered moderate fever and when associated with running nose and wet cough it is suggestive of a respiratory infection either viral or bacterial.
However for it to be serious enough or requiring emergency treatment, any or some of the following must be noticed
1. Fast breathing as indicated by more than 60 breaths per minute or associated with excessive flaring of nostrils with breathing.
2. Bluish Discolouration of skin in extremities, or excessive flushing with cold clammy extremities (hands and legs.
3.Temperature >102_103 or persistent fever even after giving antipyretic medications in maximum doses.
4.Refusal to feeds, not passing adequate urine , irritability or excessive crying/fatigued (lethargic).
5.Wheezing or stridorous sounds during breathing indicating bronchoconstriction and airway obstruction.
All these indicate a lower respiratory infection (pneumonia, bronchiolitis etc) more than a cold or flu or upper respiratory infection.If you notice any of these then its better to consult a pediatrician/ER promptly.
If your child is feeding well with normal hydration, cheerful in between as fever subsides, or responds to antipyretics (acetaminophen or ibuprofen or mefenamic acid)& not showing any of above you may wait for a routine appointment.
It is not mentioned whether the fever has responded to any antipyretics (if given).
I assume that these symptoms are present since less than 48 hrs and no medications have been
started.Considering this I would advise you to ,
1.first and foremost control the fever by starting antipyretics like acetaminophen (tylenol, paracetamol etc) in prescription doses( usually10_15 mg/kg/dose ).You may do tepid water sponging or gently wipe his body with wet towel to cool his temperature .
2 Give him plenty of water, milk or breast feed to prevent dehydration.
3.You may use nasal saline drops in each nostril 6_8 hourly to prevent nose block and congestion.Even steam inhalations may help loosen up the mucus and relieve cough.
4 Make the child sleep in a slightly propped up bed or semi recliining positon to ease breathing.
5.You may use cough expectorants and decongestant medications containing ambroxol and chlorpheniramine respectively if prescribed by his pediatrician.
If still you find the symptoms persists after such treatment then its best to undergo thorough evaluation and investigation by his pediatrician and a course of antibiotics as per prescription.
Hope I have answered your query.
I ll be awailable for any follow up queries or doubts.
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