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Injury, High Temperature, Vomiting, Urine Glucose, Blood Stick, Motrin, Tylenol. Diabetes?
Question: My 4 year old son was in the ER for an injury and very high temperature afterwards (under arm was 103.0 and didn't seem to react well to motrin/tylonol) and also had vomiting. On a random urine test they noticed glucose in his urine and after a blood stick it read 162. He has no symptoms of diabetes and is very athletic and rarely gets sick. Could this be a form of diabetes or was this due to him being so sick? His temp got as high as 104+ under the arm. The doctors did not clarify much saying without fasting we wouldn't know. He did have a glass of coke when we thought he was feeling better before he puked, spiked in fever and off to the ER. Docs said not to worry and call the GP which will see us in a week.
Hi Thanks for the query.
Can you give me some more info regarding your son's symptoms.
1.What kind of injury did he have?How long and ago?
2.After how long did he develop fever?Was is associated with chills/rigors/burning urination?
3.Do you have any family history of diabetes?
4 Any other symptoms like vomitting,diarrhea,abdominal pain etc?
Awaiting your reply.
Regards,
Can you give me some more info regarding your son's symptoms.
1.What kind of injury did he have?How long and ago?
2.After how long did he develop fever?Was is associated with chills/rigors/burning urination?
3.Do you have any family history of diabetes?
4 Any other symptoms like vomitting,diarrhea,abdominal pain etc?
Awaiting your reply.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for the quick reply. Basic break down:
5/14 @ 2:30pm My eldest daughter took him to the playground across the street from our house. My son asked a preteen if he could have the swing and the boy kicked my son pretty hard in the stomach. He came home about 10 minutes later (but wasn't crying) and told me what happened and after eating half a sandwich he said he wanted to take a nap (atypical for him) and slept for 2 hours. When he woke up he was bright red and had a blazing fever. I called my friend who is an ER nurse and said she didn't feel/hear anything and to keep an eye on him and to give him tylonol and motrin. After a dose of each and another 2 hours later he stilld idn't break his fever and began vomiting (this would be about 5ish) He began to complain further about his stomach and now his head was hurting him so we threw in the towel and brought him to the ER.
7:00pm - Midnight he was was still very feverish and would spike than his fever would dip a bit but would come right back. They decided to go with an ultrasound and an xray (for fear of radiation of a CAT scan, i'm told) both were clear.
He was very flu like, with shivers, cold fingers and so forth. No problems with urination.
Finally this morning his fever broke and he seems 90% back to normal.
Lastly there is no history of diabetes in my husband or my family that we are aware of. We usually do not allow our kids much junk food and because he was feeling so ill when he seemed to perk up (what we thought) we felt so sorry for what he had been through that we let him have a cup of pop and a marshmellow. Just like any other kid he's had plenty of candy and so forth in his time ;)
Thank you so much for your quick response.
5/14 @ 2:30pm My eldest daughter took him to the playground across the street from our house. My son asked a preteen if he could have the swing and the boy kicked my son pretty hard in the stomach. He came home about 10 minutes later (but wasn't crying) and told me what happened and after eating half a sandwich he said he wanted to take a nap (atypical for him) and slept for 2 hours. When he woke up he was bright red and had a blazing fever. I called my friend who is an ER nurse and said she didn't feel/hear anything and to keep an eye on him and to give him tylonol and motrin. After a dose of each and another 2 hours later he stilld idn't break his fever and began vomiting (this would be about 5ish) He began to complain further about his stomach and now his head was hurting him so we threw in the towel and brought him to the ER.
7:00pm - Midnight he was was still very feverish and would spike than his fever would dip a bit but would come right back. They decided to go with an ultrasound and an xray (for fear of radiation of a CAT scan, i'm told) both were clear.
He was very flu like, with shivers, cold fingers and so forth. No problems with urination.
Finally this morning his fever broke and he seems 90% back to normal.
Lastly there is no history of diabetes in my husband or my family that we are aware of. We usually do not allow our kids much junk food and because he was feeling so ill when he seemed to perk up (what we thought) we felt so sorry for what he had been through that we let him have a cup of pop and a marshmellow. Just like any other kid he's had plenty of candy and so forth in his time ;)
Thank you so much for your quick response.
OK thanks for the information
First, i would like to say that in fever after injury the first thing that needs to be ruled out esp in kids is infection.In your son's case, i believe that infection can be ruled out. I would have advised the abdominal ultrasound but i suppose that's been done.
Secondly, fever with chills, vomitting, stomach pain etc indicate infection also but possibly a stomach flu as you rightly concluded. Most often these infections run themselves out after 48-72hrs. I dont believe that you need to worry much about that.
Thirdly, diabetes had nothing to do with fever. As your son's doctor has indicated, just a random sample of blood sugar cannot diagnose diabetes. A proper fasting and post prandial sample needs to be tested. Juvenile diabetes as its called,is a very difficult disease to live with and i would suggest that you have the recommended tests done. One thing to remember is that diabetes patients carry infection faster than non diabetics.
At present, if there is no fever then you should rest easy. But the diabetes needs to be ruled out. Up until that can determined, i suggest you monitor his food/drink intake and cut down on the extra calories. Obviously kids need energy but intake needs to be monitored. Esp the candy/pop/areated drinks.
This may all seem over whelming at this point but no need to panic yet.
Let the results come in and the next course of action can be determined from there.
Regards,
First, i would like to say that in fever after injury the first thing that needs to be ruled out esp in kids is infection.In your son's case, i believe that infection can be ruled out. I would have advised the abdominal ultrasound but i suppose that's been done.
Secondly, fever with chills, vomitting, stomach pain etc indicate infection also but possibly a stomach flu as you rightly concluded. Most often these infections run themselves out after 48-72hrs. I dont believe that you need to worry much about that.
Thirdly, diabetes had nothing to do with fever. As your son's doctor has indicated, just a random sample of blood sugar cannot diagnose diabetes. A proper fasting and post prandial sample needs to be tested. Juvenile diabetes as its called,is a very difficult disease to live with and i would suggest that you have the recommended tests done. One thing to remember is that diabetes patients carry infection faster than non diabetics.
At present, if there is no fever then you should rest easy. But the diabetes needs to be ruled out. Up until that can determined, i suggest you monitor his food/drink intake and cut down on the extra calories. Obviously kids need energy but intake needs to be monitored. Esp the candy/pop/areated drinks.
This may all seem over whelming at this point but no need to panic yet.
Let the results come in and the next course of action can be determined from there.
Regards,
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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