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Regular high fever, test showed pus cells, stomach pain and loose motion. What medicine can be given?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
XXXXXXX Baby 21 Months She is getting high fever at Regular interval of 15-20 Days from last 3 Months prior to that she is very fine. Current test says Weight 11.5 Kg Age : 21 Month Pus Cells 4-6/hpf R.B.C. 3-5/hpf S.G 1.030.she is having stomach pain from last 3 Days & loose motion ( 5 to 7 Times )along with fever . Medicen given but no relief. Kindly suggest.
She is having no interest having food. less appetite and whenever we try to give milk or any veg or fruit she does not like that food showing no interest in that . How her appetite can be increased. What food / Medicine we can give to our child.
Posted Wed, 23 May 2012 in Child Health
Answered by Dr. Hema Yadav 3 hours later
Hello Mr.Vishalpriyadarshi,
Thanks for posting your query.
Considering the information and reports you have provided.
XXXXXXX is suffering from infective gastroenteritis or diarrhoea most probably chronic diarrhoea causing fever, cramps, loose motions and loss of apetite.
The treatment for this includes an antibiotic, probiotics, antidiarrhoeals and multivitamins and zinc supplements.Apart from this the most important thing is to maintain the childs hydration with WHO recommended oral rehydration solution and frequent feeding.
As of now , I assume that her pediatrician has started similar treatment however sometimes the choice of antibiotic varies with each case.The commonly prescribed antibiotics are ofloxacin ,oral colistin or cefixime .If the diarrhoea doesn't subside even after three to four days of starting the antibiotic then a stool culture test should be done for further manager.
The next best step would be to continue the treatment going on, add some zinc supplement and antipyretics for fever like acetaminophen or mefenamic acid, start adequate hydration and feeding.If the condition persists even after such treatment then you should consult your
pediatrician for a reevaluation and get her stool culture and antibiotic sensitivity tests done.This will confirm the causative organisms for the illness and also suggest alternatives for antibiotic treatment.
I would be able to guide you regarding medicines in a better way if you provide me the details of the medicines she has been prescribed till now.
Regarding food intake first and foremost increase her intake of water and oral rehydration solution (WHO ORS).Provide small frequent meals rather than usual full meals.Include soft digestible foods like khicchdi, boiled apples, rice dal, curds etc.
Avoid excessive oily or spicy food.
Her apetite will increase once her infection is cured .
Since this problem has persisted since last three months further investigations like ultrasound abdomen, stool culture test ,blood tests like complete blood counts, esr, widal test, tuberculin test etc might help in ruling out significant conditions like typhoid, tuberculosis etc which are common causes of prolonged fever and diarrhoea.
Hope this information is helpful to you.
I'll be available to answer any follow up queries.

Above answer was peer-reviewed by
Follow-up: Regular high fever, test showed pus cells, stomach pain and loose motion. What medicine can be given? 6 hours later
Dr . Blood Report of Baby XXXXXXX is mentioned as below-
Hb %-12.4 gm/dl (Cyanmethaemoglobin Method)
TLC - 13,300 cells/cumn (Normal 4000 to 10,000 for adult)
DLC- P 40%,
L 58% (Normal 20 to 40%)
E 02% (Normal 04 to 08%)
M 00 % (Normal 01 to 03%)
Platelate Counts - 5.48 Lakh /Cumn (Normal 1.5 to 4.5 Lakh /Cumn)
Serum Bilirubin - 0.59 mgm% ( Normal < 1mgm%)
SGPT - 38 I.U /L ( Normal up to 40 I.U/L)
GBP for M.P - Negative
Dr . RX as of date 20 /04/2012
Plenty of Water
Vizylac 5ml Twice a Day
Dr. does not add here any Antibiotic & Zinc supplement. I am also not satisfied with her Rx as there is no relief to my daughther XXXXXXX .
Kindly Rx some good Medicine , which can relief her , Increase her appetite, and she dont get repeted fever. Your kind and early guidance will be highly appreciated.

Answered by Dr. Hema Yadav 5 hours later
Thanks for the follow up.
As per her history and tests there is a probability of infection however a mild or chronic viral or bacterial.The medications taken do not contain any antibiotic or anti pyretics for fever.Vizylac is a probiotic which is apropriate for symptomatic relief of diarrhoea.However ambrolite is a mucolytic syrup containing ambroxol which is given if the child has any cough which you haven't mentioned in your query.
I would like you to record the childs temperature as fever should be termed only if the childs temperature exceeds 99_100 • F.Only then should she be prescribed anti pyretics like acetaminophen or mefenamic acid and apropriate antibiotics course for a week or more.
The antibiotic can be best decided after thorough clinical evaluation of the individual patient and preferable a stool culture and antibiotic sensitivity test for confirming the exact cause of infection and most sensitive antibiotic for the same .
Alternatively any of the common antibiotics like Syrup cefixime, ofloxacin , or amoxicillin etc can be started emperically as per prescription by a pediatrician who has examined the patient.
As I already mentioned the treatment is to be taken as per prescription only which is decided on clinical condition and weight of the child.

Appetite stimulants like syrup cyproheptadine, may temporarily increae the apetite but has many sideeffects too, also not advisable before present infection is cured.
Sometimes such a clinical condition can result from a mild viral infection which may resolve on its own without antibiotics in a couple of weeks to a months time.
So , as of now I would advise you please get her re examined by a paediatrician, who can get the stool test and if needed an ultrasound done and start her on antibiotics and antipyretics as per recommended weight based dosage.Also please monitor her for fever and loose stools preferably by keeping a written record of fever spikes and frequency of diarrhoea which will help the doctor in taking the apropriate decision.Please do not panic her reports are mostly normal with a mild indication of infection and nothing much worrisome as of present scenario.

Hope I have answered your query.
Above answer was peer-reviewed by
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