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Dr. Andrew Rynne

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Suggest treatment for fever and severe calf pain

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Dr. Diptanshu Das

Pediatrician

Practicing since :2005

Answered : 3739 Questions

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Posted on Wed, 4 Nov 2015 in Child Health
Question: My son is 5 years old. He had a fever of 101 a few days ago. Now he is complaining of severe calf-pain in both of his legs, and is unable to walk. He can move his legs, he can stand, but both instances cause severe calf-pain and he has to sit/lay back down.
My pediatrician thought it might be Guillain Barre, but I feel that it might be acute myositis, especially because he just had a viral infection. Can anyone offer any feedback? I want him to avoid a spinal tap if at all possible. My pediatrician also mentioned it being related to LMN issues, but I don't see how that's possible if he's able to perceive the pain in his legs? Thank you for any light you can shed on this topic.
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Answered by Dr. Diptanshu Das 3 hours later
Brief Answer:
Your child needs a multidisciplinary approach

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone through your query very carefully. I fully understand your concerns.

There are two broad possibilities to consider.
* Whether it is related to muscles, neuromuscular junction or the lower nerves (LMN)
* Whether the cause is central (UMN) and related to problems in control from the brain.

A neurologist would be able to administer the right clinical examination procedures to discerns this category.

Although acute myositis (inflammation of muscles) is a possibility, it is just a presentation and you have to consider what could be the underlying cause. Viral infection is a possible cause but that is not enough to explain and other probabilities need to be considered. In any case, these are not central causes.

A spinal tap is a procedure to identify central nervous system infections like meningitis which can be rather serious. But it is highly unlikely that this would be the presentation of meningitis, assuming that the features are the only ones that you described.

A physiatrist or a physiotherapist would be able to assess the muscle tone and related conditions and would be able to administer right therapeutic measures as per requirement.

I hope that I have been able to give you an idea on the possibilities. After evaluation of the cause your child needs proper supportive measures and developmental stimulation. A developmental pediatrician (if you can find one) or a physiotherapist would be able to help you out in this regard. Before that, get a neurological evaluation done by a neurologist.

Let me know if I could be of further assistance.

Regards
Above answer was peer-reviewed by : Dr. Yogesh D
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