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Dr. Andrew Rynne

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Suggest treatment for high fever in child

Answered by
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Dr. Irshad H Naqvi

Pediatrician

Practicing since :1989

Answered : 1194 Questions

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Posted on Mon, 1 Sep 2014 in Child Health
Question: Hi, my 13 yrs old son ( wt. 39 kg) had developed high fever 103-104F about 2 nights back. It started with little blocked nose, little headache and cramps. It would not come down fully with Crocin and had to give Meftal-P alternately. The paraecetamol is required every 5-6 hrs. Now there is no headache or cramps or any kind of pain. After 2 days we got the blood test done - TLC(WBC) is normal (9.3K), neutrophils are slight high 82 %, lymphocytes 12%, rest in range. Malaria antigen test is negative.
Mild antibiotic Erythromycin (200) also given by local doc into the 2nd day.

Today is 3rd day and fever which slill goes upto 103-104 every 5-6 hours. He is well hydrated , what should we do next ? Thanks XXXX
doctor
Answered by Dr. Irshad H Naqvi 13 minutes later
Brief Answer:
Viral fever, wait -will go in 4 -5 days

Detailed Answer:
Hi dear,

Your child is suffering with Viral fever. It usually take 4 to 5 days for the fever to reduce.
Viral fever are quite common during this rainy season. Nothing much to worry.

Fever should be taken care with regular tap water sponging,
Paracetamol every four hourly with recommended doses ( 15 mg per kg).

Antibiotics are not recommended at this stage keeping in view of the blood counts, but complete the course of erythromycin which is already started.

Along with paracetamol some anthistaminic and decongestant syrups like sinarest may also be added.

Keep the nutrition and hydration maintained.

If fever do not respond even after 5 to 6 days of such treatment then child has to be reinvestigated in terms of CBC, Typhi dot test and Urine routine examination.

Hope the query is answered.
Please feel free for the further clarification.
Thanks
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Irshad H Naqvi 34 hours later
Recd ur reply. Today towards mid of 4 th day, we had to give only crocin in 7 hr intervals and peak was going upto 103 and not 104 like before...this was a better outlook than before. But now from last 2 hrs that is with the starting hrs of 5th day, the body temp is varing hugely and automatically between 101.5 and 103.5 with no definite pattern and after fluctuation for 2 hrs, now again has shot upto 104 (104 has come after 20-24 hrs). Now we will have to give meftal p also with 4-6 hrs alternate cycle as it is not really coming down with just the sponging easily, it comes down 0.8 deg but climbs up as soon as you stop sponging. Can we start meftal p ?Is it still viral and we have to be patient or any test is required in morning? Pls comment for us. Thanks XXXXXXX
doctor
Answered by Dr. Irshad H Naqvi 9 hours later
Brief Answer:
to be reinvestigated

Detailed Answer:
Hi ,
Response to the fever comes with the adequate doses of paracetamol. should not be less than 15 mg per kg 4 to 6 hourly ,some times if required higher doses may also be given.
Tab Meftal P can also be given when ever fever is not responding to the adequate doses of crocin.
Child can be re investigated in terms of CBC, TYPHI DOT TEST. ESR. MALARIA ANTIGEN etc.
Excess of fluid to be given to maintain the hydration.
Hope the query is answered.
Thanks.


Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Irshad H Naqvi 22 hours later
Childs fever started on 4aug evening and hovered around 104 for almost 5 days. From 5th day night, with 8-9 hrly crocin it has gone to 101.7 XXXXXXX and 99.8 min. On 6th day morning it is 99.8. Was this viral coming to end or we should reexamine for cbc, typhoid,malaria etc, now that after six days, thyphoid test can be done? Still is his problem established as viral or needs investigation ? Thanks XXXXXXX
doctor
Answered by Dr. Irshad H Naqvi 14 hours later
Brief Answer:
please get him investigated

Detailed Answer:
Hi,
Viral origin possibilities are more; but at this juncture one should investigate the child for possible problems like typhoid, malaria , UTI, etc. Consider discussing about the tests with the treating doctor.

Thanks
Above answer was peer-reviewed by : Dr. Prasad
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