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Suggest treatment for high fever with cough and chest congestion in a child

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Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 7335 Questions

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Posted on Thu, 28 Aug 2014 in Child Health
Question: Hi, I've a 3.5 yr old son having high fever for last 2 days along with cough and chest congestion. Today doctor started with antibiotic and chericof for cough. Fever used to go down after 1 hour for the last 2 days. Today gave Meftal and fever is not going down after 2 hours. It is late night and hence gave ibugesic plus 3.5 ml. Please let me know if anything else should be done.
doctor
Answered by Dr. Sumanth Amperayani 5 hours later
Brief Answer:
It could be a viral illness with cough

Detailed Answer:
Hi... Greetings from XXXXXXX Thank you for consulting in Health Care magic.

You say that the fever and cough and chest congestion are only of 2 days duration. It could as well be only a simple viral illness with cough and cold. Usually, cough and cold are viral 95% of the times in children.

Coming to the issue of fever -
1. Fever of 48 hours without any complications could as well a viral illness.
2. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day.
3. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all.
4. Once viral fever comes it might be there for 3-5 days. So do not worry about duration if the kid is active (when there is no fever).

I have a suggestion for you regarding Meftal and other combination medicines with Paracetamol. I suggest not using combination medicines for fever, especially with Paracetamol. Meftal-P contains Mefenamic acid which is a NSAID. It carries the risk of gastritis and renal problems in the long run. Please do not use Meftal-P.

I have published a paper on complications of using Mefenamic acid and here is the link. I suggest you go through it.

medind.nic.in/ibv/t10/i5/ibvt10i5p453.pdf

I have a few questions for you -
1. Have you recorded the temperature and how high is the fever going?
2. Did the kid have fits with fever at point of time before or if any of the family members are having this problem of fits with fever?
3. Right now anybody else in the family is having a fever?
4. You say he has got cough and chest congestion - do you mean breathing difficulty or fast breathing or nasal block or runny nose?
5. What antibiotic has been started?

Kindly get back with answers to my questions and will be glad to get back to you soon.
Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. Wish your kid good health.
Dr. Sumanth MBBS., DCH., DNB (Paed).,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sumanth Amperayani 3 hours later
Hello Dr.

Thanks a lot for the detailed answer. After giving Ibugesic, Fever has reduced. But Cough is persisting.

1. Have you recorded the temperature and how high is the fever going?
It is almost 103 degrees
2. Did the kid have fits with fever at point of time before or if any of the family members are having this problem of fits with fever?
It started with him a month back and all of the family members had cold, cough and fever for a week and everyone is fine after medication. He was ok for a week and again caught cough, followed by fever.
3. Right now anybody else in the family is having a fever? no
4. You say he has got cough and chest congestion - do you mean breathing difficulty or fast breathing or nasal block or runny nose?
It is fast breathing and nasal block
5. What antibiotic has been started?Advent

Following is the medication given since last month.
11/8 : Fever fro 3 days, throat pain, throat congetion
Asthalin Nebulization, Syp. Advent (after food) 3.5 ml, Sporlac XXXXXXX Syp Meftl -P 5Ml, Syp Chericough 2.5ml , Syp Relent 2.5 ml

9/8: Cought for 1 day, Fever, Throat - n
Crosin (120) 7ml every 6th hour, Syp Chericough 2.5ml , Syp Relent 2.5 ml

21/7: Ofloz eye drop, Syp Relent 2.5 ml

14/7: Ear ache 1 day, Fever on & off 3 days
Syp Ambrodil-S 5ml 3 times, otrivin drop , Syp Augmentin DDS 4ml-0-4ml - 7 days, Sporlac XXXXXXX Meftal-P 3 days, Mountair LC Kid, 0-0-5ml 10 days,

Please advice on what should we do now. Thanks a lot Doctor.
doctor
Answered by Dr. Sumanth Amperayani 2 hours later
Brief Answer:
This is viral illness - probably with wheeze

Detailed Answer:
Thank you for your trust in me.

I have gone through your reports and the detailed information you gave at my request. Thanks again. You have used antibiotics every time except 09-08-2014

My views & suggestions on this -

1. This is a viral illness and doesn't require antibiotics.
2. I suggest you give only Paracetamol in the dose I suggested (that too only if temperature is more than 100F) and not to use combinations of paracetamol with other medicines.
3. For cold you can use Syrup Phenergan 2.5ml thrice a day for 3 days and I suggest you not to worry if the kid is not having respiratory distress.
4. As you say he has fast breathing I suggest you get back to your pediatrician to check if he has got wheezing and get the prescription accordingly.
5. For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.

I DO NOT SEE A NEED FOR AN ANTIBIOTIC IN THIS REGARD AS OF NOW HERE.

I wish your kid a speedy recovery. If you are happy with my suggestions, please rate my answer. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below.
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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