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Suggest Treatment For Low Grade Fever And Inability To Gain Weight

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Posted on Mon, 16 Mar 2015
Question: My 3 year old son is having fever from last 5 days. Fever is usually low grade ..say around 100.CBC done ESR is 45 and TLC 12500, HB is 11.5.
Pediatrician says his CBC looks normal and this is non localised fever due to viral or virus.
But I am tensed because when I googled it I can see low grade fever is more serious then high grade. It may be due leukemia,lymphoma,lipus etc.
He is having multiple lymph nodes all over ..which grow in size sometimes and shrink.my boy is underweight and fussy eater.

I am worried....please suggest.
doctor
Answered by Dr. Prasanna Heijebu (2 hours later)
Brief Answer:
Needle examination of the node will help.

Detailed Answer:
Hi Mam.

I understand your concern.

Since the CBC is normal,major leukaemias can be ruled out.

But the lymphomas need further evaluation.

The inability to gain weight can be related to underlying infection or suspicious lymphomas.

Hence I advise you to have an early Needle examination of the lymph nodal swellings.

Further management largely depends on the test results.

Lupus is also very unlikely.

Thank you.


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Prasanna Heijebu (3 hours later)
Hello ,

Thanks for the reply.
FNAC was done 14 months ago. Which came normal.
Can you please check my question again.I am concerned about his fever which is there from last 5 days.when ever we give him flexon it goes down to normal 98.5 but rise again after 3-4 hrs.Yesterday it was normal for around 7 hours.
He looks cranky, not eating well from last 2 days.
I am not sure why his pediatrician mentioned non localized fever , because I can see runny nose,cough and I also feel that his throat is also not well by his voice.
As you mentioned about weight, 14 months ago his weight was 9.6 kg now his weight is 12.2 kg. Doctor said it is how normal kids grow they put up around 2 kgbin a year.
My son age is 3 years 2 months. His weight is 12.2 and height is 95.5.
Is it normal that kid catch fever for week.
I am concerned because normally he gets fever for 2-3 days.
CBC report also uploaded. Which as pediatrician is normal in viral infection.you also please check.
Thanks.
doctor
Answered by Dr. Prasanna Heijebu (16 hours later)
Brief Answer:
Get a TB screen

Detailed Answer:
Hi Sir.

I understand your concern.

I have gone through your uploaded report as well.

Since his FNAC is normal you need not worry much.

The fever being non localised is quite at bit controversy in presence of running XXXXXXX

The doctor may have referred this to the generalised involvement through fever via a viral respiratory tract infection.

Its pretty normal for children to catch up with fevers every week in presence of unresolved infection within the body.

Fever is usually associated with disturbances in appetite.

ESR is often gets elevated in presence of underlying infection.This is not a diagnostic infection.

I also recommend you get a TB screen for your child as a safety measure since fever has been on and off.

Apart from this there is nothing much to worry at the moment and by rule your kid should be normal within a fortnight.

Thank you.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Prasanna Heijebu (11 hours later)
Hello Doctor,
Thanks for your response.
Yesterday morning we checked his fever and it was 99.8 (under armpit) and I think we do add 1 when we check through armpit.so it was 100.8. We gave him flexon 5ml at 1.30 pm after which his fever went down to normal then he was fine all day and at 10.30 pm his temp. was 97 under armpit. So I think no fever at that time and we gave only single dose whole day.
Today is 7th day and we checked again surprisingly in digital thermometer it is coming 97.3 and in other normal thermometer it is coming 98.5 under armpit. Now we are confused which one is right.
Yesterday he was eating and drinking well and playing...today he is bit cranky lets see how he will react today.
We are living in XXXXXXX and I think their is some viral infections are going on. And swine flu is in all over XXXXXXX
One last thing you mentioned about fever on and off. Is it for this one week only?
He got the fever after few months and last when he had the fever it was just for 2-3 days.

Thanks.
doctor
Answered by Dr. Prasanna Heijebu (11 hours later)
Brief Answer:
Mercury/normal thermometer readings are preferable.

Detailed Answer:
Hi Sir.

I understand your concern.

yes quite rightly so your son seems to have temperatures near normal.

Normal thermometer readings are preferred to digital readings.

This fever in your child's case could be possibly related to seasonal viral infections.

Seasonal viral infections can show on and off pattern.

On a whole you need not worry much as he showed significant improvement so far.

Post your further queries if any.

Thank you.
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Prasanna Heijebu

General & Family Physician

Practicing since :2010

Answered : 1422 Questions

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Suggest Treatment For Low Grade Fever And Inability To Gain Weight

Brief Answer: Needle examination of the node will help. Detailed Answer: Hi Mam. I understand your concern. Since the CBC is normal,major leukaemias can be ruled out. But the lymphomas need further evaluation. The inability to gain weight can be related to underlying infection or suspicious lymphomas. Hence I advise you to have an early Needle examination of the lymph nodal swellings. Further management largely depends on the test results. Lupus is also very unlikely. Thank you.