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What Causes Fever With Running Nose In A Child?
Question: Dear Dr,
I am seeking your expert advice on my daughter's health condition.
Age: 4 yrs 8 months
Weight: 24.1 (on 19 Aug)
Height: 110 cms
My daughter was down with a viral fever + runny nose starting 18th Aug evening and lasted until 20th Aug evening. The runny nose still persists.
I took her to our regular pediatrician on day2 (19Aug) for a check-up as the fever had shot up to 103.6 by then. The doctor prescribed Croci (7.5 ml) and Ibulgesic syrup (10 ml). She also suggested we go in for a blood test the next day if the fever persisted at 103 as she wanted to rule our Dengue and Malaria.
However, we took our daughter for a blood test even though the fever was at 101 on 20 Aug and the reports ruled our Dengue and Malaria but her CRP level was very high (see attached reports)
Since the CRP was high, the doctor said she suspected Typhoid and decided to start on Zifi 100 (8 ml x 3 times for 14 days). All this was on 20th August.
However, on 20th August, immediately after giving my daughter the 1st dose of Zifi 100 (at around 9 pm on 20th August) she started passed greenish stools twice after which she said she felt verygood and even asked for food as she was hungry. That same night her fever came down to 99.5 and then the next morning she had it again at 99.9 which went with 30 min of taking crocin syrup.
We also got the Typhidot igm test done using the same blood sample of 20th Aug to rule out Typhoid - that report also showed negative results.
However, the next day, even though there was no fever and my daughter seemed fine, the pediatrician said we should continue with Zifi 100 and complete 14 days of the antibiotics. In addition she prescribed Enterogermina for the diarrhea - twice a day for 5 days. And Maxtra syrup - 5 ml x 3 times for 5 days.
I am guessing her diarrhea was due to Zifi 100 and the diarrhea has also stopped as of today. She has not yet had a single motion (it is 7 pm now).
She has been fine since 21st August. However, since she is more of a non-vegetarian, she dislikes having to eat foods like kichdi and such foods.. and I am left with very limited options as far as her food goes. She could've lost about 300-400 gms in the last 1 week due to the diarrhea and her fear of eating due to the same reason.
My concern is, does my daughter really need to be on antibiotics for that many days? She has not been given any multi-vitamins along with the antibiotics. Also
does she really have Typhoid?
Need your expert advice.
Thanks,
XXXX XXXXXXX
I am seeking your expert advice on my daughter's health condition.
Age: 4 yrs 8 months
Weight: 24.1 (on 19 Aug)
Height: 110 cms
My daughter was down with a viral fever + runny nose starting 18th Aug evening and lasted until 20th Aug evening. The runny nose still persists.
I took her to our regular pediatrician on day2 (19Aug) for a check-up as the fever had shot up to 103.6 by then. The doctor prescribed Croci (7.5 ml) and Ibulgesic syrup (10 ml). She also suggested we go in for a blood test the next day if the fever persisted at 103 as she wanted to rule our Dengue and Malaria.
However, we took our daughter for a blood test even though the fever was at 101 on 20 Aug and the reports ruled our Dengue and Malaria but her CRP level was very high (see attached reports)
Since the CRP was high, the doctor said she suspected Typhoid and decided to start on Zifi 100 (8 ml x 3 times for 14 days). All this was on 20th August.
However, on 20th August, immediately after giving my daughter the 1st dose of Zifi 100 (at around 9 pm on 20th August) she started passed greenish stools twice after which she said she felt verygood and even asked for food as she was hungry. That same night her fever came down to 99.5 and then the next morning she had it again at 99.9 which went with 30 min of taking crocin syrup.
We also got the Typhidot igm test done using the same blood sample of 20th Aug to rule out Typhoid - that report also showed negative results.
However, the next day, even though there was no fever and my daughter seemed fine, the pediatrician said we should continue with Zifi 100 and complete 14 days of the antibiotics. In addition she prescribed Enterogermina for the diarrhea - twice a day for 5 days. And Maxtra syrup - 5 ml x 3 times for 5 days.
I am guessing her diarrhea was due to Zifi 100 and the diarrhea has also stopped as of today. She has not yet had a single motion (it is 7 pm now).
She has been fine since 21st August. However, since she is more of a non-vegetarian, she dislikes having to eat foods like kichdi and such foods.. and I am left with very limited options as far as her food goes. She could've lost about 300-400 gms in the last 1 week due to the diarrhea and her fear of eating due to the same reason.
My concern is, does my daughter really need to be on antibiotics for that many days? She has not been given any multi-vitamins along with the antibiotics. Also
does she really have Typhoid?
Need your expert advice.
Thanks,
XXXX XXXXXXX
Brief Answer:
Details below
Detailed Answer:
Hello
Thanks for asking on this platform
I can understand your concern.I have gone through the detailed History and reports.
I have concluded that your daughter had probably some viral infection but as CRP was positive I would like to continue the antibiotic and get a repeat CRP done.If repeat CRP is within normal limit you can stop the antibiotic as already 8 days of antibiotic has been completed.
The most common cause of fever with running nose in this age is some viral infection.In viral infection fever usually subsides within 3-4 days with conservative treatment.
Your daughter had same features.
Now I want to brief you the symptoms of malaria,typhoid and dengue.In malaria fever is usually associated with chills and rigor(in your case malaria test is negative and there was no history of chills and rigor).In typhoid fever is usually accompanied with pain abdomen,poor appetite.Typhidot test has about 90%sensitivity of detecting the disease. (In your case typhidot was negative and fever was with running nose).
In dengue again pain abdomen,severe headache and flushing of face are important features which may be associated with low platelet counts. (In your case these features are absent and test is also negative).
Now coming to the point whether antibiotic is needed or not.CRP is a marker of bacterial infection.Although the exact nature of bacteria is not known in your daughter.I would like to continue the antibiotic giving the benefit of doubt and without taking any risk.
In typhoid antibiotic should be given for 14 days but as your daughter has no features suggestive of typhoid if CRP gets normal,you can stop the antibiotic.
In any febrile illness weight loss is common due to poor oral intake.I won't get worried if baby is active,playful,accepting feeds well and there are no other significant complaints.
You can continue giving Maxtra for running nose for next 3-4 days.Regarding feed,if she is passing stool normally and there is no vomiting you can give anything what she wants.
I hope this helps.
Please let me know if you have any more doubts.
Wishing for your baby's good health.
Regards
Details below
Detailed Answer:
Hello
Thanks for asking on this platform
I can understand your concern.I have gone through the detailed History and reports.
I have concluded that your daughter had probably some viral infection but as CRP was positive I would like to continue the antibiotic and get a repeat CRP done.If repeat CRP is within normal limit you can stop the antibiotic as already 8 days of antibiotic has been completed.
The most common cause of fever with running nose in this age is some viral infection.In viral infection fever usually subsides within 3-4 days with conservative treatment.
Your daughter had same features.
Now I want to brief you the symptoms of malaria,typhoid and dengue.In malaria fever is usually associated with chills and rigor(in your case malaria test is negative and there was no history of chills and rigor).In typhoid fever is usually accompanied with pain abdomen,poor appetite.Typhidot test has about 90%sensitivity of detecting the disease. (In your case typhidot was negative and fever was with running nose).
In dengue again pain abdomen,severe headache and flushing of face are important features which may be associated with low platelet counts. (In your case these features are absent and test is also negative).
Now coming to the point whether antibiotic is needed or not.CRP is a marker of bacterial infection.Although the exact nature of bacteria is not known in your daughter.I would like to continue the antibiotic giving the benefit of doubt and without taking any risk.
In typhoid antibiotic should be given for 14 days but as your daughter has no features suggestive of typhoid if CRP gets normal,you can stop the antibiotic.
In any febrile illness weight loss is common due to poor oral intake.I won't get worried if baby is active,playful,accepting feeds well and there are no other significant complaints.
You can continue giving Maxtra for running nose for next 3-4 days.Regarding feed,if she is passing stool normally and there is no vomiting you can give anything what she wants.
I hope this helps.
Please let me know if you have any more doubts.
Wishing for your baby's good health.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you...I went to the pediatrician again on 25 Aug and she says I can stop zifi 100 by 28 Aug.
My question is when can my daughter start eating chicken/non-vegetarian.
My question is when can my daughter start eating chicken/non-vegetarian.
Brief Answer:
There is no harm in giving well cooked non vegetarian food
Detailed Answer:
Thanks for follow up
There is no harm in giving non veg foods if she is passing stool normally,there is no abdominal discomfort and there is no past history of intolerance to non veg.
I shall be glad to answer if you have any more queries.
Wish you and your family good health.
Regards
There is no harm in giving well cooked non vegetarian food
Detailed Answer:
Thanks for follow up
There is no harm in giving non veg foods if she is passing stool normally,there is no abdominal discomfort and there is no past history of intolerance to non veg.
I shall be glad to answer if you have any more queries.
Wish you and your family good health.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doc,
This is her latest blood report(CRP+ CBC). Please take a look and let me know.
Thanks,
XXXX
This is her latest blood report(CRP+ CBC). Please take a look and let me know.
Thanks,
XXXX
Brief Answer:
Report is normal
Detailed Answer:
Thanks for follow up
I have seen the report of CBC and CRP. CRP value is within normal range and CBC is also normal(I won't get worried for mild raised hemoglobin,platelet,monocyte and lymphocyte count as this may be normal variation).
No need of any further treatment.You can give her all the healthy diet including non-veg.
Regards
Report is normal
Detailed Answer:
Thanks for follow up
I have seen the report of CBC and CRP. CRP value is within normal range and CBC is also normal(I won't get worried for mild raised hemoglobin,platelet,monocyte and lymphocyte count as this may be normal variation).
No need of any further treatment.You can give her all the healthy diet including non-veg.
Regards
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. Prasad
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