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What Causes High-grade Fever While On Ibuprofen?

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Posted on Thu, 29 Jun 2017
Question: Hi Doctor,
a few days ago, I posted a question that all my family (me, my wife, my son who is 2 years old and my daughter who is 7 months old) developed high-grade fever starting from Saturday 27th of May. This question concerns about my Daughter

My daughter who is 7 months old had febrile seizure on 27th of May which made us all paranoid and ran to the emergency and her temperature was 38.5, the doctor said usually, children don't get febrile seizure at 38.5 but from now on we have to watch her temperature very carefully and try to avoid it from rising, she discharged my daughter with 125mg adol suppository every 4 hours and PRN 125mg adol the next day. My daughter got better the next day.
last Friday 2nd of XXXXXXX she developed a fever again (she was fine for at least 3-4 days), which was hard to put down we give adol suppository but no improvement, we then give her ibuprofen 3ml and the fever goes down. we took her to a pediatrician on Saturday night because we got tired of given her both ibuprofen syrup and adol suppository otherwise the fever won't go down. the doctor checked on her and she says that her throat is swollen and it seems like viral infection so she told us to keep on given her adol suppository every 4 hours and if it didn't help give her ibuprofen syrup 3ml.
Today the fever reached to 39.1 all the way to 39.3 yet adol didn't help to put the temperature down so we went to another pediatrician who decided that we should start her on oral antibiotics known as Curam which is amoxicillin 457mg+claculanic acid 57mg per 5ml. The doctor said to give her 2.5ml twice daily for 7 days.

overall, the baby is doing well, she is playing, feeding well except for tonight she didn't want to breastfeed, she is also alert.

Doctor what worries me the most is that her temperature rises very quickly, like tonight it went from 37.5 to 38.5 in a matter for 30 minutes. I feel like we are late with the antibiotics I regret that we should have given her earlier. I also feel like we are giving her too many medications especially that ibuprofen is not safest option but without it adol doesn't really do anything

Questions,

1.we give her ibuprofen syrup every 6 hours, and aodl every 4 hours. do you think giving her to much ibuprofen will cause other harms?
2.Do you think it's better to hospitalize her or do you believe that this oral antibiotic should do well and no need for iv antibiotics? given that we are too late to give her the antibiotic
3. how come last time she had febrile seizure at 38.5 but these days she reaches to 39.0 and doesn't have seizures? does that mean we can stop being worried about febrile seizure?
4.can we give her Voltaren 12.5mg suppository (her weight is 9.6kg) because she cries alot with ibuprofen syrup it will be easier if we could give her as a suppository?
4.what other suggestions or medications do you suggest.
doctor
Answered by Dr. Dr. Erion Spaho (1 hour later)
Brief Answer:
I think you should continue this treatment.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

Almost all drugs have their probable adverse effects, but in your daughter's case, ibuprofen seems to indispensable to be used.

I think you should continue the current medication since the condition is improving, and I don't think you are too late.

Voltaren could result in adverse effects too, some of them more severe than ibuprofen, so, I don't think it should be used at the moment.

The antibiotic takes approximately two days to control the infection and the fever, so the need for ibuprofen and adol will diminish and you can use them gradually if needed not at a fixed time.

Febrile seizures may occur in temperatures above 38 grades Celsius, so, it is not necessary to be worried too much.

I suggest you a near cold bath next time your daughter seems to have rising fever before use of ibuprofen or adol.

In conclusion, I think you should continue this treatment regimen.

Hope you found the answer helpful.

Wishing a speedy recovery about your daughter.


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Erion Spaho (18 hours later)
Hi Doctor,

My daughter seems a little bit better today she had fever once at night and once at 11 am in the morning, we are giving her Adol suppository only today, she got the fever at 11 am so we gave her adol, however, the fever didn't go down at all it just kept on rising from 37.8 all the way to 38.6, we later decided to follow your advice and gave her bath, after the bath the fever went down from 38.5 to 38 for about 30 minutes and spiked again to 38.5 until it was 3 pm which was her next dose of Adol suppository, at about 4 pm the fever went down and now at almost 9 pm she has no fever yet, however, we still gave her Adol at 7 pm just in case.


Doctor my biggest concern today is that about 6 pm I gave her the antibiotics for today, she really doesn't like it and it takes us about 5 minutes to give it to her slowly so that she doesn't spit it out. unfortunately, after 30 minutes of giving her the antibiotic she vomited all over the bed and when I tried to hold her up she vomited again. now my concern is that, did she get the benefit of the antibiotic I gave her. is 30 minutes or less enough for the medicine to go from her stomach to the body. Or should I give her the antibiotic again???




doctor
Answered by Dr. Dr. Erion Spaho (2 hours later)
Brief Answer:
You can give another half dose.

Detailed Answer:
Welcome back.

A major part of the antibiotic should have passed from stomach into bowels, so, I don't think there was a major loss after the vomitng.

However, to be sure, you can give now half dose of the antibiotic to get a correct coverage.

Even if the antibiotic was absorbed totally, an additional half dose doesn't cause any harm.

Hope I helped you.

Kind regards.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Erion Spaho (23 hours later)
Hi again Doctor,

I gave her the antibiotic normally on the morning dose 6am, it's really difficult and takes long to give it to her but luckily she took it after 5 mins of trying.
She didn't develop any fever all day today.
I gave her the next dosage of the day at 6pm today. Unfortunately again after almost an hour of giving her the medicine she vomited almost 3 times , one major vomiting all over the bed and two smaller vomits. Now I'm starting to think that this antibiotic we are giving her might be triggering this vomiting and I really don't know what to do Doctor.

Should I still continue on the antibiotic or should I stop it? Do I need to give her iv fluid or electrolytes ROS because of the vomiting (given that she feeded after vomiting)

Please suggest me what to do ?
doctor
Answered by Dr. Dr. Erion Spaho (1 hour later)
Brief Answer:
Yes, Antibiotic is necessary to be continued.

Detailed Answer:
Hello again.

The antibiotic seems to be working since there is no fever, but it's necessary to continue the antibiotic at least for five days in order to prevent any recurrence of the infection.

If she is feeding sufficiently there is no need for i.v.fluids, you can add electrolytes such as
Infalyte, Pedialyte, revital, etc. according to your daughter's age and body weight.

The antibiotic should be stopped only in case of severe persistent vomiting or diarrhea.

Hope this helps.

Greetings.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr. Erion Spaho (7 hours later)
thanks i will do as per your suggestion, hopefully, the vomiting will stop.

final questions doctor. this morning me and my wife noticed my daughter getting absent for a while about 5 to 10 seconds, she just stops what she is doing suddenly and stares blankly, we try to talk to her or run our hands near her eyes to make her look at us or respond but she just continues the blank stare for a while and then comes back to normal. she didn't have shivering, she didn't roll her eyes up or anything of that sort. the first time it happened while she was on the trolly and her mother cooking and the second one happened while she was on her table eating.

otherwise, she is normal, playful, smiling. she currently doesn't have any fever or any other symptoms.

i did some research online and i read that this could be of what's known as absence seizure, but i also read it happens at older children not at 7 months old..

1.then what could this thing be?
2. is it a type of seizure?
3.should we take her to a hospital and what check up should we do?
4.is it just a normal thing for a 7 months old baby?
I forgot to mention that after that absence that continues from 5 to 20 seconds , she is back to normal activity, she doesn't feel sleepy or tired, basically she just goes blank for a while and then returns to her normal activity . For example when it happened the second time while she was eating , she went blank for a while and then she just looked at us and went back to her normal eating pattern...
doctor
Answered by Dr. Dr. Erion Spaho (6 hours later)
Brief Answer:
Possible simple febrile seizures.

Detailed Answer:
Hello again.

It is true that absence seizures occur in an age greater than your daughter's.

Febrile seizures in the other hand may occur at this age and only starring for few seconds means that this could be a mild form of these type of seizures.

Normally these episodes should disappear as the temperature and infection are controlled.

If these episodes become more frequent, or new symptoms appear, evaluation by a Pediatrician is necessary.

Hope I helped you so far.

In good health.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Dr. Erion Spaho (14 hours later)
got it.

ONE final question before i close this discussion, please accept my apologies.

my wife has fever for almost 5 days now, it comes back every 4 to 6 hours of taking paracetamol. it reaches to 39.5 degrees. the doctor gave her Suprax 400mg once daily, today is her 4th day of taking Suprax 400mg but no improvement at all. her throat got even much more painful, the fever is still the same. and when i checked her throat with my phone light there is tiny white spots on the left side of her throat other than that it's just red swollen throat.

I don't know what we should do now. is the antibiotic ineffective? should I change it to amoxicillin (if we decide amoxicillin what dosage should i get her?) or just continue with Suprax until 7 days?! is it normal that the fever lasts for 5 days with no improvement at all?


doctor
Answered by Dr. Dr. Erion Spaho (10 hours later)
Brief Answer:
Probably the Suprax isn't working.

Detailed Answer:
Hi again.

White spots in the throat may be a bacterial infection that produced pus, and in such cases, antibiotics such penicillin may be necessary (if no contraindication).

Since there is no improvement in fever after 5 days afSuprax use, probably it is not the right antibiotic in this case.

However, it is necessary that your wife to get evaluated by her GP before to change the current antibiotic.

Hope this helps.

Take care.

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. Kampana
doctor
Answered by
Dr.
Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4493 Questions

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What Causes High-grade Fever While On Ibuprofen?

Brief Answer: I think you should continue this treatment. Detailed Answer: Hello and thanks for using HCM. I have read your question and understand your concerns. Almost all drugs have their probable adverse effects, but in your daughter's case, ibuprofen seems to indispensable to be used. I think you should continue the current medication since the condition is improving, and I don't think you are too late. Voltaren could result in adverse effects too, some of them more severe than ibuprofen, so, I don't think it should be used at the moment. The antibiotic takes approximately two days to control the infection and the fever, so the need for ibuprofen and adol will diminish and you can use them gradually if needed not at a fixed time. Febrile seizures may occur in temperatures above 38 grades Celsius, so, it is not necessary to be worried too much. I suggest you a near cold bath next time your daughter seems to have rising fever before use of ibuprofen or adol. In conclusion, I think you should continue this treatment regimen. Hope you found the answer helpful. Wishing a speedy recovery about your daughter.