Brief Answer:
I would like to get some investigations done

Detailed Answer:
Hello

Thanks for the query

With a history of fever(upto 103 F) on and off for last 2 weeks,I would like to get some investigations done to find out the cause of fever.

Most common cause of fever in this age is viral infection.But the viral fever comes down within 4-5 days and does not stays for such a longer duration.

I would like to rule out some common causes which can cause long duration on and off fever in a well child like malaria,urinary tract infection and sometimes typhoid.

So get a hemogram(to see leucocytosis or raised neutrophils),C reactive protein(to see any bacterial infection),urine microscopy examination (too see urinary infection),malaria card test,Typhidot(for typhoid) test done.
After getting the report the use of antibiotic is justified.
Environmental fever are known in pediatric age but as you are using AC the chances are very unlikely.
Please explain what do you mean by heavy breathing(increased rate,noisy breathing,chest wall retraction).As you have visited a pediatrician I assume that his physical examination is within normal limit.

I shall be glad to answer if you have any more query
Regards

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Brief Answer:
I would continue the antibiotic and will wait for reports

Detailed Answer:
Thanks for the follow up

If CBC is normal and CRP is only slightly raised, I would wait for the urinary/USG report and continue the antibiotic. Also discuss with your doctor for the need of test for typhoid and malaria, as in these condition all these test may be normal.

Regards

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Brief Answer:
Details below

Detailed Answer:
Thanks for the follow up

I have gone through all the reports and everything is OK except hemoglobin which is at its lower limit with microcytic,hypochromic picture.Although USG is showing mild gall bladder wall edema but I wont get worried for this as it is a very nonspecific finding.

The Azithromycin has a good coverage for the organism causing respiratory infection in this age group.I would like to continue the azithromycin as fever is also showing downhill course.I would like to get him examined for tonsilar enlargement and chest symptoms.If there are associated chest symptoms due to spasm of airway giving bronchodilator like salbutamol to relieve the spasm will help.

Also I would like to get his iron profile done as low Hb with microcytic hypochromic picture can be due to iron deficiency.Giving iron syrup will help in increasing the hemoglobin thus proper growth of the baby.The iron supplementation should be done once baby recovers from this illness.

Please let me know about further proccedings.
Regards

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Brief Answer:
Probiotic is safe,Don't worry for the blood picture

Detailed Answer:
I wanted to say that the only abnormality which I could be able to notice after going through all the reports is mild low hemoglobin and microcytic/hypochromic picture.
There is nothing to worry about this and it is not related to the current illness.

The normal blood picture is normocytic/normochromic.In the presence of low hemoglobin the microcytic/hypochronic picture suggests that there can be iron deficiency.
Iron deficiency is very common in pediatric age group(usually due to poor dietery intake of iron) and it is usually remains undetected.
The iron play a role in proper growth so once investigation is suggestive of any deficiency it should be supplemented.
This iron deficiency has no relation to the current illness and is just an incidental finding.It should be better confirmed with iron studies.
So don't worry.
Probiotic is safe and it should be given with antibiotic to maintain the healthy flora of the gut.
Regards

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