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What causes persistent fever, headache, fatigue and diarrhea in a child?

Answered by
Dr. Pradeep Kumar

Pediatrician, Cardiology

Practicing since :2006

Answered : 1912 Questions

Posted on Fri, 24 Aug 2018 in Child Health
Question: Hi,

We have 5 year old niece living with us in USA. Last Thursday she became seek and I believe following information will help me tell the question.

Thursday (6 days ago)
-> She took a shower for about 45 min to 1 hr. in bath tub where at the end i believe the water became colder.
-> On the same night, she has asked us for water 6-7 times in 1 hr window.

Friday (5 days ago)
-> went to school and school called us saying she had fever of 102+
-> we got her back and started paracetamol , i believe it was 50 mg.
-> Friday night, she was running a fever of up to 103 and we started placing cold clothes on her forehead to get her fever in control

Saturday (4 days ago)
-> we went to her granmother's house and she was ok during day time

Sunday (3 days ago)
-> in morning she had a fever of upto 103 again and we stopped paracetamol and started iboprufen 100 mg childrens.
-> day time things were fine
-> while coming back she felt totally tired and we came back home.
-> we needed to put her in bathtub to get her fever in control.

Monday (2 days ago)
-> she didn't go to school and we stayed home to take care of her. she was running a fever of 103+..
-> we took her to DR. and they diagnosed her with FLU B type and prescribed oseltamivir (tamiflu) and we started giving her that along with ibuprofen.
-> she felt fine on that night

Tuesday (1 day ago)
-> didn't go to school.. she was feeling ok but tired.
-> she seems to be performing at 25% of her capacity..

Wednesday ( today)
- we gave her both medication first thing in the morning and she vomited.
- we still took her to school to see if that was missing part. but she complained about stomach pain and vomited right away at the school
- we took her to same Dr. , things per Dr. is same and Dr. is saying she would be concerned if the fever does not get resolved by Monday (4 more days)

- So far she has complained about fever, joint pains, headache, tiredness, lethargic, vomit, loose stool, too much sweat while sleeping...

We are not sure what needs to be done .. please help.

Answered by Dr. Pradeep Kumar 2 hours later
Brief Answer:
Most likely due to viral infection

Detailed Answer:


I have gone through the query and do understand your concern.

Fever with joint pain, vomiting and loose stool with tiredness is commonly seen in viral infection in this age.

The symptoms in most of the viral infection start improving after 4-5 days. Sometimes symptoms may persist longer. But possibilities of bacterial infection should be ruled out.

As symptoms are there for 5 days I would like to get few blood investigations done like complete blood count, C reactive protein and procalcitonin to check for bacterial infection. Even bacterial infection may present with same symptoms and if the test is suggestive, antibiotic will need to be started.

As the child is vomiting and passing loose stool also there are chances of dehydration if she will not take adequate fluid. Ensure that she is taking plenty of fluids, urine output is OK and vomiting is not too frequent.

Till then I would suggest you continue the medications as prescribed, give plenty of fluids to avoid dehydration and to consult your pediatrician immediately if there is any danger sign like decreased urine output, persisted vomiting and altered sensorium.

Hope I have answered your query.
Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
Follow up: Dr. Pradeep Kumar 23 hours later
Hi. Thank you Dr. for your information. We are terrified as she has following symptoms from last 2 days.

Muscle Aches
Shortness of breath
soaking night sweats
joint pains

The other reason for our concern is that myself may have an HIV. I have had exposure to HIV 21 months ago (not in between) and I tested negative at 21 month just yesterday.

The thing is when I had Exposure, I have had similar symptoms that she's going through (ARS symptoms)...

Our Dr. is saying she was tested positive for FLU type B and our concern is that what if that's not FLU and something else....

Answered by Dr. Pradeep Kumar 12 hours later
Brief Answer:
Chances of having HIV infection or ARS is negligible

Detailed Answer:

I won't get worried as you are tested negative for HIV and child is positive for Flu.
There is window period for initial few months for HIV infection to get detected. You have been tested negative even after 21 months of exposure, so chances of having HIV is negligible for both of you.
Other important rule is that one should not consider two diagnosis at a time. The symptoms are suggestive of flu and test is also corroborated.
I hope within next two to three days the symptoms will improve.

Take Care!
Dr. Pradeep Kumar,

Above answer was peer-reviewed by : Dr. Kampana

The User accepted the expert's answer

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