Brief Answer:
Detailed investigation work up for fever require
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
It's quite common for children to have repeated fever and infection.
I do understand your concern and apprehension of monthly fever and persistent
lymph node.
Let's start analysing her problems. She basically has two different problem
1. Fever with persistent lymph node swelling.
2. Chronic Constipation
Let's analyse the first one.
Recurrent fever especially every month along with persistent lymph node requires further assessment and investigation. If the lymph nodes are only at one location and smaller then 1 cm it's unlikely to be of much clinical significance. I would suggest the following investigation to arrive at cause for fever( fever is not a disease but it's a cardinal manifestation of underlying disease process )
1. Complete Blood count
2. Chest
X ray : to rule out any focus of infection in chest
3. Urine examination: to rule out
urinary tract infection
4.
Ultrasound of the lymph node and if required fine needle aspiration cytology. ( I would like to know the exact location of lymph node, providing clinical photograph will be appreciated)
I suggest you to discuss it with your
Pediatrician and things can be planned.
Coming to constipation.
Following are the commonest causes of constipation in children
1. Decreased intake of water
2. Decreased consumption of fiber in diet.
3. Presence of painful anal condition like fissure
I hope fissure has been ruled out in your child.
Apart from the laxative I would suggest you the following which I am definitely sure will help your kid too as it has helped majority of my patients
1. Retention
Enema with Normal saline and glycerine: it will help in evacuation of loaded colon
2. Ensuring good intake of water.
3. High fiber diet: Suggest you to add vegetables salad and a serving of citrus fruit. Avoid fruit juice as they are deficient in fiber
4. Avoid constipation causing diet: Food stuff containing refined wheat flour and refined sugar.
Diet modification, water intake and enema form a combined integral part of the management.
In non responding cases possibility of Hirschsprung disease has to be considered.
I suggest you to consult a Pediatric Surgeon for further management.
In case you require any further assistance, will be glad to assist you.
Take care
Best Regards
Dr Deepak Kishore
MBBS, MS, MCH
Consultant Pediatric Surgeon