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Why Is My Child's Feet Hurting With High Fever?

Posted on Wed, 22 Jan 2014

Question: My grandson is almost 4 years old. He gets sick often. every month or so. The pediatrician sent him to an Immunologist and found that XXXXXXX has "neutropenia". But neither he nor the pedriation suggested anything to do for him. He runs these terribly high fevers every month or so. My daughter just called me and said XXXXXXX was sick "again". He always complains about some body part hurting. Tonight it is his feet. What can be done to help him? I know he is not old enough to take "airborn" or "coldeze". What can we do to help him?

Answered by Dr. Irshad H Naqvi (47 minutes later)

Brief Answer: Improve immunity, good diet, through investigations Detailed Answer: Hi Dear, I have read your concern. His immunity is to boosted with high protein and rich diet. Supplementation with vitamin D, multivitamins and iron also helps in improving the immunity and diet. As a whole, it is quite common to contract viral infection on exposure for a child, when they start getting social like going to school etc. Because viral infections are usually community borne. Gradually with recurrent exposures of the body to such infections, antibodies are formed itself by the immune system of the body and immunity improves. Almost all viral infections are known to cause some neutropenia and later it recover as viral infection fades off. I would like to request you to please upload the investigation report of the child so that I can explain you better. Please feel free for further explanation. Thanks

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Irshad H Naqvi (7 hours later)

appreciate your answer. This is basically what the pediatrician said also. But what do we do meanwhile. I've done some other research and the use of gamma gobulin has been used to treat neutrapenia in children. I wonder why neither dr. has suggested that?

Answered by Dr. Irshad H Naqvi (17 hours later)

Brief Answer: Gama Globulin to be used mainly in autoimmune mediated neutropenias. Detailed Answer: Hi What we pediatricians are trying to explain that it is better to improve the self immunity. If the neutropenia is auto immune type with some evidence and quite severe that the body is not at all able to defend itself from even mild trivial infection. Only then we would like to advice for the administration of gamma globulin keeping all the possible long and sort term negative possibilities. In the initial stages we do avoid this intervention and try to enhance the natural immunity provided the Total leukocyte count is quite low or less that 1000/cu mm. Hope the query is answered. Please feel free for further clarification. Thanks

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Irshad H Naqvi (10 hours later)

Again you've reiterrated the need to naturally improve the immune system. XXXXXXX drinks pediasure and gets double vitamins everyday. His mom very seldom leaves the house with him so as to not expose him. These drinks like airborn or coldeze that is supposed to strengthen the immune system during an oncoming cold does work well in adults but children can't take them. In Warrens case, you'd think it would help him. You said he needs to take in protein, XXXXXXX prefers to eat only meats so you'd think he would get quite a bit of protein along with all the vitamins that he takes. So the answer to my question is that theres nothing that can be done for him, during the time his immune system is trying to build up. Conscequintly, he will remain getting sick every month. right?

Answered by Dr. Irshad H Naqvi (14 hours later)

Brief Answer: Immunologist to decide for gamma globulin. Detailed Answer: Hi I can feel your concern and please be patient. Immune development is a gradual process. Every infection he gets is a process to strengthen his immune functions. I was expecting detailed report of investigation in the previous query to exactly get the level of neutropenia. If you have reports with you, please share them with me. I can be able to provide you with helpful information tailored as per Warren's needs. Detailed investigation report is required to know the exact problem with the child. I investigate thoroughly all my patients with recurrent fever to arrive at a final conclusion. I order for complete blood count, ESR, CRP,Typhi dot test., Malaria Antigen, Mx Test, BLOOD CULTURE, PEREPHFERAL SMEAR FOR GENERAL BLOOD PICTURE, CXRAY, Xray Water's view to rule out subtle sinusitis, CD4 Counts and CD4/CD8 ratio, URINE ROUTINE EXAMINATION, LIVER FUNCTION TEST, ULTRA SOUND WHOLE ABDOMEN TO RULE OUT ANY MICROABSCESS OR PUS etc. If neutropenia is quite severe then one should think of Bone Marrow Examination also. If XXXXXXX has undergone some of the above test, please share the reports with me. If every thing is ok regarding investigations then please let the child grow, more he is exposed to the antigens more antibodies will form in his body to fight the infections. For some thing extra apart from the pediatricians view, it will be better for your expectations to discuss with immunologist along with detailed workup. Hope you are guided satisfactorily. Thanks

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Above answer was peer-reviewed by : Dr. Prasad