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Child have fever. Blood test, urine test and culture test done. What could be the problem?

Dear Dr.,

My 4-year old daughter is suffering high fever with shaking chills since 2-3 days. we did a blood test & the result indicated that there is infection as the CRP is 10.01 mg/dl knowing that WBC is 15.3 K/UL, Hemoglobin 10.6 g/dl, haematocrit 30.9 %, MCV 76.3 fL, MCH 26.2 pg, neutrophils 87% & lymphocytes 10%. The initial urine test was negative & we are waiting for the culture test after 3 days. Her doctor suggested to wait for another two days more as the he couldn't find any inflammation clear in ears or throat. what shall I do?
Asked On : Fri, 19 Apr 2013
Answers:  3 Views:  30
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Pediatrician, Neonatology 's  Response
Hi Shadihs,
It would be better if you could mention the initial urine report in details.
Please maintain a hourly (or 2-3 hourly) temperature chart of your kid with a thermometer. We should know the fever pattern ( like - temperature, frequency etc). Otherwise, it is difficult to diagnose the cause of fever.

Please also note the breathing pattern (rate, any difficulty) and urination frequency (if it is increased ) of your child.

As you mentioned, if ear and throat is ok, I would like to check for Malaria, UTI, Pneumonia.

I would suggest you to keep Paracetamol Suspension and use it as SOS medicine when the temperature is >100 degree F. Dose will be 15mg / Kg body weight. (If your kid is 10Kg, dose will be 10 X 15 = 150 mg ; Usually the medicine is available as 100mg / 5ml, so give 7.5ml). Similarly Ibuprofen suspension can be used (dose 10mg /Kg). [ I am sure that your doctor must have prescribed it already].

Give your kid a sponge with normal temperature water (not too cold) if temperature rises above 103 degree F.

Note the points I mentioned and report to your doctor. He / She will take care of those.

Please post if you have more queries.
Answered: Fri, 19 Apr 2013
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Pediatrician Dr. E Venkata Ramana's  Response
Feb 2013

Thank you for your query on Healthcare Magic.

I advise you to follow the advise of your Pediatrician.

Give paracetamol for fever in prescribed dose.

Maintain her hydration by giving plenty of oral fluids and water.

Once you get the culture report consult the doctor again for reevaluation and for further treatment.

Hope I have answered your query.

Answered: Fri, 19 Apr 2013
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General Surgeon Dr. Deepak Kishore Kaltari's  Response
Welcome to HCM
Greetings of the day
raised CRP and WBC are non specific indicator of infection in body. Was your daughter put up on antibiotics before doing urine test? if antibiotics are started before urine sample is taken it could be negative. There could be urinary tract infection inspite of urine being negative....
Commonest causes of Fever in child are Four(4) W's
1.Wind--- Respiratory tract including nasopharyn and middle ear cavity( can be diagosed clinically by history of cough associated with fever, also to rule out tonsilitis
2. Water( Urinary System)--- proper urine routine and culture and also Ultrasound KUB region.
3. Wound( Presence of pus or infected wound)--- Thorough clinical examination of whole body looking out for abscess/pus anywhere in body
4. Waste( Gastro-intestinal tract)-- GI tract infection.

So next step would be thorough search to look out for source of infection , thorough clinical examination and investigations.
Take Care
Answered: Fri, 19 Apr 2013
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