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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Child Not His Usual Self, Lethargic, Quiet, Exhausted, Congested, Has Inflamed Throat, Low Appetite. Negative Strep Test, Suspicion Of Virus. Taken Sudafed. Is The Diagnosis Right?

I m worried about my 8 year old grandson. He s normally bouncing off the walls but has been very lethargic. He had a bad headache Friday night and was again normal shortly afterward. Saturday he played Soccer but seemed a little subdued but didn t complain. He came home from his dad s on Sunday night and his dad said he had complained about being tired. He had dark circles under his eyes - looked like allergy . Gave him children s benadryl about 7:00pm and he quickly became very drowsy. Woke up 3am & couldn t go back to sleep. He missed school on Monday beause he was exhausted and congested. Laid on couch all day. Missed school again Tuesday and I took him to doctor. She said his ears looked fine. Throat was inflamed, although he said it wasn t sore and no other pain in head, stomach, etc. She took throat swab for strep but was negative and said she would call if culture came back positive for strep. He still has no energy today (Wednesday), no appetite , and congested and just super quiet. My daughter has been giving him non-drowsy sudafed for stuffiness. This is just not like him - he s never been down like this for more than a day. The doctor said it s probably just a virus. I hope so. Maybe flu? Sorry, but I was once told it s probably just a virus and turned out I had MS.
Sat, 30 Jun 2012
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Pediatrician 's  Response
Hello marieg42,
I saw your question posted on Sunday April 29 2012, only now ( Friday June 29th Indian standard Time).
Though it will not be useful to you, since this is in public forum, some aspect of the following answer will be useful to few parents and grand parents.
Let me first salute your affection for your grandson. This is probably the greatest gift you can give to your daughter, by taking care of her son.
In general let us follow this rule. If as a caretaker, something tells you that all is not well, take a medical opinion.
Yes. Viral fever can cause these symptoms and can make the child lethargic.
In such doubtful situations apply these four simple steps
A.
1. How is his sleep. Is he able to sleep undisturbed?
2. How is his fluid intake. Even if he is not able to consume solids, his fluid intake should be fair
3. How is activity: When he is awake is he oriented? Recognize you as grand parent, he knows where he is and can roughly tell which time of the day it is.
4. Fever level: More than 104 F is high.
B.
1. How is his urine? He has to void atleast 3 times to 4 times in a day
2. How was his motion? Was there any blood?
3. Is there any red or purple patches in the skin ? Indicates serious viral illness or complication
4. Did he have any yellow or green colour vomiting? Indicates stomach ulceration, again pointer to careful observation
C.
1. How are his eyes? any evidence of jaundice?
2. How is mouth ? any painful ulceration?
3. How is neck? Any swelling or stiffness? swelling can be due to infection, stiffness may be a pointer to problems inside the skull
4. How are the limbs? Are they swollen
D.
1. Any ear discharge or pain?
2. Any nose leak or nasal tip redness
3. Any Fast breathing
Above problems can be evidence of bacterial infection
4. Severe cough? Post viral : cough can be a problem
Hope he should be doing fine.
If you are worried any time, always consult. We doctors, respect and understand your anxiety
with regards
arulalan
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Child Not His Usual Self, Lethargic, Quiet, Exhausted, Congested, Has Inflamed Throat, Low Appetite. Negative Strep Test, Suspicion Of Virus. Taken Sudafed. Is The Diagnosis Right?

Hello marieg42, I saw your question posted on Sunday April 29 2012, only now ( Friday June 29th Indian standard Time). Though it will not be useful to you, since this is in public forum, some aspect of the following answer will be useful to few parents and grand parents. Let me first salute your affection for your grandson. This is probably the greatest gift you can give to your daughter, by taking care of her son. In general let us follow this rule. If as a caretaker, something tells you that all is not well, take a medical opinion. Yes. Viral fever can cause these symptoms and can make the child lethargic. In such doubtful situations apply these four simple steps A. 1. How is his sleep. Is he able to sleep undisturbed? 2. How is his fluid intake. Even if he is not able to consume solids, his fluid intake should be fair 3. How is activity: When he is awake is he oriented? Recognize you as grand parent, he knows where he is and can roughly tell which time of the day it is. 4. Fever level: More than 104 F is high. B. 1. How is his urine? He has to void atleast 3 times to 4 times in a day 2. How was his motion? Was there any blood? 3. Is there any red or purple patches in the skin ? Indicates serious viral illness or complication 4. Did he have any yellow or green colour vomiting? Indicates stomach ulceration, again pointer to careful observation C. 1. How are his eyes? any evidence of jaundice? 2. How is mouth ? any painful ulceration? 3. How is neck? Any swelling or stiffness? swelling can be due to infection, stiffness may be a pointer to problems inside the skull 4. How are the limbs? Are they swollen D. 1. Any ear discharge or pain? 2. Any nose leak or nasal tip redness 3. Any Fast breathing Above problems can be evidence of bacterial infection 4. Severe cough? Post viral : cough can be a problem Hope he should be doing fine. If you are worried any time, always consult. We doctors, respect and understand your anxiety with regards arulalan