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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Fever, Panadol, Ponstan, Vomiting And Loose Motion, Shivering, Cause And Treatment

my 8 month old daughter had fever last Friday 6/4, we gave panadol alternating with ponstan every 4-5 hrs to keep the fever down. Intensity of fever was bearable for Friday though heading into Saturday, fever intensity increased, recorded up to 102degrees, also she started to vomit & loose motion. also roughly about 3 hrs after the dose of panadol/ponstan she would start to shiver ( lips , hand & toes would even turn blue). however her head would be quite warm. seeing her get cold shivers we would wrap her up and after 30min or so she would get high fever upto 103. her hands & toes would follow to same temp but after 30-40mins. as the 4th hr completes we would give her next dose of panadol/ponstan and it would take roughly an hour or so for temp to drop to normal. we got her tested for malaria , typhoid , & blood CBC. former 02 were Negative (thank God), however her CBC showed Nutrophilis count as 48.6%, and on doctor s advice we started antibiotic - CEFSPAN (Cefexime). Today was the 4th day of this antibiotic, her fever intensity has definitely dropped, though she still get temp around 5th hr after the last dose of panadol/ponstan. shivering has improved too but again not completely gone. a little background of my daughter...she was born & is completely healthy (MASHALLAH). However, jan this yr she suffered a bacterial infection in blood & urine, she was hospitalized for 3 days & completed 04 day intravenous + 11 day oral antibiotic course. Unfortunately, she caught measles pretty soon after that episode, probably from her stay in the emergency ward at hospital, and unbelievably, after measles she caught chicken pox too (her measles/chicken pox vaccine was due at age of 9months, while she was 7 months only then). so she has constantly been falling ill for one reason or other for past 4 months now. My questions: • are we on the right track? i mean should we go for some other test/medicine etc? • What is causing her this shivering? • Should i get her tested for urine DR too? (the sample drawing procedure is really very painful). • Even if bacterial infection is shown in her urine, how would her medication change? may be intravenous again? she is already on antibiotic now, so would the urine DR report be accurate? Thanks guys, i know its a long query but i am a worried father, so any help/advice would be much appreciated.
Thu, 24 May 2012
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General & Family Physician 's  Response
Hello and Welcome to ‘Ask A Doctor’ service.

I have reviewed your query and here is my advice. From your daughters symptoms I can gather that she has recurrent urinary tract infection. This infection gives rise to vomiting and shivering as you described with high grade fever. It will be useful if you get her urine tested for culture and sensitivity as cefspan is not effective nowadays for urinary tract infection.

Since your baby is only 8 months old the antibiotic which is most effective for UTI cannot be used (nitrofurantoin). You can try Augmentin syrup after consulting your pediatrician if you want to go for oral treatment. If you want to get her admitted and treat her injection netromycin is a good option (as UTI causing bacteria are usually sensitive to this antibiotic). All medications have to be started after consulting a pediatrician regarding the dose and potential side effects.

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

Regards,
Dr. Abeed Basheer
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Fever, Panadol, Ponstan, Vomiting And Loose Motion, Shivering, Cause And Treatment

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. From your daughters symptoms I can gather that she has recurrent urinary tract infection. This infection gives rise to vomiting and shivering as you described with high grade fever. It will be useful if you get her urine tested for culture and sensitivity as cefspan is not effective nowadays for urinary tract infection. Since your baby is only 8 months old the antibiotic which is most effective for UTI cannot be used (nitrofurantoin). You can try Augmentin syrup after consulting your pediatrician if you want to go for oral treatment. If you want to get her admitted and treat her injection netromycin is a good option (as UTI causing bacteria are usually sensitive to this antibiotic). All medications have to be started after consulting a pediatrician regarding the dose and potential side effects. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Abeed Basheer