Ear Infection, High Fever, Cranky, Vomiting, Blisters In Throat, On Amoxicillin, Prescribed Augmentin. Emergency?

Posted on Sat, 18 Jun 2011

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 18 Jun 2011 Answered on

Wed, 23 May 2012 Last reviewed on

Question : My 13 month old was diagosed with ear infection on XXXXXXX 7th (tues). He also had his 1 year shots at that visit. He was put on amoxicillin (1 tsp) 2x a day for 10 days. Started antibiotics same night. 8 days into treatment (morning of 15th) he developed fever of 102.5 and was quite cranky and vomiting after his morning bottle. Took him to doc that afternoon. Doc advised he seemed to still have an ear infection but, also saw blisters in the back of his throat and thought he also had the mouth part of hand, foot and mouth. Doc prescribed augmentin for 10 days. The pharmacy was closed that night so we gave him a final dose of amoxicillin and about an hour later he vomited off and on for about 4 hours. He refused anything else to drink until the following morning, XXXXXXX 16th. We decided to hold the new antibotic until he stopped vomiting for 24 hrs. He has been vomtiing off and on since with low grade fever. He is taking about 16-18 ounces of fluid in a 24 hour period but, usually takes 24-32 plus 3 jars of baby food. He was in a decent mood on Thursday and Friday but, today he is quite cranky and has only taken about 6 ounces of formula since waking (usually is on his second or third bottle by now). I don't know what is wrong with him. I don't want to take him to the ER but, the doctors office isn't open until Monday. What should I look for to know if I should take him to the ER verses wait it out until Monday to go back to the doctor?

Answered by Dr. Dr. Prasad J (1 hour later)

Hi,

Thanks for your query.

I am a General Physician. Your query has been forwarded to a pediatrician for his expert opinion. An answer from the specialist is expected in a few hours. Since the problems reported by you look concerning, I take this opportunity to answer it now.

You reported that your child is suffering from upper respiratory infection (ear and throat) since last 11 days associated with fever, vomiting, reduced appetite/refusal to feed and irritability. A viral infection (mouth part of hand, foot and mouth disease) is being suspected as the cause. Amoxicillin has been ineffective inspite of more than 10 days use.

Viral infections usually are self limiting illness. Though antibiotics are not effective, most children recovery very well. However, excessive irritability, recurrent vomiting, refusal to feed in the back ground of on going viral infection can be a sign of viral(aseptic) meningoencephalitis. Absence of neck stiffness rules out meningoencephalitis. "Check if your child's neck is stiff on passively flexing the neck. If it is, then he needs medical attention".

Since subtle stiffness can be missed easily, I encourage you to consult a doctor as soon as possible.

Lastly, viral meningoencephalitis is also not life threatening, but I advice close monitoring to my patients who develop it.

Hence in my opinion, you need to get to the ER and not wait till monday.

Hope my answer is adequate and you appreciate it.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar