Hello,

Thanks for posting,

Let me start with the first question. Yes you can administer crocin (paracetamol) as it is an antipyretic and should be used especially in children with fever. If your son was diagnosed with ocular toxo and was given those treatments first septran (which in high doses is very effective) and dalacin (clindamycin, which is not best indicated for toxoplasma gondii infection-a parasitic protozoa but can be an alternative treatment). Spiramycin is drug of choice when patients develop allergy to cotrimoxazole (septran) as your son had. Given the present symptoms your son is having my impression is that he might have developed systemic toxoplasmosis (as it can cause fever + chills just like malaria). If septran was not in high doses and properly taken then it is possible that the treatment was not effective. Blood tests being normal is not strange as toxoplasmosis can present that way and specific blood test for toxoplasma IgG/IgM should be done. If positive then drug of choice should be spiramycin and should be started immediately before more severe complications like cerebral toxoplasmosis develop. Depending on your environmental/epidemological context it will be wise from your doctor's part to rule out other affections such as malaria, dengue fever, typhoid fever, AOM etc.

Hope this was helpful and let me know if you got further questions.
Regards
Dr Nsah

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Hello,

Thanks for updating,
If toxoplasma IgG are positive and IgM negative it simply means there was an exposure of toxoplasma in blood but some how the active protozoal parasite is no longer available in blood. Yes it is possible for the parasite to spread from the ocular regions to the blood stream. The dosage of septran is fairly optimal for toxoplasmosis ( so we need not worry about the dosage). Just wish to know when the toxoplasma IgG was done, is it before or after starting treatment with septran? If before, then it needs to be redone again and the IgM tested equally too. The lab tests requested are good and you should just wait for the report. Dolo 650 or Crocin are both antipyretics (each with basic molecule of paracetamol). Either will still control the fever.

Hope this is a useful insight.

Dr Bernard, Nsah

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Hello Mr XXXXXXX

If Toxoplasma IgM is persistently negative, then there is a very high chance that there is active systemic diseases. The only possible way to actually determine the presence of toxoplasma is by doing blood culture and analysis. A parasitologist will be the specialist of choice to contact.
Fever of unknown origin is hardly idiopathic and there is always almost an underlying cause ranging first from infection, autoimmune diseases, tumors/blood cancers etc, hormonal imbalance, and other possible rare viral infections before we can even start thinking of idiopathic ( no cause) causes of the fever/other symptoms.
My suggestion is, if from the test nothing is identified, then a blood culture should be done and thorough investigation of all organs should be done.

Hope this helps
Dr Nsah

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Hello XXXXXXX

Yes it is very possible that it is just the viral infection and no more toxo. Like i said before toxo IgM being negative signifies there is no active systemic toxoplasma parasite. If the fever has not come back again there, it is good sign. A few days of observation will be worthwhile.
Since you present a whether as a possible issue, I am totally for that proposition.
To me the fever is nothing to worry about. Just wait a little for the test results to be out, if negative, then you can say for sure that your child has nothing to worry about.

If there is a viral flu going on, then your son must have been affected. If that is the case, then just paracetamol for fever will be enough and since there is no more fever, then it would not be necessary.

Wish you the best with your son and hope he stays healthy.
Dr Nsah

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Your Welcome Mr. XXXXXXX Wish your son a better health.

Cheers
Dr Nsah

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