Suggest Treatment For Acute Tonsillitis In A Child

Posted on Tue, 5 Jan 2016

Question: Hi my 20 months old son has got pus in his tonsils due to which he has got high fever which is going upto103.3F.. I have been giving him Ibugesic plus every 6 hours and Azithral BD as per his paed. He also suggested to give him a dose of Meftal P in case fever doesnt go down. Since evening he has been vomitting and not eating or drinking milk. He has vomitted six times till now and right now his fever is 101F. Pls suggest what should i do?

Answered by Dr. Sandip Kabra (1 hour later)

Brief Answer:
Consult pediatrician immediatly.

Detailed Answer:
Hello,
Welcome to HCM.

Acute tonsillitis is not uncommon in children and the treatment you have been given is okay (azithromycin,ibugesic plus,meftal-p) to get relieved from the high fever and infection.

If his fever is not subsiding (101 F) and he has vomited six times and not able to take oral feeds/milk then you should see your treating pediatrician immediately rather than waiting for more time.

Your doctor may order some blood works and your son may require intravenous antibiotics with anti-pyretics and intravenous fluids (dextrose 5%,Iso-P) since continuous vomiting is not a good sign.

However,One can wait for next 12 hours to subside this vomiting and the antibiotic effect to occur but personally I would never recommend to do that,rather see your doctor immediately and give your son IV medications with the help of pediatrician.

Hope this will help.

Regards,

Dr.Sandip Kabra

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Sandip Kabra (22 hours later)

Thanku sir! I did meet his paed. He has now prescribed him meftal P every 5 hours and Crocin DS after 2 hours of Meftal P also Advent forte BD alongwith Azithral. He is still vomitting and there is only 5 to 10% improvement in his tonsil despite three days of medications. He has asked me to watch him overnight and if he still doesnt take any feed which he is not,he will admit him in the morning for IV.. Also he is saying as he has got tonsils thrice since birth always very severe he might have to decide upon a surgery for the same! I hope we are going the right way. Please advice!!

Answered by Dr. Sandip Kabra (23 minutes later)

Brief Answer:
better to get admitted.

Detailed Answer:
Hello,
Welcome again,

If your son is still vomiting and not taking any feeds then the best treatment is to get admission in pediatric hospital and initiate IV line treatment.

Here,I am not able to understand why your doctor wants to wait further, despite almost no improvement with medications even after three days has passed.

Also,there is nothing wrong to admit the child and keep him under observation for at least 24 to 48 hours.

We can also ensure his medications frequency,temperature,pulse,respiration,fluid intake/urine out put,stool frequency and overall well being by keeping him under observation.

Anyway,you can see him tomorrow in his morning OPD and ask him to admit the child.If he does not agree then it would be better to take another opinion from some different pediatrician for the same.

However,there is nothing serious or nothing to be worried much since this kind of problems can be easily managed by proper medical treatment and care but better to be in a safer side especially in case of child/infants.

Surgery can also be done if the tonsil problem is frequent but it is not possible at this point of time or can be only possible once your son come out from this symptoms.

hope this will help you and let me know if anything is unclear.

Regards,

Dr.Sandip

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj