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Suggest Treatment For Fever With Fatigue And Appetite Loss

Posted on Mon, 16 Jun 2014

Question: My 9 year old was a bit tired at her field trip on May 22 and that evening after taking a bath she got hot and her temp was 101.4, we gave her Advil and she sleep through the night, in the a.m. she had a 100.4 so we kept her home from school and took her to her ped. the urine sample did show some pustels but the rapid strep came back negative. The doctor prescribed amoxicillin and to start it due to holiday weekend and the length of time the culture would take to get back. She has had 4 doses of amoxicillin and her temp. has been as low at 98.2 but has mostly hovered around the 100.8 to 102.7 range all day. She is lethargic and has a decreased appetite and is sleep a good part of the day. What do I do. Thank You.

Answered by Dr. Sumanth Amperayani (1 hour later)

Brief Answer:
It looks like viral illness

Detailed Answer:
Hi...Thank you for consulting in Health Care magic. Fever of 3 days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If she is active and playing around when there is no fever, it is probably and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. You can treat fever with Paracetamol at 15mg/kg/dose every 4-6th hourly if fever is > 100F.
Moreover once rapid test is negative you can be rest assured that it could as well be viral. But once you have started antibiotics I suggest you wait for the initial culture reports which will be available in 2 days.
Being lethargic and decreased during fever is common. Please do not worry.

Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.
Dr. Sumanth MBBS., DCH., DNB (Paed).,

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Sumanth Amperayani (36 hours later)

Hello, she is still having fever and now both knees are hurting but mostly the right. However, right now she is acting fine and eating more, not her regular self but much more happy, what do I need to do. The uti culture came back with a little bacteria but we were instructed to stop the antibiotic, she did have a small vomiting episode this am after drinking water, it was only clear liquid that came up. She still has 2 canker sores/mouth ulcers. Thank you for your help.

Answered by Dr. Sumanth Amperayani (9 hours later)

Brief Answer:
Viral illness (Recovering)

Detailed Answer:
Hi... Thank you for the trust in me.

Today is only 5th day of fever. Mild joint pains and occasional vomiting is common in viral illness. That too when her food intake is improved and she is active fine, it means she is recovering from the viral illness.

Your pediatrician was very much right in stopping antibiotic for insignificant growth in urine culture.

But you compare how her fever was initially during the start of illness and how it is now. Definitely it would be better. That is a sign of recovering viral illness. So be rest assured. She is on the recovery path.

Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.
With regards - Dr. Sumanth MBBS., DCH., DNB (Paed).,

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Above answer was peer-reviewed by : Dr. Prasad