Suggest Treatment For High Fever And High CRP Level

Posted on Fri, 17 Apr 2015

Question: My son got admitted in hospital after 3days high fever. His crp is 153. Which is very high. What could be cause. What are the further tests required. His chest xray is normal. Next waiting for urine culture report. Iam very panic..

Answered by Dr. Sumanth Amperayani (39 minutes later)

Brief Answer:
3 DAYS FEVER AND HIGH CRP COULD BE VIRAL

Detailed Answer:
Hi...CRP being high doesn't mean that the illness is serious. Most important thing is the activity of the kid when the fever is down after giving fever medicine.

Fever of few 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 the kid is active and playing around when there is no fever, it is probably viral illness 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.

Paracetamol can be given in the dose of 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.

I have a few questions - You did not mention his age.

1. Is there chronic or recurrent fever off late?
2. Is there significant weight loss or loss of appetite?
3. Is he pale or has anemia?
4. Does he have any abdominal distension?
5. Are there any enlarged glands anywhere else like arm pits/ groins lateral part of neck etc?
6. Are there any limb pains?
7. Is he becoming exhausted very soon?
8. Is he having any pain while voiding?
9. Does he have any rash over the body?

Regards - Dr. Sumanth

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

Follow up: Dr. Sumanth Amperayani (31 minutes later)

reports attached

Answered by Dr. Sumanth Amperayani (27 minutes later)

Brief Answer:
I have gone through the reports - it is viral illness

Detailed Answer:
Hi...I have gone through the reports - it is viral illness.

If you observe the lymphocytes in blood test are more than polymorphs, it can happen only in viral illness and if really the infection is bacterial and very severe, the total count will be more than 15000-20000. It is only 5200 here.

This looks like viral illness only. Do not worry.

regards - Dr. Sumanth

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

Follow up: Dr. Sumanth Amperayani (5 minutes later)

But here doctor said crp is 153 which is very high.isn't it.. So definitely bacterial infection. So they started giving antibiotics since yesterday via iv.. Fever is getting slow down m. Still I see 101 some time today. And confused abt crp

Answered by Dr. Sumanth Amperayani (9 minutes later)

Brief Answer:
Blood and urine cultures before antibiotics

Detailed Answer:
Hi...It is safe to start antibiotics but I would have done blood and urine culture and waited. High CRP alone doesn't qualify to start antibiotics. Most important is as I have already told you, the activity of the kid. I wouldn't be worried if the kid is active and playful when the fever touches baseline after giving fever medicine.

Hope the doctor there has ordered a blood and urine culture before staring IV antibiotics.
regards - Dr. Sumanth

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