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Suggest Treatment For High Fever At Night
Question: Recently, my father-in-law has recovered from chicken pox diagnosed on 04th Apr 15. Though my son Avyay (turning 6 months old on 23 Apr 15) was diagnosed with chicken pox by a General physician (treating my father-in-law) on 14th Apr 15 after seeing blisters(around 10-15) on him. he was not having fever and was having formula milk normally. Parakem (kids) and lacto calamine were being applied. Further, new wave kept coming till 17th Apr 15 with total count around 300-400 blisters. Meanwhile we went to paediatrician on 16th Apr 15. Paediatrician prescribed Aciclovir(100mg three times), Atarax(2.5ml two times), Biocetamol(0.9ml three times) and Visyneral(1ml thrice a day) at 2000 hrs on 16th Apr 15. On 18th Apr 15 at 0100 hrs , my son Avyay was having 104.8F high fever with fussiness though blisters on stomach, face and back started crusting up. Biocetamol was given and fever subsided to 101.6F and then at 0700 hrs it was 104F again...ALL TEMPERATURE MEASUREMENT TAKEN UNDER ARM USING MERCURY THERMOMETER..After that we started wet cloth patting on face, hand and legs. Fever subsided to 101.8F. My queries are as follows:-
(a) What exactly has to be done at night in case of high fever like 104.8F ?
(b) Is the fever this high normal during chicken pox?
(c) What are the complications of chicken pox?
(d) With attached pictures could you tell me what can be safely applied to baby to prevent chicken pox marks?
(e) is it normal to have increased fever at night and early morning?
(f) is it normal to have Fever which started after 03-04 days of appearing of blisters?
(a) What exactly has to be done at night in case of high fever like 104.8F ?
(b) Is the fever this high normal during chicken pox?
(c) What are the complications of chicken pox?
(d) With attached pictures could you tell me what can be safely applied to baby to prevent chicken pox marks?
(e) is it normal to have increased fever at night and early morning?
(f) is it normal to have Fever which started after 03-04 days of appearing of blisters?
Brief Answer:
Suggestions on chickenpox and fever
Detailed Answer:
Hi...I have read through your query in detail.
Coming to your queries one by one -
1. Even if the fever is high the latest recommendations say not to do cold sponging. But 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.
2. High fever is common in chickenpox but not after so many days of illness. Fever like this after so many days of rash is suggestive of secondary bacterial infection and needs work up and intravenous antibiotics. But you son is looking well in the photographs and doesn't look like he is having a bacterial infection as he is not looking toxic or sick.
3. Complications can and do occur from chickenpox. Infection of the open pox sore by bacteria can injure the skin, sometimes causing scarring, especially if the patient scratches the inflamed area. Bacterial skin infection is, in fact, the most common complication of chickenpox in children. The next most common complications in children affect the central nervous system and include a disorder of the cerebellar portion of the brain (cerebellar ataxia with wobbliness, dizziness, tremor, and altered speech), encephalitis (inflammation of the brain with headaches, seizures, and decreased consciousness), damaged nerves (nerve palsies), and Reye's syndrome, a potentially fatal combination of liver and brain disease that can be associated with aspirin. (Children with fever should not take aspirin.)
4. Do not apply for the skin. Any application over the skin may spread and aggravate the lesions. Stop calamine lotion too.
5. Increased after so many days is not normal. I suggest you get your kid evaluated by a pediatrician for secondary bacterial infection.
6. It is not normal - That is why I am suggesting you to get him evaluated. He might require antibiotics either orally or intravenously.
Regards - Dr. Sumanth
Suggestions on chickenpox and fever
Detailed Answer:
Hi...I have read through your query in detail.
Coming to your queries one by one -
1. Even if the fever is high the latest recommendations say not to do cold sponging. But 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.
2. High fever is common in chickenpox but not after so many days of illness. Fever like this after so many days of rash is suggestive of secondary bacterial infection and needs work up and intravenous antibiotics. But you son is looking well in the photographs and doesn't look like he is having a bacterial infection as he is not looking toxic or sick.
3. Complications can and do occur from chickenpox. Infection of the open pox sore by bacteria can injure the skin, sometimes causing scarring, especially if the patient scratches the inflamed area. Bacterial skin infection is, in fact, the most common complication of chickenpox in children. The next most common complications in children affect the central nervous system and include a disorder of the cerebellar portion of the brain (cerebellar ataxia with wobbliness, dizziness, tremor, and altered speech), encephalitis (inflammation of the brain with headaches, seizures, and decreased consciousness), damaged nerves (nerve palsies), and Reye's syndrome, a potentially fatal combination of liver and brain disease that can be associated with aspirin. (Children with fever should not take aspirin.)
4. Do not apply for the skin. Any application over the skin may spread and aggravate the lesions. Stop calamine lotion too.
5. Increased after so many days is not normal. I suggest you get your kid evaluated by a pediatrician for secondary bacterial infection.
6. It is not normal - That is why I am suggesting you to get him evaluated. He might require antibiotics either orally or intravenously.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
First of all, let me thank you Doctor for your detailed reply. As suggested by you I had my son checked by a paediatrician Dr. Hemraj Ingale at Dombivli(Mumbai) for concerns raised by you. The doctor said that baby seems to be okay and told fever will come and go. Following medicines are prescribed:-
(i) ATARAX dose same as before{last dose- today 0500 hrs)
(ii) DERMADEW lotion (instead of calamine)
(iii) FEPANIL 125 (only in case of fever above 102F){last dose- yesterday 2130 hrs}
(iv) ACYCLOVIR dose same as before {last dose- today 0500 hrs}
Yesterday before going to Paediatrician, around 1900 hrs he had first loose motion and then next loose motion was today morning 0800 hours(little quantity) followed by second bout at 0900 hours (little quantity). Loose motion are slightly greenish in colour and baby is being formula fed(Nestle NAN PRO1). Fever of 101.2F was checked underarm at 0900 hrs today and has been below 102F for most time since putting up of yesterdays question. My questions are as follow:-
(a) Is it normal to have loose motions in chicken pox?
(b) Is loose motion side effect of any of the medicines mentioned above ?
(c) What is the temp (when taken under arm) considered as fever for baby 06 months old?
(i) ATARAX dose same as before{last dose- today 0500 hrs)
(ii) DERMADEW lotion (instead of calamine)
(iii) FEPANIL 125 (only in case of fever above 102F){last dose- yesterday 2130 hrs}
(iv) ACYCLOVIR dose same as before {last dose- today 0500 hrs}
Yesterday before going to Paediatrician, around 1900 hrs he had first loose motion and then next loose motion was today morning 0800 hours(little quantity) followed by second bout at 0900 hours (little quantity). Loose motion are slightly greenish in colour and baby is being formula fed(Nestle NAN PRO1). Fever of 101.2F was checked underarm at 0900 hrs today and has been below 102F for most time since putting up of yesterdays question. My questions are as follow:-
(a) Is it normal to have loose motions in chicken pox?
(b) Is loose motion side effect of any of the medicines mentioned above ?
(c) What is the temp (when taken under arm) considered as fever for baby 06 months old?
Brief Answer:
Suggestions on Chickenpox
Detailed Answer:
Hi.....coming to your queries -
1. Loose stools can occur in chickenpox as its a viral illness. Not very unusual. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.
2. There are no antibiotics in the prescription. Unlikely that Diarrhea is because of these medications.
3. Temperature of above 101F under armpit, measured with a thermometer and not adding anything to it is to considered as fever and paracetamol can be given in the prescribed dose.
Regards - Dr. Sumanth
Suggestions on Chickenpox
Detailed Answer:
Hi.....coming to your queries -
1. Loose stools can occur in chickenpox as its a viral illness. Not very unusual. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.
2. There are no antibiotics in the prescription. Unlikely that Diarrhea is because of these medications.
3. Temperature of above 101F under armpit, measured with a thermometer and not adding anything to it is to considered as fever and paracetamol can be given in the prescribed dose.
Regards - Dr. Sumanth
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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