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Suggest Treatment For Recurring Fever
Question: My son is 3 years and 8 months old. he keeps geting fever after every 15 days. last time he had high fever for 7 days. and now today again, he is having fever. I contacted child specialist. but every time, he writes the same medicines. Should we go for any specific medical tests for my son?
Brief Answer:
Additional information required
Detailed Answer:
Hi
Welcome to Healthcaremagic
Greetings of the day
Dear Mr XXXXXXX
Fever Is not a disease but it is manifestation of underlying disease. The most common cause of Fever is infection.
I would require additional information for me to be able to assist you further
1. Since how long has he been experiencing bouts of Fever
2. What is recorded temperature during fever
3. Is there any associated symptoms like urinary , respiratory , loose motion
4. Is the child gaining weight adequately?
5. Is there any rash during fever
6. What are all the investigation done so far
Awaiting your response
Take care
Best regards
Dr Deepak Kishore
Consultant Pediatric Surgeon
Additional information required
Detailed Answer:
Hi
Welcome to Healthcaremagic
Greetings of the day
Dear Mr XXXXXXX
Fever Is not a disease but it is manifestation of underlying disease. The most common cause of Fever is infection.
I would require additional information for me to be able to assist you further
1. Since how long has he been experiencing bouts of Fever
2. What is recorded temperature during fever
3. Is there any associated symptoms like urinary , respiratory , loose motion
4. Is the child gaining weight adequately?
5. Is there any rash during fever
6. What are all the investigation done so far
Awaiting your response
Take care
Best regards
Dr Deepak Kishore
Consultant Pediatric Surgeon
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
1. Since how long has he been experiencing bouts of Fever
He has been getting this fever from last two months. Last time it was 15 days back.
2. What is recorded temperature during fever
Last time, it went upto 102. Today, it was mild but we gave paracetamol in advance.
3. Is there any associated symptoms like urinary , respiratory , loose motion
No, other symptoms, just high fever.
4. Is the child gaining weight adequately? - No
5. Is there any rash during fever - No
6. What are all the investigation done so far .
No investigation as such. Last time, we gave him Meftal-P for Paracetamol and Mox as antibiotic. This was prescribed by doctor we visited.
He has been getting this fever from last two months. Last time it was 15 days back.
2. What is recorded temperature during fever
Last time, it went upto 102. Today, it was mild but we gave paracetamol in advance.
3. Is there any associated symptoms like urinary , respiratory , loose motion
No, other symptoms, just high fever.
4. Is the child gaining weight adequately? - No
5. Is there any rash during fever - No
6. What are all the investigation done so far .
No investigation as such. Last time, we gave him Meftal-P for Paracetamol and Mox as antibiotic. This was prescribed by doctor we visited.
Brief Answer:
Further investigation required
Detailed Answer:
Dear Mr XXXXXXX
The commonest cause of recurrent fever in children is
1. Non Specific Viral fever
2. Urinary tract infection
3. Tuberculosis
It is important to thoroughly evaluate and investigate. I would suggest the following investigation in consultation with your Pediatrician
1. Complete Blood Count
2. Peripheral smear examination
3. Urine Routine and microscopic examination
4. Chest X Ray
5. ESR
6. PPD testing
Do get back to me with the results
Take Care
Best Regards
Dr Deepak
Further investigation required
Detailed Answer:
Dear Mr XXXXXXX
The commonest cause of recurrent fever in children is
1. Non Specific Viral fever
2. Urinary tract infection
3. Tuberculosis
It is important to thoroughly evaluate and investigate. I would suggest the following investigation in consultation with your Pediatrician
1. Complete Blood Count
2. Peripheral smear examination
3. Urine Routine and microscopic examination
4. Chest X Ray
5. ESR
6. PPD testing
Do get back to me with the results
Take Care
Best Regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
I have attached the reports for following tests :-->
1. Complete Blood Count
2. Peripheral smear examination
4. Chest X Ray
5. ESR
Report for PPD Testing would come day after tomorrow. And I will get the Urine test tomorrow.
In the mean time, we are continuing with Meftal-P and Mox.
The blood report shows MICROCYTIC HYPOCHROMIC ANEMIA WITH LEUCOCYTOSIS.
i hope nothing to panic. Would be waiting for your review.
Thanks,
XXXX
I have attached the reports for following tests :-->
1. Complete Blood Count
2. Peripheral smear examination
4. Chest X Ray
5. ESR
Report for PPD Testing would come day after tomorrow. And I will get the Urine test tomorrow.
In the mean time, we are continuing with Meftal-P and Mox.
The blood report shows MICROCYTIC HYPOCHROMIC ANEMIA WITH LEUCOCYTOSIS.
i hope nothing to panic. Would be waiting for your review.
Thanks,
XXXX
Brief Answer:
There is no need for panic
Detailed Answer:
Hi
Dear XXXXXXX
Looking at report there is nothing to panic for sure. There is increase WBC(Leucocytosis) which denotes infection. I would suggest you to get Urine examination ( Clean Catch midstream ) and Urine Culture and antibiotic sensitivity.
Take Care
Best Regards
Deepak
There is no need for panic
Detailed Answer:
Hi
Dear XXXXXXX
Looking at report there is nothing to panic for sure. There is increase WBC(Leucocytosis) which denotes infection. I would suggest you to get Urine examination ( Clean Catch midstream ) and Urine Culture and antibiotic sensitivity.
Take Care
Best Regards
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Is there a deficiency of Iron as well. Around 1.5 years back we got the test done. Then also, we got MICROCYTIC HYPOCHROMIC ANEMIA.
As and when we get the urine test reports, should we continue with the same medication?
As and when we get the urine test reports, should we continue with the same medication?
Brief Answer:
Continue Meftal
Detailed Answer:
Hi
Dear XXXXXXX
Meftal p is antipyretic for reducing fever. Mox is antibiotic. I would not ideally recommend giving antibiotic unless specifically indicated in proven bacterial infection. Do continue with Meftal p for control of Fever.
I would suggest the following for anemia
1. De worm the child ; Single dose of Albendazole 400 mg
2. Hematinic and multi vitamin supplements
Let's wait for urine and ppd report.
Take care bro
Regards
Deepak
Continue Meftal
Detailed Answer:
Hi
Dear XXXXXXX
Meftal p is antipyretic for reducing fever. Mox is antibiotic. I would not ideally recommend giving antibiotic unless specifically indicated in proven bacterial infection. Do continue with Meftal p for control of Fever.
I would suggest the following for anemia
1. De worm the child ; Single dose of Albendazole 400 mg
2. Hematinic and multi vitamin supplements
Let's wait for urine and ppd report.
Take care bro
Regards
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Doctor for all your help till now. Will upload reports as soon as I get them.
Brief Answer:
Take Care
Detailed Answer:
Take Care Bro
Good night
Take Care
Detailed Answer:
Take Care Bro
Good night
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
Today we got the report for Urine regular and PPD. They are attached.
Montoux test is positive. Please look into the reports and advise.
Thanks,
XXXX
Today we got the report for Urine regular and PPD. They are attached.
Montoux test is positive. Please look into the reports and advise.
Thanks,
XXXX
Brief Answer:
It is active Tuberculosis
Detailed Answer:
Hi
Dear Mr XXXXXXX
Thanks for providing me the reports.
Montoux test is conclusively positive. In view of repeated fever being present for more than 2 weeks ( no other cause being found for fever) it suggest the possibility of active Tuberculosis. Chest X ray being normal is very reassuring.
The child will require anti-tubercular treatment for 6 months. Do not worry the temperature should settle down after initiation of treatment. I would suggest you to start the same in consultation with your Pediatrician.
Do keep me updated about progress.
Best Regards
Dr Deepak
It is active Tuberculosis
Detailed Answer:
Hi
Dear Mr XXXXXXX
Thanks for providing me the reports.
Montoux test is conclusively positive. In view of repeated fever being present for more than 2 weeks ( no other cause being found for fever) it suggest the possibility of active Tuberculosis. Chest X ray being normal is very reassuring.
The child will require anti-tubercular treatment for 6 months. Do not worry the temperature should settle down after initiation of treatment. I would suggest you to start the same in consultation with your Pediatrician.
Do keep me updated about progress.
Best Regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Hello Doctor,
Thanks for your advise. I have one question.
My son had BCG vaccination and the chest x-ray is clear.
Can BCG vaccination cause positive montoux test in kids?
My son had from 25th Aug to 30 Aug. After that he was fine. The fever started again a day before yesterday.
Can it be a case of getting bacterial infection again?
Thanks for your advise. I have one question.
My son had BCG vaccination and the chest x-ray is clear.
Can BCG vaccination cause positive montoux test in kids?
My son had from 25th Aug to 30 Aug. After that he was fine. The fever started again a day before yesterday.
Can it be a case of getting bacterial infection again?
Brief Answer:
Anti-tubercular treatment needed
Detailed Answer:
Dear XXXXXXX
There could be cross reactivity with BCG vaccine and PPD used for Montoux test, but the amount of induration is usually less than 10 mm.
Possibility of Active Tuberculosis infection is more likely in view of below facts
1. Fever which has not responded to antibiotics:
2. No other localising sign of infection that can be attributed to other possible bacterial infection
3. Positive Tuberculin test
In case of Latent active infection Chest X ray could still be normal .
The child requires further assessment by
1. Sputum for AFB and LJ medium culture
2. If there is no Sputum , it can be induced by nebulisation or nasopharyngeal swab can be taken
3. Gastric lavage specimen
These specimen need to submitted for
1. AFB staining
2. LJ culture
3. BACTEC/PCR
Even if the test are negative, in clinical picture of long standing fever and positive Montoux test, I have started my kid patients on Anti-tubercular treatment . They do well.
Take Care
Regards
Deepak
Anti-tubercular treatment needed
Detailed Answer:
Dear XXXXXXX
There could be cross reactivity with BCG vaccine and PPD used for Montoux test, but the amount of induration is usually less than 10 mm.
Possibility of Active Tuberculosis infection is more likely in view of below facts
1. Fever which has not responded to antibiotics:
2. No other localising sign of infection that can be attributed to other possible bacterial infection
3. Positive Tuberculin test
In case of Latent active infection Chest X ray could still be normal .
The child requires further assessment by
1. Sputum for AFB and LJ medium culture
2. If there is no Sputum , it can be induced by nebulisation or nasopharyngeal swab can be taken
3. Gastric lavage specimen
These specimen need to submitted for
1. AFB staining
2. LJ culture
3. BACTEC/PCR
Even if the test are negative, in clinical picture of long standing fever and positive Montoux test, I have started my kid patients on Anti-tubercular treatment . They do well.
Take Care
Regards
Deepak
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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