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What Causes Headache, Chronic Fever And Sore Throat In A Child?

Posted on Fri, 22 May 2015

Question: 6 year old with headache, chronic fever and sore throat

Answered by Dr. Sumanth Amperayani (36 minutes later)

Brief Answer:
It could be viral or streptococcal pharyngitis

Detailed Answer:
Hi....by what you quote I feel it could be a viral or streptococcal pharyngitis.

I have a few questions for you -

1. How long has the fever been there and if so how high?
2. Is there severe cough?
3. Is there severe pain in throat while swallowing?
4. If you can see in the throat, check if there are any red spots in the palate or pharynx?
5. Is anybody else in the family having fever or sore throat now apart from the kid?
6. How is the activity of the kid when the fever touches normal?

Kindly get back to me with answers to above questions and I will be glad to guide you further.

Regards - Dr. Sumanth

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

Follow up: Dr. Sumanth Amperayani (17 minutes later)

The fever was first noticed three days ago. It is between 102 and 103. There is no cough. She is having severe throat pain but not necessarily when swallowing. Nobody else in the family has similar symptoms. When the fever touches normal her activity is normal.

Answered by Dr. Sumanth Amperayani (1 hour later)

Brief Answer:
It could be viral or streptococcal pharyngitis

Detailed Answer:
Hi...I have the following suggestions for you -

1. Approach your pediatrician and get the rapid test for streptococcal sore throat done.

2. If it is positive that means it is a streptococcal sore throat and hence it requires oral antibiotic - preferably Amoxycillin which you are already on.

3. If it is negative then a throat swab with culture and sensitivity is indicated and the result will be available in 2 days.

It might be a simple viral illness too and I will suggest how a viral illness behaves - 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.

Regards - Dr. Sumanth

meanwhile you can give Paracetamol for fever and ask her to do warm saline gargles

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