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What Causes High Fever With Red Rashes On Body In An Infant?

Posted on Tue, 24 Nov 2015

Question: 17 mo old. In hsp. Temp up to 106 over 15 days. Down to 96 last night. All blood work norm. CTs of head, chest, abd normal. Red rash intermit.

Answered by Dr. Anshul Varshney (1 hour later)

Hello. Probably viral fever.

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

Follow up: Dr. Anshul Varshney (5 minutes later)

That has been ruled out b/c of duration. Peds have no answer. Consult with hematologist and rheumatologist are next on list. Do you have any ideas that are less common?

Answered by Dr. Anshul Varshney (10 minutes later)

Brief Answer:
Provide me details.

Detailed Answer:
Welcome To HCM. I am Dr Anshul Varshney. I understand your concern.
I need to know a few more things before providing you my opinion:
1. Is the fever still ongoing as so high up to 104-5?
2. Exact age and weight of your child?
3. What is the ESR value?
4. Where exactly is the rash and since when?
5. Attach all reports.
6. City of residence.
Revert with the asked details for a better help.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Anshul Varshney (17 minutes later)

Temp still going up as high 106. Treated w/ tylenol, ibuprfen and indo---. The rash is gone now. It appears intermittently on torso and legs. Tiny red dots. What is ESR? We are asking at the hosp. She is 10.5 kg in weight, 17 months old. She is at Childrens Hosp. In XXXXXXX AL.

Answered by Dr. Anshul Varshney (3 minutes later)

Brief Answer:
I need reports to comment.

Detailed Answer:
ESR is a market of inflammation and it can guide us that there is any inflammatory process ongoing or not.
I need to see reports to comment.
I would recommend a MRI Brain, CT Abdomen , Bone marrow and CSF examination further to make the diagnosis. It's very unlikely to be viral fever as it's still high even after 15 days.
Further investigations are must and warranted.
Revert with all investigations.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Anshul Varshney (13 minutes later)

Ct of brain and abdomen done. Clear. Spinal tap done. Clear. We are working on getting the reports. We are working to get ESR, too. We hope to see specialists today: rheumatology and hematology. If you type another resonse, then the window opens so i can send more info as we get it. Thank you very much.

Answered by Dr. Anshul Varshney (14 minutes later)

Brief Answer:
Attach reports.

Detailed Answer:
I suppose Rheumatology opinion is must. I would consider Juvenile Still's disease as a possibility. It also presents with rash. We need to have serum ferritin levels and a clinical examination looking for lymph nodes.
Get all reports from hospital and attach them.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Anshul Varshney (6 hours later)

Cant get records. I think you might be right on. Rheumatology team in XXXXXXX AL says all signs point to JUvenile Arthritis. She is having a bone marrow biopsy tomorrow. Thank you for your assistance and you get five stars.

Answered by Dr. Anshul Varshney (3 hours later)

Brief Answer:
Good luck.

Detailed Answer:
If they are suspecting Juvenile Arthritis then ESR must be high.
Keep in touch. Share the final diagnosis.
If you have any further query, please ask me.
Wish your child a speedy recovery.

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Anshul Varshney (37 hours later)

The diagnosis is Juvenile Systemic Arthritis, or Still's, as you suggested. Bone marrow biopsy was normal. She is being treated with Anakinra, beginning last night. Her body temp went down to 96 overnight. We have high hopes that the treatment will bring remission, but if not, we are rsigned to ongoing treatment. Thank you again for your help.

Answered by Dr. Anshul Varshney (5 minutes later)

Brief Answer:
Hopefully she would improve.

Detailed Answer:
I am hopeful Anakirna should work. Your doctor's must have considered giving her steroids that would also get her into remission very soon.
Keep discussing and updating me her progress.
I wish the little girl a very speedy recovery.
Stay Healthy.

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