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What Causes Persistent Fever In A Child?

Posted on Fri, 6 Oct 2017

Question: Dear Doctor,
My son (4 years old) had fever a few days ago, went to the doctor (a General Practitioner). As per his advice we were giving "Refid Plus" thrice a day (5ml-5ml-5ml) for three days. Later it looked like the fever is reduced. We stopped giving the medicines.
From past 2-3 days my son was a little dull, his palm & forehead were a little hot so we consulted the Pediatrician & explained the same that he had fever a few days ago & about "Refid Plus". When he checked the temperature, 98 degree Fahrenheit. He suspected Typhoid & suggested some tests to check the platelet counts & other details. He also prescribed the following:
Coldhit (5ml-5ml-5ml)
Macpod - 100 (3.5ml - 0 - 3.5ml)

Please refer to the attachments (Lab Reports, Doctor Prescription). Pls suggest what to do

Answered by Dr. Dr. Pradeep Kumar Jain (2 hours later)

Brief Answer:
Continue same and don't get worried

Detailed Answer:
Hi

Thanks for asking on this platform

I have gone through the attachments and do understand your concern.
Here I won't get worried as the blood reports are normal. Raised lymphocytes can be due to some viral infection.
No need to give any regular medicine for temperature as the temperature of 98 is normal.
Continue giving coldhit (cough syrup) and macpod(antibiotic) as advised. In most of the cases the condition improves within 3-5 days.
Watch for general activity and temperature. Give frequent small feed with plenty of fluids. If you notice any significant abnormality please contact your pediatrician immediately.

I hope this helps.
Please let me know if you have any more questions.
Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Pradeep Kumar Jain (19 hours later)

Thank you so much for providing such convincing answer.
I was just looking at the lab report & going through the parameters mentioned on it. As there are two columns (Result(s) & Biological Reference Interval), I was able to take a look but couldn't understand a few things.
Can you please brief on the below?
'TOTAL & DIFFERENTIAL COUNT'
(1) Electrical Impedence: NEUTROPHILS % : In children it should be Children (Children:2 - 6 Years) : 30 - 53% [but my son has 22.30 % which is lesser than the ideal range]
(2) Flow Cytometry: LYMPHOCYTES % : In children it should be Children (Children:2 - 6 Years) : 30 - 60% [my son has 64.70 % which is more than the ideal range]
(3) Flow Cytometry: MONOCYTES % : In children it should be Children (Children:2 - 6 Years) : 2 - 8% [my son has 9.40 % which is agai more than the ideal range]
What are NEUTROPHILS, LYMPHOCYTES & MONOCYTES & what it means if these are above or below the average level as mentioned above? pls explain in detail.
Pls look at the new attachments

Answered by Dr. Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
No need to worry as mild variation can be there even in normal baby

Detailed Answer:
Thanks for follow up

Neutrophil, lymphocyte and monocyte are white blood cells which help in immunity and fight against the different type of organism. Like Neutrophil count increases in bacterial infection, lymphocytes mainly in viral infection and monocyte in some atypical infections.
I have seen the reports carefully and won't get worried as mild variation is very common in all age group(different labs have their own range which may differ slightly from the standard value) and unless there is some significant derangement no specific treatment is needed.
So don't worry and observe the general condition of your child.
I shall be glad to help you out if you need any.
With regards

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