Hello, Thanks for posting on HCM, Your daughter is suffering from fever of unknown origin and when faced with such situation (plus the fact that he was in a tropical region), it is best the doctors start running investigations to find out any possible loci of infection. The lump on her forehead could simply be an abscess developing (which might not even be related to her symptoms). Most children in my consultation who present with fever of unknown origin usually get screened for enteric/typhoid fever, UTI, respiratory tract infection, ENT infection (Acute otitis media), sepsis, malaria (even though you mentioned that she was on malarone but she could have had more resistant strains of the parasite or suffer from hyperparasitosis which would not respond to oral treatment-allowing IV quinine or arthemeter to be the only treatment of choice). etc. Detecting ear infection is clincial (through otoscopic exams) but treating with only amoxicillin might not be the optimal possibility given that most germs nowadays are resistant to simple amoxicillin but with additional clavulinic acid, the treatment might be more effective or changing treatment with a 3rd generation cephalosporin such as cefotaxime could be much more beneficial. I suggest that your daughter should undergo some laboratory tests such as - Complete blood count - CRP - Urinalysis - Blood culture - Widal test - Thick blood film - Stool exams - Sputum test for AFB - others deemed necessary by her doctor. Note that, a negative chest radiograph does not always rule out a respiratory tract infection. Diseases such as pulmonary tuberculosis could be solely responsible and if that be the case your daughter will require specific antibiotics to get rid of the causative microbe. I do not know of any tropical parasites or spiders that can result to such symptoms. If you want further detailed answer, please do consider upgrading to our premium questions. Hope this helps