Fever reoccuring with regular interval with normal blood tests.

Resolved Question:

My 13 month old child fever has not been going for last 3 month. I consult with a lots of doctor but improvment is neel. He got a fever of 102┬░-103┬░ after a regular interval of 6-8 hour.
Recently he was admitted in holy family hospital for 7 days where dr. Sona visit my child daily. At last as always she says that she can't help my child because she cn't find the actual cause of fever.. thats why i discharge him today. His weight is 10kgs


Category: Pediatrician

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Category: ICU/ Critical Care Specialist
Dr. Saptharishi L G is online now

Expert:  Dr. Saptharishi L G replied 4 Days.

Dear parent,
I can understand your concerns.
Any child who continues to have fever for such a long duration and if despite inpatient evaluation, no cause can be identified, then this child would fit into the label of PYREXIA OF UNKNOWN ORIGIN/ FEVER OF UNKNOWN ORIGIN.
Such a child usually has atypical infections such as brucella, tuberculosis, etc or cancers such as lymphoma or autoimmune disorders.. Your child also would need evaluation for these conditions. These children usually require hospitalisation. A detailed history and examination may give valuable clues. A child with PUO cannot and should not be diagnosed over the internet. I would desist from giving any views regarding the underlying diagnosis, but will surely guide you to the right paediatrician.
Where are you based? Which is your nearest big town or district headquarters?
Regards
Dr. Saptharishi L G


Patient replied :

Sir we lived in Sarita vihar, New Delhi
And sir i wanna say that his X-ray and echo report is also normal..


Expert:  Dr. Saptharishi L G replied 3 Days.

Thank you for providing me with the details of your location. As I have already explained, a child with PUO is always a diagnostic challenge. Medicine is not all black and white where every investigation can be categorised as 'normal' or 'abnormal'. It is the combination of multiple subtle findings that leads to the diagnosis. So a child with PUO needs admission and evaluation.
As you are based in Delhi, you could consult at AIIMS ( government set ups) OR GangaRam or Apollo (private set ups) where sufficient facilities for evaluating a child with PUO exist.


Patient replied :

My 13 month son did not do potty for last 4 days Any medicine you can prescribe for him


Expert:  Dr. Saptharishi L G replied 2 Days.

Dear parent,
I can understand your concerns.
Medicines are given to treat a problem based on the underlying cause. A symptom like constipation can be because of multiple reasons. In a child with PUO, it can be because of the poor oral intake, fecal impaction, megacolon or even related to the primary disease.
Though constipation is very bothersome to the parent, there is no one medicine that will cure all forms of constipation. You could start Syrup Lactulose if other causes such as fecal impaction and chronic constipation have been ruled out.
A better approach would be too not treat the child piece-meal for each problem separately and focus on the disease process - on the whole. If you treat the underlying disease, then all symptoms would automatically disappear.
All the best.
Regards
Dr. Saptharishi L G


Dr. Saptharishi L G
Category: ICU/ Critical Care Specialist
Experience: 
Senior Residency: DM,  Pediatric Critical Care, PGIMER

Residency: MD, Pediatrics, Postgraduate Medical Education & Research (PGIMER), Chandigarh, 2013

Internship: JIPMER, 2009

Medical School: MBBS, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry, 2008
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