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Otitis media

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My 1 yr old son has developed a fever since morning.he is running a temperature of 100-101F since 11 a.m. he is very whiny and tearful and less active than normal.He had no cough or cold,Ň°uddenly he got the fever. a similar incident of fever occurred about 3 weeks back, which lasted for a day. it was preceded by a bout of loose motions for 4 days. no medication other than paracetamol was given. for the past 2 weeks he has been passing stools 2,3 times daily, every time he takes his meals. But the consistency of the stool was normal. But today he has not passed stool at all.also for the past two weeks he has been tugging at his ears at night but no major bout of crying occurred.


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,

Thank you for your consult at DoctorSpring.com.

The description that you have provided seems to be related to a febrile viral illness.
Child being whining and tearful during febrile episodes can be attributed to fever itself, if the child is well and interactive during fever-free hours. At this point, no blood or urine investigations would yield anything significant. Hence, it would be advisable to continue oral anti-pyretic therapy (Paracetamol) alone for child's comfort. It is also better to get the child's EAR EXAMINATION by a pediatrician to rule out underlying OTITIS MEDIA as the cause of fever.

In case fever persists for a day or two, then it would be advisable to visit the nearest pediatric emergency and consider a few blood and urine investigations to detect the cause of fever. At this point, these investigations may not have a significant diagnostic yield. In case of any more concerns, please feel free to revert back to me for further advice.

Regards
Dr. Saptharishi L G


Patient replied :

Thank you for your time. Could you please suggest what type of food i can give to him in his febrile state?


Expert:  Dr. Saptharishi L G replied 3 Days.

Dear Parent,
Though there are no standard recommendations on the type of diet to be prescribed for a child with fever, easily digestible food substances are to be preferred. These should also be food substances that the child has already been introduced to. Breastfeeding the child (if the child was already on breastfeeds) would help. Easily digestible food substances include cereals, milk, fruits, mashed vegetables, etc. can be tried if he is used to taking these. Avoiding excess of milk and non-vegetarian diet could help.

Regards
Saptharishi L G


Patient replied :

Thank you doctor. Just one final question. My son's fever is not going down below 100 and three times has gone up to 102F. I have given him Paracetamol every time his temperature reached 102, but not when it is 101 or below as he was otherwise okay, playing and eating. Now a friend told me that a temperature of 100 for long can damage his brain. I am very scared now, have I done something wrong? Also, he has not passed stool for two days now, while he used to pass at least twice and sometimes even thrice every day. what to do?


Expert:  Dr. Saptharishi L G replied 2 Days.

Dear Parent,
Rest assured! You have done nothing wrong and unfortunately, I do not agree with your friend. There is no evidence to prove that temperature above 100 F can damage brain. Certain children aged 6 months- 6 years are prone to even seizures with fever, but even among these children with febrile seizures, there is no evidence of brain damage. You can refer standard medical textbooks as well as peer-reviewed medical literature. Persistent fever would be of concern in view of the possibility of an underlying bacterial infection, but not for brain damage.

Constipation during acute illness is not uncommon. No particular action needs to be taken for that. Give him plenty of fluids and fibre-rich diet. In case the constipation persists, one could try oral lactulose (5 ml twice daily).

Hope your son gets well soon.


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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