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Temperature of 39.6 for 12 days in a 5 year old.... any ideas what is wrong?

(29 Posts)
hutchblue Sat 19-Jan-13 09:59:59

DD has had a temperature of 39.6 for 12 days now.

When we give paracetamol or ibuprofen it comes down to 37.6 for a few hours, then shoots straight back up. This is night and day.

When she's had medicine, she's almost like her old self, though tired and still hot and flushed looking. She will eat and drink. But once it wears off, she's very hot, and becomes distressed etc.

In the early part of the illness she fell asleep every day. She is not sleeping anymore now, which we think means maybe she's getting partly better but the temperature has not shifted.

We've been through 2 antibiotics which have made no difference and seen a consultant paedtrician at hospital in the A&E dept, as were getting desperate, as our GP was out of ideas.

Had chest x-ray, run blood tests (we're awaiting results). Initial results show a viral infection of some sort but we don't know what yet.

Has anyone on here ever had this kind of thing happen to their child? Or would anyone have any advice? What should we do next if the temperature stays high? It will be 2 weeks tomorrow.

dikkertjedap Sat 19-Jan-13 13:28:41

Did they check her for flu given that there is a flu epidemic?

The good thing is that the temperature responds to medication and that she is less sleepy. It may be best for her to have constant levels of medication in her blood to control pain/fever. The best way is to spread the doses of ibuprofen and paracetamol over the 24 hours and to space them so you do not give the two together. This does mean that you may give a dose during the night but usually they will take the dose and then fall straight away asleep again (no need for food).

It can be several weeks to recover from a bout of flu and if you are very unlucky you can catch different types of flu one after the other. In December it was mainy influenza B, end of December/start of January it was mainly H3N2 but now H1N1 (formerly known as swine flu) is started to increase. They are all nasty in their own right and were all included in this year's flu vaccination.

If suddenly she gets very high fever again, especially if not responding to medication, then it could indicate that she has a secondary infection (possibly pneumonia) and will need treatment. So even that her X-ray was clear now, this is something to remain vigilant about.

Hope she gets better soon. smile

hutchblue Sat 19-Jan-13 20:26:09

Thank you dikkert,
Do you really think flu would give a temperature so high for so long? I always thought it was over within a week or so, perhaps 10 days. We are on day 13 now and tomorrow will be 2 weeks and the temperature has never gone down, just remains stubbornly high at 39.6, occasionally higher. We haven't been out at all so I don't think she could have caught more flu from anywhere...
She also complains of eye pain sometimes, like tonight she tried to do something a bit more physical, like carrying her baby brother for a few steps and then burst into tears saying 'my eye hurts, my eye hurts'. This was when the paracetamol was working.
I just don't know what to think or do sad
She said it hurts right in the middle of her eye. It makes me think it's an infection of some sort, but on the other hand, she's had 2 antibiotics now, so surely that would have knocked out any infection.
Am at my wits end with it all.

Have you checked her mouth? Teething can cause nerve pain in the head/eye.

She could have sinusitis.

Glandular fever?

You mean two courses of antibiotics, not two doses?

hutchblue Sat 19-Jan-13 21:04:39

Yes yes, sorry, two courses of antibiotics, one for 5 days, now the second we are on day 4.

Yes the doctor did mention glandular fever, but said it is rare in someone so young. Also, would it give such high fever, so consistently, for so long?
I thought GF would give a temperature for a week perhaps - but 2 weeks?

Yes, we have wondered about sinus infection but the antibiotic she is on is specifically for respiratory areas, so should knock it out, we hope, if that is causing the problem.

It is a good idea to check her teeth, we will get that done too.

Floralnomad Sat 19-Jan-13 21:06:06

Ask them to do a throat swab , my son was very ill with a glandular fever type illness at about 9/10 years old and it turned out to be some kind of bacterial throat infection that didn't affect his tonsils so was initially difficult to diagnose. He never had a sore throat just pyrexia / tiredness/ general malaise.

hutchblue Sat 19-Jan-13 21:09:55

OK, thank you Flora, I will ask them to do that on Monday when we go back. Her throat is indeed red but not sore.
Can you remember the name of the bacteria or the antibiotic that helped get rid of it?

Zoomania Sat 19-Jan-13 21:12:20

Any funny rashes? Have they ruled out Kawasaki Disease? Very rare but worth excluding. Hopefully just a virus and hope she gets better soon.

Floralnomad Sat 19-Jan-13 21:12:38

No sorry he is 20 now. I do know he had about six or seven weeks off school before it was diagnosed and cured. Hope she feels better soon and you get to the bottom of it

hutchblue Sat 19-Jan-13 21:15:18

No funny rashes Zoo, thank goodness.
OK Flora, yes she's had 2 weeks off already. It sounds like you had a hard time back then! Thank goodness it's in the past now smile Hope it's soon for us too. Fingers crossed. Thanks again

dikkertjedap Sat 19-Jan-13 21:17:35

Is her eye red at all? Swollen?

When do you get the results of the blood test they took at the hospital?

For some specific infections you need to get exactly the right antibiotics rather than a broad spectrum anti-biotics. Also, what antibiotics has she had so far? There are the so called first line anti-biotics (amoxycillin etc.) and the more heavy duty second line anti-biotics (clarithromycin etc.) and then the heavy duty IV stuff. The key is the blood test.

If you are very concerned (you certainly sound very concerned), I would take her back to A&E, as this is the only place where they can do a blood test again (just in case the first one was lost), keep her in for observation if necessary, etc.

Do trust your own judgement. Are you far from the nearest A&E?

hutchblue Sat 19-Jan-13 21:25:06

She's on clarithromycin, after being on ethryomicin, as she has suspected allergy to pencillins.

Her eye looks fine, no swelling. It seems like it's an internal feeling. She points right to the middle of her eye. It's only for a few seconds and then goes.

She's got an appointment on Monday morning to see the Consultant at A&E. They have run a whole batch of tests last Wednesday (though no throat swab) so we are going back to get the results. They showed us the bag going to Bloods and said wow look at that, what a lot of tests, that will keep them busy.

So I kind of hope/think we are in good hands. I just fret about giving her paracetamol and ibuprofen for such a long time and seeing nothing changing in her, despite the 2 antibiotics. I wish I could see some improvement but still nothing...

dikkertjedap Sat 19-Jan-13 22:01:14

Erythromycin and clarithromycin are used for the same things. Erythromycin is the slightly older antibiotics, not so well tolerated (often causes upset stomach) and needs to be take four times in 24 hours, whereas clarithromycin is newer, better tolerated and only needs to be taken twice in 24 hours. So basically, they can be counted as one type of antibiotic. So, either what she has is viral, and she has to sit it out as it is probably too late now to give antivirals or it is bacterial but doesn't respond to this type of antibiotics.

3gorgeousgirlies Sat 19-Jan-13 22:06:06

My dd was like this before Xmas . She had pnuemonia. Took nearly 3 weeks to recover

dikkertjedap Sat 19-Jan-13 22:37:56

If the chest X-ray was clear then it is unlikely to be pneumonia though. Also, with pneumonia the temperature often stays high even with maximum doses of paracetamol and ibuprofen.

However, it is still possible that she develops pneumonia as a secondary infection, but as long as she is on clarithromycin the risk should not be too big given that clarithromycin is second line defence against pneumonia.

Babymay1 Sun 20-Jan-13 08:47:54

Hi, just ask them to rule out Kawasaki's disease. Had similar incident with DS. Turned out to be Kawasaki's. symptoms can be vague. Had similar high temperature for a week with conjunctivitis like symptoms of the eye and red lips. Eventually swelling of hands and feet. Gp's kept putting down to viral infection . Good luck x

Zoomania Sun 20-Jan-13 12:35:28

Yes agree with babymay, it wouldn't hurt to ask them about Kawasaki as can just present with a fever and is rare so they may not have considered it.

hutchblue Sun 20-Jan-13 14:12:04

Thank you Zoo and Babymay, yes I will ask about Kawasaki's. She does have one big red crack down the middle of her bottom lip which looks like it's a sign. It has got progressively worse as the illness has gone on. However she doesn't have any of the other symptoms mentioned such as swelling of hands and feet or rash or anything else, literally just constant temperature (which responds to paracetamol etc) and one crack on her lips. No redness or anything anywhere else. We assumed that the cracked lip was down to the dehydration as despite repeated encouragement and access to as much 'squash' type drinks as she wants, it's still hard to get her properly hydrated each day. We are succeeding better than before but her lip had already broken slightly and as she has a temperature every morning between doses of medicine (she sleeps through the 39.6 amazingly) I wondered if that's why it's not healing.

Anyway, I will definitely mention it tomorrow.

Also, thank you dikkert, I will be aware of that too, either virus or a different antibiotic.

I just hope they can do more tests if we don't have anything definite tomorrow.

dikkertjedap Sun 20-Jan-13 14:17:52

Cracked lips can also be lack of vitamin C. Maybe consider a vitamin supplement? If she has a sore throat than pure orange juice would make it even more sore, as many other types for fruit/fruit juice.

I wouldn't be too concerned about giving her the paracetamol and ibuprofen for a prolonged time. These are very safe and in a hospital setting they are given at much higher doses. The key is to get the outcome of the blood tests.

Good luck tomorrow and I hope you get some answers and a treatment plan.

NK346f2849X127d8bca260 Sun 20-Jan-13 15:06:05

My son had Atypical Kawasaki disease and didn't get the right treatment, he now has damage to his coronary arteries because of this.

Please get them to rule out KD.

www.kdforum.org/

www.kssg.org.uk/ give Sue a ring she is really helpful.

Babymay1 Sun 20-Jan-13 22:45:03

Let us know how you get on x

hutchblue Mon 21-Jan-13 14:55:23

We are back from the hospital now and EBV/ Glandular Fever has been confirmed from her test. She also had an ultrasound and has an enlarged spleen and slightly bigger liver so all fits in.

Very relieved as I know what we are dealing with as had this myself when I was 18.

We've been discharged and have to go back for another blood test next Monday and then meet the Infectious Diseases team to work out what next depending on the results.

Really want to thank you all from the bottom of my heart for all your helpful advice and suggestions. I was so worried yesterday. I did mention Kawasaki's disease today and got it ruled out by three separate doctors, as you told me I must be sure, thank you again so much for that and I'm wishing you all the best with your little ones too.

She's on the sofa resting now, watching Winnie the Pooh. x

dikkertjedap Mon 21-Jan-13 15:45:52

Well done for persevering. At least now you know what is the matter.

5madthings Mon 21-Jan-13 15:49:19

I was coming on to say kjawasakies disease as my ds3 had this, it wasn't recognized in time to get treatment but thankfully follow up scans show his heart is fine.

Glad you know what she has and hope she gets better asap, I had gkandular fever as a teen, its not nicesad

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