Shit-it could be just a virus, right?

[winnybella]

My friend just called me for advice (as a more experienced parent) and said her 14 mo has a fever of 39.7 (taken rectally) and is all weird/spaced out and has got freezing feet.She gave him a paracetamol and hour and a hlf ago and it didn't bring the fever down. She doesn't have ibuprofen at home.

I told her to call her doctor and/or go straight to A&E.

Still, it could just be a bug, right? I immediately thought about meningitis.

Shit.Did I give a good advice?

She is being unfair to make you responsible. I would tell her to go to A&E whether that is what you would advise or not. She obviously needs a second opinion and it is better that that comes from a doctor or nurse that someone "ordinary" IYSWIM.

Just because you are a surgeon does not mean that you would know all the things a parent would do for a fever. The friend just wants reassurance from someone who has had first hand experience of being a parent with a sick child. DD (17 months) just improving today from a flu virus with exactly these symptoms. I alternated paracetamol and ibuprofen as temp was 39.6 on average and it went down to 38.3. She was still fairly lethargic at this temperature, but not so glassy eyed and floppy. Removed some clothing (down to short-sleeved bodysuit), covered in a sheet to sleep. Gave extra fluids and breast fed more to reduce dehydration. DD also vomited so gave dioralyte. Fever lasted 3 days now has gone. If fever not reducing after ibuprofen then I would take to A&E, but I would expect them to be lethargic even at 38.2. I know I was with the same bug. Here is a site which gives useful guidelines re: fever www.patient.co.uk/doctor/The-Ill-and-Feverish-Child.htm that you can give to your friend.

She goes to A+E. End of.

It could just be tonsilitis but I have to say that my friends wee boy had a temperatire of over 41 rectally with 'just' tonsilitis and was very ill for a long time.

He is still only little, bugger what her dh thinks tbh, my dh never thinks anything is serious because he is just like that, he has been wrong several times.

fwiw, ds is almost 4, had FREEZING and I mean like ice hands and feet and his body felt like it was on fire, he was unable to walk 2 feet, was shaking and his eyes were glazed and he was sick etc - this was the other week, I was so so so worried, ahve never seen him so sick. It was a virus with tonsilitis like symptoms and 2 days later he was back to more like himself. I have heard quite a few people report similar things.

Ime you should always trust your instincts and get tehm seen again if you are not 100% sure.

Tell her to go to A and E. 39.7 is a very high temp for a small child.

Better to get a second opinion (I have two mis-dx from our local A and E in the past - missed a collapsed lung in dd and a bad post-natal uterine infection in me - thank god I sought second opinions both times).

If she is worried and feels that something is wrong, she should take the child back to doctor or to A&E. I always trusted my instinct, and yes, I was wrong a couple of times, but the doctor was ALWAYS understanding and happy to reassure me.

But once, the receptionist was dismissive of me, but the minute the doctor saw my ds, she called an ambulance. He was diagnosed with a virus which then caused serious breathing problems and was in hospital for two days.

No need to panic, but she should trust her instinct.

People jump to meningitis as it is very serious and the sooner it is treated for, or ruled out the better.

temp come down is a good sign - I'd be giving the antibiotics to be honest and if it was one of mine I'd just watch him

D&V, tonsilitis and fever would tire anyone out and children can get lethargic with fever

I don't personally feel that 39.7 is unusual in a small child - they commonly spike high - higher than older children.

So father who's a medic doesn't worry overly

If she can't be calmed A&E it because mother's instinct counts - but A&E on a snowy saturday isn't the best idea for me

I went to the docs with my DS1 when he was 11months. It was my first appointment with him for anything. Doc said its just a bad bug go the normal paracetamol suspension/ ibuprofen route. I went home wasn't happy so called the docs back a few hours later. He rang me back and said please pop back in. He was really good we were seen straight away and sent with a note to the hospital, DS put on antibiotics and a drip suspected meningitis. We were lucky as we were out after a couple of days, he took a few weeks to be back to fully himself. The big thing was the doc was very happy to go with my instinct and reassess his initial diagnosis without being in any way patronising. I think if you're really unhappy with what you've been told seek a second opinion, even off the same doc - instinct is important.

Ds, aged 2, became very ill and was referred to A&E by the gp. All his extremities and his lips were blue. He couldn't be woken, couldn't eat or drink, didn't urinate, was utterly floppy for about 24 hours. But it wasn't meningitis . Sometimes viruses can be very nasty. You have definitely done the right thing by telling her to go to A&E, but most times these illnesses are not meningitis. Thank God.

Limp could mean an infection, chest or throat. Either pulseox is probably low. A&E now would be my advice. From experience. My DS had chest infection and the limp/lifelessness was because his pulseox was 70% it was frightening. But the drive to hospital actually helped, upright in a cool car.

Right, I just texted her that if she's really worried, then she should get him checked out at A&E, even if he's most probably fine blah blah blah

And now I'm off to put my own ill DD to bed.
Thank you all for advice

herbietae - I didn't mean the medical stuff of course they should know that, but not all doctors are parents and as such there may be tips that an experienced parent can give that a doctor with just medical training would not think of.

Winnybella - good idea she as the parent needs to make the judgement call, hope your DD gets better soon.

fwiw - our gp missed it - said it was flu. 4 times.

he ended up in hospital for 6 weeks and like i said, took over 2 years to recover.

doctors dont always know everything. id go on instinct - if worried sod what the gp says and get him checked.

hope he is ok. x

Well, she didn't respond to my text telling her to go to A&E if she's really worried, so I'm hoping all is ok (she often turns her phone off in the evening). I also sent her an email with links to the website with children's assessment guidance for doctors and to the meningitis symptoms in toddlers just so it may help her in the future.

I know that I would be very worried if my dd or ds were really lethargic and listless-DD now has had fever for 3 days-but is perky and has all the symptoms of a cold so I'm just watching her-but it's hard to know what to advise when it's not your own child.

I'll update tomorrow- most probably it's just a bug and she's panicking about her pfb. So am I a bit- I don't like this unresponsivness thing...hmm.Perhaps it's just the few days at home with one sick kid and other with half of his face bruised and cut and moaning (run into a wall) and me having the bloody cold as well that has shot my nerves to pieces!

Sounds like you are ina difficult position. Hope he is OK - please let us know.

I agree with what someone else said about meningitis rash & add - i had meningitis & my rash passed the glass test. So don't be falsely reassured by that if you are concerned get it checked!

Just got a text from her and apparently they didn't give the ABs, just paracetamol and ibuprofen and he seems better this morning.

Pheewwwww.