Getting worried about dd - any ideas?

[chandlersfraud]

Dd is 2 3/4. She's been unwell since sat night, but if vomiting sat night and Sunday and worsening fever. Only started measuring it yesterday (digital ear thermom) but last night 2130 she hit 40.1 degrees. Basically forced some meds in her and it came down. This morning, 40.1 again. I cannot get Meds into her. She had maybe 2ml of nurofen in yogurt but has v little appetite.
Spoke to GP who wasn't too worried said sounds like virus. Asked about paracetamol suppositories and she said they should be available over the counter.

Midday today tried calpol but she choked then vomited back up as I was basically forcing it in. Temp is now 40.4.

I asked in one pharmacy about suppositories and they'd have to order jn.

Any ideas? She's my 3rd and I normally get on with it but the very high temp is worrying me and she's so listless/periodically distressed.
She is drinking and weeing fine but v little appetite.
No obvious sign of infection source and no other major symptoms.

Oh, and she also had another what I assumed to be virus just 2 weeks ago with spiking high temp but she was much better in herself than she is now and temp was not so high.

Does she just point blank refuse meds? Could you bribe her with a sticker or special toy or game u don't play all the time etc? I wouldn't worry about the appetite she won't starve and as soon as the virus goes her appetite will gradually come back again but I would definitely want to lower that high of a temp with meds if it were me, specifically to see if meds DO work on lowering it.

She is just not herself so not at all open to bribery to take the calpol/nurofen. Not so worried about the appetite but it does make it impossible to hide the medicine.
Yes my main worry is her temp is so high and I can't get it down. When she has had medicine it has come down a bit.

I'm also concerned that the last few days she has been a bit better in the morning then worsened as the day goes on especially afternoon/evening but this morning she's already very hot/unwell.

I think I will phone round some pharmacies to see if they have any toddler suppositories in stock.

Is this day 3 of the fever? If so I'd have her looked at by a doctor tomorrow if it doesn't break tonight. As you say she seems to be getting worse so to me it sounds like it's likely to be something bacterial rather than viral, many things can cause the vomiting even uti's and tonsillitis in lo's, it doesn't necessarily mean she's had a tummy bug.

Maybe give the doc a call?? A high fever and lethargy after an initial infection is not good. I’d definately get her seen. Hope she improves soon

She might have a urine infection which has spread to her kidneys. I'd seek medical attention for urine and blood tests.

My DD had similar symptoms at age 10 with the temp repeatedly going over 40 degrees, very pale indeed and lethargic, GP under prescribed antibiotics for a urine infection twice - she kept getting a bit better then worse again so we thought it was separate infections but finally saw a different GP on 3rd visit who did proper tests including a finger prick blood test and sent us straight to hospital, rang ahead so we were seen immediately. She was very seriously ill in hospital on intravenous fluids and antibiotics for 10 days.

She's fine now - btw :) Don't leave it with a temp that high and that duration though.

Thank you for your help. I did speak to the dr on the phone this morning & they didn't want to see her but yes, if the fever doesn't stop in the next 24 hrs I will go back to them because it doesn't feel quite right that she seems to be getting worse not better.

I did manage to find a local pharmacy with one box of suppositories - very expensive (£25 for 10) but so glad now that she got some paracetamol on board. Fever is now 38.4 with paracetamol so not gone but much better.

Has her mood improved now the temp is lower? Glad you managed to get some meds into her.

How is your LG this morning?

Need to rule out a UTI with temps that high and vomiting.

She was v hot overnight and this morning temp was 40.7 which is a record for her. I was very worried. However she did take some oral nurofen which brought it down a bit. I managed to see the practice nurse about 11.15 and got a sample - it looked clear and she dipped it & there is no uti she said. There were white blood cells and she's sending it off.
There was no other obvious source if infection - throat, ears etc fine, couldn't hear chest because of crying but she hasn't had a cough.
Thankfully right now (nearly 4 hrs after nurofen) although she looks pale and is irritable she finally feels cooler to the touch and at the GP her temp was only 37.8.
So perhaps she's peaked and the fever has broken, I hope so. Thank you for all your help.

Hi op, wow 4th day of very high fever with no obvious reason for the infection, I'm a bit surprised they didn't send you to A&E.

You really need to get a second opinion and blood tests if her temperature is still so high in the morning. The GP saw our DD and did dip stick tests and yet she still didn't get appropriate treatment until the third doctors visit when luckily the first gp was not in and we saw a different one, who did the finger prick blood test and sent us straight to hospital as a priority. The doctors' note for my employer explaining why she needed me in hospital with her for ten days and nights listed her condition as life threatening.

Don't be fobbed off if she isn't totally better tomorrow, or gets a bit better then the fever returns in a few days.

How is she now?

Is she weeing ok Oo?

Thank you, unfortunately she didn't 'turn a corner' as I hoped and yesterday morning she was hotter than ever (41.4 on the ear thermometer) and breathing very rapidly as a consequence of the fever I think (counted 60 in one minute). She was seen straight away at the GP (by a practice nurse again) who again checked ears, throat, chest, tummy and no sign of infection there. The practice nurse from the day before popped her head round and said she hadn't sent off the sample but would now and suggested we treat so we have a 3 day course of antibiotics. She said there's 50% chance of uti if there's white cells but no nitrates in the wee. I think she is weeing ok - possibly small amounts each time but it's hard to tell because we only started potty training on Friday just before this so don't know what's normal and obviously with this going on I have been encouraging her to wear a pull up. I do think she's holding the front of her bottom sometimes.
I'd say since yesterday morning she's not any worse (managed to get some nurofen in her in milk in a bottle after which she brightened up) but she's still not right and overnight she was extremely hot though I didn't measure it as didn't want to upset/wake her.
I'm still very worried but in general she is responsive and was quite perky for a bit yesterday late morning so that reassures me. Nurse said they don't really worry about the 'number' of the fever but I think it's significant that she's had multiple viruses before and never been this hot, and the temp has been rising and has persisted for 5-6 days.
I guess if she doesn't improve by this evening the ABs are not working and I will call 111.

There are guidelines which I believe says if a child has a fever for 8(?) days or more with no sign of infection they need a series of blood tests. It’s not unusual for children to have chest infections without a wheeze or cough. Honestly I don’t want to worry you and I’m sure she will be right as rain - but I do think the Gp should have done more. Id have expected a referral to pau now.

Do call 111 or take her to an out of hours walk in if she's not better by evening chandlers

Also if she's only a bit better then gets worse again take her and insist on blood tests.

3 days of antibiotics is what my DD had - twice. It didn't clear the infection which spread to her kidneys and left her hospitalised needing a week of intravenous antibiotics and seriously ill. It's such a good job we saw a different GP on the third visit to the GP and he did a blood test, or it could have been even worse. Your dds illness sounds so similar. My DD had no pain on urinating either - children don't always have the same UTI symptoms as adults.

Sorry if I missed it OP but why are you thinking UTI rather than anything else?At the start of this year my DS who is 12 had similar symptoms,not really complaining of pain in his stomach but turned out he had appendicitis and it was removed in emergency surgery.I think this is going on a bit too long and you should take her to a&e for a proper investigation,surely she’s getting dehydrated by now?

It's very hard to know what to do and how worried to be. Every time we go to the doc she screams because she doesn't like them and gets really really distressed (she's previously been fine) so I don't want to go back today unless absolutely necessary. I think an a&e trip or at least a call to 111 tomorrow would be appropriate because of how long this has gone on. And I will insist on more investigation/blood test at least. Just going to take her temp but she feels less burning hot than yesterday which is positive.

I think uti sprung to mind just because she is able to say if things are sore and she's not complaining of tummy ache or pain anywhere else. She hasn't vomited for a couple of days now and is drinking a lot so I think she is hydrated. She's eating bits here and there, mainly yogurt. The nurses at the surgery felt her tummy. I also wondered about uti because of just having started potty training and I think there can be a link.