Over 4 days with high fever for 7 yo. When would you worry?

[habibibibi]

My DD is usually healthy as an ox.

Since Thursday morning, she has had a high fever, often over 40 and never below 38 without ibuprofen or paracetamol. Complaining of head ache and joint ache, intermittent rash of pale red blotches, hardly eating but drinking enough although sometimes throwing it back up (just fluids as her stomach is mostly empty). She's seen pediatrician (we're not in UK so see pediatrician for anything kid related) who checked her and think it's a virus. I spoke with him this morning and he wants to see her tomorrow if she's not better.
She perked up a bit this morning and had some brakfast So she's just gone to bed with a 39.5 degree fever. She hates taking meds so I don't force unless it spikes over 40 and then I prefer we bring it down a bit. One of her eyes has turned bright red too.
I'm usually quite laid back but the last time one of my kids was this sick for so long, she ended up in hospital with a kidney infection.

Now I've started worrying myself with Dr Google and Lukaemia and kawasaki disease and covid (negative rapid test though).

It's probably just a random virus and she'll wake up bright and bushey tailed in the morning, right?

Please get them to check her for Kawasaki disease, my son had KD and it went undiagnosed which resulted in heart damage.
Normally affects younger children but older ones do get KD. A fever lasting 4 days or more is a warning sign.
Red eyes is another sign.

Hopefully it is just a virus, but if it persists another unusual possibility to look at is systemic JIA that my son has. Key blood test are for CRP ESR and ferritin. Fever is normally periodic rather than constant though. My other son had a constant fever for 5 days… and then a painful leg. It ended up being a Staph infection in his blood that then rooted in his leg as osteomyelitis. Blood tests really can be the key to solving many diagnosis, so I would push for them on your next visit if your child isn’t feeling any better in the morning. Google is a dangerous thing, try not to worry yourself too much at this stage….. you can’t control it, you can only advocate for a diagnosis if it persists.

Thanks for the responses.
After a decent night, she's woken up with 37.8 which is the lowest it's been without paracetamol since this started. She's also eating something (only an orange but better than nothing).
I'll see how she does during the day. If her fever starts spiking again, I'll take her into Dr but if stays low and she seems to be getting better, then I'll just keep her home to recover.

She saw Dr yesterday as it's all still ongoing.
Dr examined her and still thinks it's a virus that is taking a while to shift. However, he'll send us to be seen in the hospital tomorrow to do some tests just in case if she's still unwell.
I think she is a little better and her temp isn't spiking quite as high but she's still unwell and still got a high fever so I'll see how she is tomorrow. If she's clearly improving, I'll keep her home. But it's been a week of high fever now so it's getting worrying!

Has she been tested for covid? A rash and ongoing fever are not uncommon in children. Especially with COVID PIMS or
PIMS - TS.

My DS (21 months) recently had a virus (not covid - tested) and had a persistent very high temp 38.5-40.5 for 7 days!

He was seen my docs twice as like you I was worried as he usually only runs a temp for 2/3 days max.

Anyway, in short, they weren't worried about him as he was awake / alert and taking fluids / not dehydrated.

I would always take them to be checked if I was worried - you DO no best! No harm in being checked and told they're ok and to wait it out.

I think there's some nasty bugs doing the rounds after all the lockdowns etc. Hope they're on the mend soon.

Is she immunised ?
It could be measles

@traumatisednoodle

Is she immunised ? It could be measles

Fully immunised including for chicken pox. Also had another covid test at dr's whcih was negative

Just noticed you said she's had a rapid test , has she also had a PCR? As she's still symptomatic, testing is different in many countries and here we do PCR in symptomatic patients as it's more sensitive than our Lateral Flow tests

@dopeyduck

My DS (21 months) recently had a virus (not covid - tested) and had a persistent very high temp 38.5-40.5 for 7 days!

He was seen my docs twice as like you I was worried as he usually only runs a temp for 2/3 days max.

Anyway, in short, they weren't worried about him as he was awake / alert and taking fluids / not dehydrated.

I would always take them to be checked if I was worried - you DO no best! No harm in being checked and told they're ok and to wait it out.

I think there's some nasty bugs doing the rounds after all the lockdowns etc. Hope they're on the mend soon.

Yes, exactly why the Dr isn't too concerned about DD. She is functioning, eating a bit even, drinking (a lot, she's super thirsty), no serious pain anywhere - just pains and aches everywhere! He is pretty sure it's a virus but thinks it would be prudent to do some tests if she's still unwell tomorrow.

@1fluffydoodle

Just noticed you said she's had a rapid test , has she also had a PCR? As she's still symptomatic, testing is different in many countries and here we do PCR in symptomatic patients as it's more sensitive than our Lateral Flow tests

She's only done rapid antigen tests. One was a home one in saliva and the other was in the dr's office with a nasal swab. Presumably in the hospital tomorrow if we go they'll do a PCR.

Hope she's feeling better soon

DS had similar symptoms when he was 17 months old
(More than 11 years ago). It was an infection in his knee joint causing reactive arthritis. He was in hospital for 9 days on IV antibiotics. Do any of her joints feel hot?

No, the Dr looked for any swelling or redness as she has been complaining about joint pain. But it's all her joints and more like aches - which is more consistent with how you might feel with a virus.