Toddler Fever - Paracetamol Not Working

[BoopityBoop]

Toddler (2) has had fever of 39+, yesterday evening to this morning we couldn't get it below 40. DC is clearly uncomfortable and mostly unlike their usual self (aside from 30 mins yesterday and a short period today playing before going back to wanting to be held and grizzly).

We're alternating paracetamol and ibuprofen. I've noticed the paracetamol doesn't seem to get it down, sometimes the temperature seemed back up to where it was before it began or higher than that, before the ibuprofen is due.

I've monitored it hourly on the paracetamol and it's because it's not doing anything at all for the fever.

We've tried:
Cooler room - rads turned off in that room
No blanket
Cool clothing (just a light vest or nappy)
Cool foods and drink although DC isn't eating or drinking much.

Any advice?

I think you probably need to be getting some more medical advice. Not being able to take meds and liquids coupled with issues urinating sounds like it might not be manageable in the community.
The issues weeing might be due to dehydration and the urine being stronger or a badly timed UTI.

If you haven't got each full dose of AB into your DS and he's not drinking I think you've reached a point where I'd be seeking more medical advice.

My DD had Strep A last year, insufficiently treated and became very unwell. Lots of time in hospital and to be honest hasn't recovered physically or mentally a year later.

I think there are some things where parents can get away with their kids refusing the AB but Strep A isn't one of them.

I spoke to the surgery today re urine and meds. I was told how to syringe it in, not to worry if DS didn't take it all just make sure DC gets as much in as we can and there are no alternatives. DH was very confident he'd get DS to take it but just coughed and spluttered the entirety up again.

I've managed to get DS to take a few sips of water. We'll hopefully get a sample first thing to be checked tomorrow.

I didn't get the impression they were too concerned at the moment, potentially more of the view that we need to be doing a better job with these things. However, this is not my "PFB" and we've not had these kinds of issues before with medicine. DS is worse at taking fluids than DC1 when ill but never this bad.

Is it the bright pink Pen V? My youngest can't have that as it brings him out in hives and has instead had the yellow banana flavour amoxicillin for Strep A twice now (not scarlet fever though so although same bacteria I don't know if scarlet fever, being more serious, needs to be Pen V)
It's so hard when they're so young. Could you pop a sweet in immediately afterwards to take the taste away? Might work better than choc?

I do a spoonful of neat blackcurrant squash straight afterwards. Seems to help stop the spitting out.

For me not being able to give the treatments at home for more than 24h that allow the condition to be managed and not managing fluids are my markers for getting checked out.
My daughter goes down to 1-2oz of water in 24h and maybe 3 grape's. We get brought in quickly to be checked over. Get given the markers and referral number for the paediatric assessment unit to bypass a and E.
My sister ended up in hospital as a teenager for IV antibiotics and painkillers due to not being able to take the oral antibiotics at home. When you have a bacterial infection and you can't get the antibiotics in them it's an uphill battle to manage the infection.
I only have 1 but I rarely have her at the GP the times I few times I have they have sought advice from paeds about whether it can be managed at home or if we need to go in.

I'd take to A&E a temp that high and that long could indicate a thyroid issue called Kawasaki disease and that can have serious side effects

Kawasaki is an important condition associated with persistent fevers, but it isn't connected particularly to the thyroid, fwiw.

It's actually Scarlet Fever.

DH spoke to someone today as the antibiotics prescribed earlier this week are still being spat up. The pharmacist had said there's 1 other option but I think it was a dispensing clinician who said to him that it's possibly more bitter than the one that was prescribed and no point.

We've had 1 more suggestion to try and if that doesn't work then the hospital may have to put DC on an IV as coupled with lack of fluids we need to sort it. They did say DC could come in tonight or the morning if it didn't work but we are torn.

We'd like to avoid the hospital and IV as it won't be nice for DC and imagine it'll be a few nights. However, do understand the seriousness of getting these antibiotics started.