Undiagnosed illness

[SundanceLeopard]

Looking for experiences and/or advice from those of you that have gone through something similar or have any knowledge!

My 8yo has had a consistent fever for the past 9 days (to the point I have used the thermometer on everyone else in the house and purchased another one just to double check it's reading right!). Temperature has varied between 38.2-39.9C every day. Only other symptoms have been a bloodshot eye which the doctor is confident that this is unrelated and red/inflamed palms which we think may be eczema/winter weather related.

We took her to A&E Sunday evening after her temperature increased to 39.9 an hour after medication and she became quite groggy and tired. Confirmed ear/chest/throat all looked fine. They were initially concerned about Kawasaki Disease (incomplete) and booked us an appointment to go back today if the fever persisted. Fast forward to today and we went to the appointment, had urine tested, basic blood test and viral swab which all came back clear. Doctor sent us for a chest xray as a precaution and that was clear too so they've booked us back in for Saturday and asked for us to complete a diary of her temperatures over the next few days. They said if we come back Saturday, they will do an more in depth blood test and start potentially looking at autoimmune diseases & things that are less common.

She is absolutely exhausted and has started lashing out (getting very angry with her younger brother) which I suspect is an effect of her body having the fever for a while. I know I'm going to have to wait for the appointment on Saturday but just wondered if anyone has experienced anything similar or has some words of wisdom?

My first thought was Kawasaki disease as the on-going temp, red palms and red eye are all huge symptoms! Peeling skin is also another symptom later down the line. Definitely make sure to tell the hospital you are concerned with the symptoms it seems likely. Has your child got a red or strawberry looking tongue or sore red lips?

Hey @impartialusername 😊

She hasn't got any of the other symptoms, her lips are fine and so is her tongue. It was one of the things they checked for with the blood test but her CRP levels etc were all normal indicating that there's no inflammation which is why they are happy to rule it out. It was the one thing I went into the appointment today prepared for after they 'skimmed' over it last time! This is all new territory for me so I feel absolutely helpless and even more so that I don't know what to do to help my daughter!

I am wondering if it might be parvovirus B19 which has the tell-tale sign of slapped cheeks in infants but this symptom is usually missing in older children and adults. Does she have body/joint pain, OP?

I would ask a bit more about the viral swab if you can. It might mean they have done a comprehensive viral panel or it might mean they've only done an RSV/flu/COVID triple test.

Kawasaki disease could be triggered by something that hasn't been tested for yet (EBV, adenovirus, possibly CMV).

Scarlet fever or scalded skin syndrome (Group A strep and Staph areas, respectively) are also ones that come to mind.

When/if you go back ( I hope your LO is better before then!) ask what had been tested for in terms of infection and ask whether they have involved the Infectius Diseases and/or Virology teams. If it's a small district general, they will probably need to phone a bigger hospital to consult on this. They might need... Encouraging... To do this.

Adenovirus can cause fever and a red eye…. Id assume this would have shown on a viral screen tho 🧐 Might be worth a mention if you have to go back

@Allsizes8to14 Yes, pharyngeal conjunctival fever! I hadn't thought of that...

Thank you @DorisTheFinkasaurus , she doesn't have any joint pain currently other than complaining her knee hurt for around 1 hour last night so I don't think I'll count that 😅 the only other symptom of her being sick is the fact that she's been pale for over a week. I had never heard of Parvovirus before though so this gives me something to research, thank you!

@OtterMummy2024 I'm pretty sure it was just the triple test they did so I will ask for them to expand the panel next time, this is helpful information thank you. They are definitely a hospital with little resources as they are actually unable to admit any children, any admissions need to be transferred to another department. I already feel like I'm having to carefully encourage them to look further but glad I seem to have found a doctor who is willing to put more effort into the investigation and follow ups!

@Allsizes8to14 I've had a quick Google of the symptoms of this and I don't think it quite looks like it but it gives me something else to consider, thank you!

Has she had a throat swab for Strep A? You can have this without the scarlet fever rash and without visible Strep throat. It was missed in my DD for this reason

@SundanceLeopard - what's the update on your little girl? My ds is 7 and has had a fever for 7 days not going with antibiotics. He has red cracked lips and red tonsils with puss and well as red eyes (only 1) but GP has dismissed as viral. Terrified it is Kawasaki!

@Aklein38 Google adenovirus PCF - basically adenovirus that causes simultaneous conjunctivitis and a bad throat (the pharyngo part of the name) with fever. But you would need your GP to refer you for a throat/eye swab to be sure. The pus suggests bacteria (possibly as well as a virus).

@OtterMummy2024 - yes I did think adenovirus!! Just been back to the GP for reassurance and they were very unhelpful. They said they don't know why penicillin isn't workingas it usually does and have switched it for erythromycin. They dismissed my concerns about kawasaki as they had never heard about it themselves!