Urgent advice needed - 20 month old 40 Degrees fever

[Pavlovthecat]

My family travelled to USA and have been here two weeks, for a week of this DD has been poorly, we travelled round a bit, she has had a fever on and off, green nose, cough, generall unwellness. Some improvement, then fever again, then improvement.

Took her to see Dr on Friday, who said it was virus, chest and ears fine, no antibiotics needed, give her paracetamol (tylonol) and ibruprofen as needed for fever, will clear on its own in a few days.

Over last two days, fever reduced, yesterday mostly back to her normal self, temperature fine, slept well for first night in a few.

This morning had a fever at 38.6, gave her tylenol and ibrupofren, she slept this afternoon for almost three hours and now fever is 40.2. Gave her more medicine, cold flannel, stripped to nappy.
In good homour, but much more cuddly than normal (clingy?), wont play with her cousin which she usually wants to do.

What is causing this? I am a bit worried. IS this fever continuing going to do her harm?

anyone?

First thing is NOT to use cold water - it will make her body try to warm her up to compensate!
Use warm water.
Take her back to the Dr if you can. It should be investigated - it may be an infection that wasn't there last time.

I would get back to see a doctor.. sorry I know that is probably not easy but the tylenol had been working and it isn't any more, therefore in my little brain there is a change to the problem.

Good luck

take her back to the doctor in the morning if you are worried

keep up the good work in reducing the fever (sponging, cooling, tylenol)

it's possible she may have a febrile convulsion if she gets very hot but this varies from baby to baby. if she does you should treat it like any other fit (make sure she is safe but don't try to restrain her, keep up the cooling afterwards, expect her to be drowsy or even unconscious for a spell) and take her to A&E (or call an ambulance). Febrile convulsions most often look much worse than they are.

40 degrees is high, but not worryingly high. I'd only panic if it didn't come down with ibuprofen / paracetemol (and I seem to remember paracetemol is slightly more efficient at bringing down a fever).
clinginess also usual.

I would however take her back to the docs if she still has a fever in the morning.

Ibuprofen is actually better at reducing temp. Paracetamol stabillises temp.

I have always taken mine to walkin when they hit 39 - as is advised by the NHS. I have always been greeted with sufficient concern to have felt it was worthwhile going - sometimes they find an ear infection. Some times we go home with cause unknown.

Obv it is hard as you are in a foreign country - but if it was me I would try and get her seen again.

I would actually say that 40 deg. is worryingly high in a child as young as 20 months. I would get her seen again asap.

Tepid sponging isn't recommended any more - it can cause rapid cooling which then causes shivering and so raises the temperature.

Better to reduce clothing, offer plenty of fluids and give regular ibuprofen - but I would get her checked again if she keeps spiking a temp, she might have a urine infection or something.

Hope she's better soon.

pavlov, i would take her back to the doc in the morning if no improvement. It might be she has developed a baterial infection secondary to the virus and might need antibiotics.

Don't do the cold flannel, the current advice is warm bath (as warm as poss actually) then air dry in warmish room. Brings the temp down far quicker and is more likely to keep it down.

If her temp is still 40 despite the paracetemol and ibruprofen then i would get her seen immediately. I always find that it takes about an hour to kick in with DD, she is 2.5 and can really throw some whopping temps.

someone mentioned an ear infection - i would definately get this checked out if she is going to be flying anytime soon, they will not let her fly with an ear infection.

Hey all, thanks for reply. Went to Dr, only to get there 5 mins after shutting due to traffic, Would not see her, even though i enticed them with cash! They said back in the morning. Typical, its a family Dr and they are miles away, no car tomorrow! Will have to find somewhere local.

Anyway, I stopped the cold flannelling immediately, makes perfect sense. She is naked to her nappy. I cant give her ibruprofen as she has a 6 hour one and its only been 5.5 since her last lot, but has had new dose of paracetamol. Keeping time check and will kep her dosed.

Paracetamol/tylenol has reduced fever to 38.3 which I belever is still a fever but not so serious. She is chatting away, and has just stolen my crisps and yelling at her cousin to leave them alone.

The apartment is very warm too, brother in law trying to figure out how to turn his heating down, never had to do it before!!!!

Luckily not flying until 26th. Her ears and chest were checked on friday and were fine then, but she has had a stinking cough and I think it might have gone to her chest...? who knows. She was fine yesterday, and was slept great. woke up in good mood, but high temp that rose....weird.

Sorry to be picky again.

I was told off by a GP for stripping DD3 down to a nappy as it does something to the circulation in the skin...I can't remember what though.

Admittedly she was only 8w at the time but he said better to have a thin muslin or sheet over her just to keep skin covered but allow the air to circulate.

I Would usually agree with you slightlymadsimnelcake, and have been told this also, but the apartment here is so hot, she would usually be in just her nappy or a short undersuit anyway, so I think its ok.

I think, but dont quote me on it, that the reason for keeping something on is the same reasoning as not sponging down with cold water, due to the body overcompensating...which makes perfect sense once someone told me at the begining of this, and lodged that from my memory!

She seems ok in herself.

oh dear, her cousin, 3 months younger now has a fever . I wonder what it is?

For those who responded to my original post, thank for your support.

I went back to Drs today, and DD has most likely sinus infection. Apparantly over here there is a very nasty throat virus which is doing the rounds. Must be following us, as DD had this almost exactly the same in UK about 2 months ago!!

She has a large ulcer on her throat which is why she is not eating. She has green snot, which bothered the Dr. Her chest was gunky but cleared when she coughed, and she has same viral spots by her eye that she had last time, tyical of this kind of virus apparantly.

Dr said 40.5 was very high. She has been given antibiotics as clearly has infection somewhere, and Dr suspects sinus along with the virus, as DD bangs her head with her hands, and green snot, and no ear or chest problems.

She also told me if fever does not decrease/stop spiking in next two days with antibiotics, bangs her head along with a high fever or vomits with high fever she should go straight to ER or back to Dr asap as it means something other than infection, but this was precautionary rather than expected.

Whilst I was there DD has a slight nose bleed, glad it happened there as I panicked! Dr said it was common of toddler with nose blocked, explained difference between nose blood and blood from other areas (one bright red, one dark red/back) and that she might even cough with some in, from nose, not to panic!

Her fever is down now and she is playing. Hopefull she will improve.

Poor DD, think we have been a bit mean to her dragging her round USA.

glad you have some results pavlov Its so shitty when the lo's are poorly. She sounds a pretty resilient little mite though and probably loving all the "dragging around". Honestly, my DD1 was/is pretty oblivious to being ill, hardly ever had time off school, when i took her to docs once, the doctor commented that he hadnt actually seen her for YEARS Unlike me, i get every bug going and am lousy patient. DD2 seems to take after her mother though.

DD is quite resilient, although I think that from time to time she might have been getting neural overload! She has met and stayed with a good few new family members who have not left her alone, played with cousins, seen new sights and smells, eaten (well almost) new food, been spoken to constantly in chinese!!! Just before she got sick she ate chinese food like she could not get enough of it, loves pork dumplings and can almost use chopsticks!

She is now taking a nap with daddy. We had a chilled day yesterday, one today and tomorrow we will go to Time Square, keep it gentle for her for a few days.

Is it usual in UK for toddlers to have antibiotics for 10 days? Last time she was here she had ear infection and needed some, Dr in UK was horrified at the strength of antibiotics she was given, but this time it is amoxillin, last time it was different.

AB courses are normally between 5-10days - so you are on the long side.

I wonder if teh US healthcare system are making money on your insurance

Amoxyl won't hurt her though so I would give the full course and not worry

no insurance, making money from me!!! unless you mean travel insurance? The ABs were not expensive to be honest, $16.99, which is about 8pounds (no pound sign on US keyboard!). The last lot we got when we were in US last time cost us $40!