On day 4 of 2 year old's 40 degree fever

[AlexaStop]

Hi, my poor DS has had tonsillitis and a fever of 40 degrees since Wednesday. It comes down to about 38 with calpol and ibuprofen so I've been alternating these but like clockwork once it wears off it's straight back up. GP diagnosed bacterial tonsillitis on Thursday and he's been on antibiotics since then. Took him to A&E paeds ward last night after he started having some convulsions who also confirmed nasty tonsillitis case and said convulsions are due to very high temp. They said we can come straight back to the ward if he gets worse.
Do we just ride it out? I'm concerned it's not getting much better and also worried about the constant stream of paracetamol and ibuprofen he's been having - I've stayed to the time limits but this will be the fourth day in a row of it.

Hasn't eaten since Wednesday but is managing to drink some things (water, milk), nappies wet and few cases of diarrhoea yesterday. We have a difflam spray but it makes him vomit every time. Poor thing feels so miserable and just wants cuddles but I also have a 10mo to see to. Any advice is welcome!

Should have said he is 23 months old.

How many days of antibiotics is he on ? When does he finish them ?

It normally takes 48 hours for antibiotics to work. How is he in himself. What’s your gut instinct? If in doubt get medical advice.

If it was me, I would seek further advice as the temp isn't coming down.

When we were discharged from children's wards in the past we were given a number to call - to avoid having to go via A&E again. If you have that number call it and ask for help. You are allowed to be worried.

If no number, call your local out of hours GP and say you remain concerned and want someone to check that things are OK.

This will be day 3 of antibiotics. When his temp lowers he is cheerier for an hour or two but as soon as it starts to spike he cries and just wants me. Both doctors I've seen said it's textbook bacterial tonsillitis as they are all red and covered in pus. When he gets very hot and I strip him off he says he is cold and wants his blanket over him.

He's also tested negative for covid .

Little one has got over tonsillitis last week, though not as serious as your son's by the sound of it. She started antibiotics on Thursday night, and turned a corner on Monday lunchtime. I wouldn't worry about giving what is needed medicine wise until the weekend is over, but you might find the fever breaks today after 2 full days of antibiotics- we saw periods were she clearly felt better for an hour at a time on both days, but still had periods of fever and feeling ill too. Hope he feels better soon.

Definitely seek medical help now. I would start by ringing 111 unless you have another fit, dry nappies or less responsive.

If he isn’t getting worse I’d personally carry on. It’s fine to keep giving paracetamol/brufen as he needs it, and keep giving fluids.
If he gets worse take him back like they said, or if he’s not significantly better on his last day of antibiotics, call the GP.

Oh poor wee thing. I wouldn’t worry about the paracetamol/ ibuprofen, but I’d be worrying about antibiotics not kicking in by now. I’m sure it’s fine but I think I’d contact 111 for advice/ reassurance. Hope he’s better soon, you must all be done in!

Yes they gave me the number to bypass A&E and go straight to the ward. The thing is he is in exactly the same presentation just now as he was when they saw him, so I'm not sure what else they will do at the moment. They did mention he could have some blood tests to see how bad the infection is as his medicine could need switched, but wanted to wait and see as it hadn't been long on the antibiotics at that point. This was about 6pm last night. He is on Clarithromycin 2x a day.

He's had tonsillitis before when he was 9mo but nothing as bad as this.

If he is no worse than when they sent him home, sit tight and carry on.
Every day of antibiotics you get in him you should see an improvement.
Keep going. Medicine, fluids and cuddles are what he needs .

@DinosaurDiana

If he is no worse than when they sent him home, sit tight and carry on. Every day of antibiotics you get in him you should see an improvement. Keep going. Medicine, fluids and cuddles are what he needs .

Out of interest, are you a medical professional?

@AlexaStop Mumsnet is no substitute for medical advice from trained medical professionals. You have the number for the ward, please use it.

Yes I am. And if she rang me at work I’d say the same thing.

"They did mention he could have some blood tests to see how bad the infection is as his medicine could need switched"

If no improvement after 48h on antibiotics I would ask for the blood tests, I would want him on the most effective antibiotics and wouldn't be wasting any more time waiting.

Personally, and to caveat as above posted im not a doctor but I've been through a lot with young ones , I'd say if it's severe you aren't letting the temp get high enough for long enough to fight it. When mine had it we tried to have a break once a day from the paracetamol to let the fever work. Temp was over 40. It did help, however obviously you can't if it causes convulsions.

If the doc isn't worried and you're only on day 3 with no change I doubt they'd do anything. If the paracetamol stops working I'd go back in though.

If I were you, I'd call the number you've been given, better to get him checked over again. When they're that little, doctors don't mind at all. Tonsillitis is nasty though.

Call the ward with the number you’ve been provided to ask what they recommend
They will understand your concerns as he continues to feel unwell and his temp continues to spike

Thank you I really appreciate all the replies and advice. His temp is 38 at the minute because he had his ibuprofen 2 hours ago. About to give his next dose of antibiotics so I will monitor over the next few hours and ring the number in the afternoon if still no improvement.

He has a very upset tummy which I suspect is due to the antibiotics.

@DinosaurDiana

Yes I am. And if she rang me at work I’d say the same thing.

Thank you. It's so hard on MN to figure out who is trained and who isn't.

Oh, he sounds so poorly. Poor mite. I'd hang on, but the minute you think something changes for the words, or your gut instinct says something isn't right, I'd go straight back. Even if there's nothing else they can do, he'll have been checked by the doctors again.

No Dr minds seeing a poorly small child. Remember that.

Hope he's better soon.

*worse

Temp back up at 40. He's shivering away too. I think he will need his antibiotic changed because it doesn't seem to be doing much.

I called the ward and they are reviewing his notes etc and will call me back.

Good call, IME day 3 of antibiotics is when they either perk up, or they aren't working. So many days of a high temp would be concerning me too, hopefully the ward gets back to you soon.

They called back and said as he's already started the course they would like him to finish it and if not better by then will look to changing it. Just to monitor at home and rotate the calpol and ibuprofen and to call back if he gets worse.

Hard to see him like this. He's just woke from a nap and has a heat rash from being so hot on his body too. He did drink a few oz of his baby sisters milk - the only thing he's asked for!

Did you ask them about the blood test?
How long is the course of antibiotics - 5 or 7 days?