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!

It's 5 days. So will review on Monday.

He is just so hot and gets this heat rash with the fever. It looks alarming but the doctor said it's not a rash to worry about. Transferred him to my bed and the room is freezing with all windows open but he's still 39.4 at the moment. Just gave calpol

You must be so worried! Please don;t worry about calling them if you feel even slightly more concerned tonight/tomorrow/etc.

I phoned the NICU so many times, they understand how hard it is to be at home without medical knowledge.

Hope he gets a bit better soon

Ah bless him
My DS had high fevers when he was little, it was stressful. They are resilient little things though. Hope he turns the corner soon and if he gets worse or the paracetamol/ibuprofen stops working to bring his temp down, don't hesitate to call 111.

I wouldn’t be happy - I’m not a dr but I am a parent who has watched her child end up on IV antibiotics with sepsis from tonsillitis that was missed. The cynic in me says they are wanting to see if he can manage through the weekend, but don’t hesitate to take him back if he gets worse. My child (3 at the time) saw a GP every single day that week, but abx were given too late and he got so poorly.

We had similar for an ear infection at around the same age: ended up in paediatric a&e twice, the first time at the start of the week because temp spiked 41 and we freaked out and were advised on the phone by out of hours GP to go there, the second time the GP sent us at the end of the week because a week of alternating ibuprofen and calpol had kept the temp under control but it wasn't going down. They did a load of blood tests at that stage, nearly admitted her but eventually sent us home with two different kinds of truly foul antibiotics. The pharmacist rang to check it wasn't an error they were prescribing that dose for such a young child and it took two adults to force it into her, it smelled so awful. But she started to improve within 24 hours.

Don't worry about the calpol/neurofen. We were alternating for about ten days constantly, I don't think its something to be concerned about. Its stopping another fit.

I would however be concerned these antibiotics aren't working at this stage and you should be on another kind. I think monitor closely and don't be afraid to ring back in a day, or sooner if anything changes, and specifically ask about blood tests to identify the infection and why you haven't seen any impact of the antibiotics.

They are sturdy robust things but they can take a sudden turn for the worse, and all the cases I"m aware of which have been life threatening are ones where people had already had medical attention and didn't want to bother the doctors again/thought things hadn't changed enough to go back. Definitely follow up if there's not an improvement in the time frame they would expect, if the antibiotics aren't working but he needs antibiotics then the infection is basically being untreated.

Hope he gets better soon.
Have they considered scarlet fever with his rash? It is the same bacteria as tonsillitis

Oh the poor wee thing! And poor you! Alllllways call if even slightly concerned. IME they'd always rather check him again and send home than risk not seeing again and missing something. Are you overlapping the calpol and paracetamol? When my LO had high temps from ear infections, we were advised to alternate the meds 3 hourly...ie before the previous one ran out at the 4h mark. This helped to contol the temp rather than have it spike and lower in a cycle.

Eldest DD had a UTI when she was 7 that caused her temp to hit 40. Paeds ward kept us in for 2 days as her temp would not come down. They also gave us a different dose of paracetamol and ibuprofen based on her height and weight, so more than it says on the boxes. I also had a 7 week old at the time. I spent 2 weeks with an alarm going off every 3 hours to give eldest DD either paracetamol, ibuprofen or antibiotics. It was hell.

Just a quick one from the photo - as much as the meds are reducing his temperature and you have the windows open, remove as many laters as you can - that will help him feel less lousy as well.

And even if he says he is cold, take his temperature first - fevers make you feel cold even though you're boiling.

Sounds like you're doing everything you can, and definitely don't hesitate to call the ward back if unsure, however if there is no change or difference to him they aren't highly likely to do a lot!

Sorry I meant overlap calpol and neurofen!!!!!!!!

Thank you, really helpful to read all your replies. I am keeping a very close eye on him and will definitely call again if he doesn't improve soon. He had tonsillitis when he was 10 months and it cleared up much quicker than this time - he was given a penicillin antibiotic but it made him very sick and he refused all food from a spoon after that because he was traumatised from us forcing it into him 4x a day. That's why the GP prescribed Clarithromycin this time.

I hadn't considered scarlet fever as the rash disappears when he has the small dips in temp but will keep that in mind. They asked if GP swabbed his tonsils but he hadn't.

I'm keeping on top of the painkillers, but it hurts for him to swallow and he's really unhappy with it. But I will persevere! He has been asleep for 3 hours just now, waking up periodically to cry for me.

Thankfully DH is off and can take care of our 10 month old while I tend to the poorly one.

We had a similar story to the poster above, and because she vomitted at day 4 or something she was admitted for IV and fluids. I'd not hesitate to keep calling if you are worried esp with the rash.

@ZombiePara he is in a thin t shirt and a nappy and is saying he's cold and wants blankets etc but I know it's just because of the fever. His feet are ice cold too. Will take his t shirt off again, temp has come down to 38.7 at the minute thanks to the calpol.

My DD was kept in for 48 hours with a temp like this. As a PP said they have him a different dose of calpol and ibuprofen based on his height and weight not the benefit advice on the box, I'd want him seeing again if he was mine.

DS not DD

Official advice is not to undress them when they have a fever (surprised you weren't told this), keep them in light clothing. You can put a cold flannel on his forehead and neck. Don't give him a cold bath though.

If it hurts for him to swallow, you can get paracetamol and ibuprofen suppositories for children. (They are quite common in other countries, less so here in UK.) I think you would need a prescription and would need to ring round pharmacies to see if any of them have it, or could order it in.

www.nhs.uk/conditions/fever-in-children/

Keep an eye on the cold feet too Alexa, are his hands cold too? Apologies if the hospital have already addressed this but I remember being told to look out for cold extremities when mine were littlies.

Hope he picks up soon, I remember how stressful these times are

I would take him back. Not trained but a parent.

Are you having lots of wet nappies? If he isn't eating keep on getting fluids down him even if you have to resort to things you would only give as treats, even use a bottle if it helps you persuade him to drink.

I would take him back in late evening to be honest
You started the antibiotics on Thursday it’s Saturday afternoon that’s 48 hours then of them. He might well need something different
I also wondered about scarlet fever

It’s exhausting and very distressing I’ve been there several times myself. Make sure you are eating and drinking too the last thing you need or your DS needs is for you to get run down.
Hope he turns a corner soon bless him

I would ring the ward back and tell them your bringing him back in

You'd expect some improvement by now, don't wait until Monday

I would also take him back. Parent, not professional.

My Ds was admitted at a similar age with a 41 degree temp. They said it was too high and they needed to keep a close high. He was totally out of it and they had fans on him etc. I hope they went through sepsis markers with you? Is there not something about cold hands/feet with a high temp?

I'd take him back if it were me. I'm sure the cold hands and feet are a warning sign of something dangerous.

Ask them: could it be sepsis? All the posters in our GP surgery say to ask this, so make sure you do ask them.