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!

I hope your poor little boy is on the mend soon. It’s so worrying when they’re this poorly.

@Springchickpea Yes I had considered during the night that we may be heading that way. This is his 2nd infection but surely they must be able to see he has a couple of golf balls at the back of his throat disrupting his life.

Can you look at them? Get him to look up and say ahhh while you shine a torch in. It’s a useful skill if you have a tonsillitis-y child. One thing to rule out every time they get ill. My child’s were always big, even when not infectious, but that morning he got up, went to the bathroom. Was coughing and trying to get ‘something’ out of his throat. When I looked it was clear he was trying to eject his own tonsils. We just went straight to a&e that time; it was about 5am!

So sorry he's not well.

My 3 year old is also sick and on antibiotics.
Its horrible when they're sick.

Hope the new antibiotics work better for you.

@shenanigans5 giving it with milk is the only way he's kept it down. He's on the double strength one so only has 2.5ml 4x a day but he vomited 4 times yesterday when we gave him it on its own. He didn't eat anything yesterday so his stomach would have been relatively empty.

@Springchickpea I looked last night and they are huge and completely covered in pus! It was quite shocking to see it so bad. I've had it myself a couple of times but never like that.

Ok. So the worst we ever had was when I couldn’t actually see any ‘throat’ between them. They were actually touching 😱

When DS1 was 18 months (he's nearly 16 now) he began with an awful temperature of 38-40 that I couldn't control.
I was 22 and found it terribly difficult to get anyone to listen to me. This went on for weeks until one day he had a convulsion and I rang an ambulance.
I explained to the paramedic how long it had gone on etc and he said he would get him admitted to children's ward so off we went in the ambulance.
Once admitted, they found he had pneumonia and so started intravenous anti bs for that only to find the temperature wasn't getting better. His infection count in his blood (white blood cells?) we really really high.
They then realised he had a kidney infection which needed different meds and it was this infection raging on that was causing the temp but because he was a boy and boys don't usually get kidney/water infections, they hadn't investigated that possibility.

Maybe he has something else going on alongside which is why the temp isn't coming down?

@Souther hope your little one is on the mend soon too.

I have nothing useful to say apart from incredible sympathy about how horrible this sounds for you both and what an amazing job you are doing.

Can you try to handover to DH (if the baby is asleep) so that you get some sleep today?? You must be absolutely exhausted

[quote AlexaStop]@shenanigans5 giving it with milk is the only way he's kept it down. He's on the double strength one so only has 2.5ml 4x a day but he vomited 4 times yesterday when we gave him it on its own. He didn't eat anything yesterday so his stomach would have been relatively empty. [/quote]
Oh yeah I totally feel your pain. I’ve been there with pen v with both of mine.
All I meant is that if symptoms aren’t improving it might be that you just can’t get enough in and absorbed so need to try another administration route.

I’ve been there at A&E for tonsillitis with DD and iv antibiotics for sepsis with DS. And I’m a HC professional. So I know it’s a worrying time.

@FusionChefGeoff thank you. unfortunately it's been like this for the past 4 nights as he's been in bed with us so we (me) can keep an eye on him. Grandparents have been great at coming round each day and sitting cuddling with him while I get a shower etc. I feel like I've barely seen the baby for a few days as he's been attached to my side!

Just to throw something else in to the mix, he's awake and I went to change him but his nappy is dry. Just over 12 hours and no wet nappy.

@AlexaStop

Just to throw something else in to the mix, he's awake and I went to change him but his nappy is dry. Just over 12 hours and no wet nappy.

Time to take him back. They might let you do a fluid challenge and take him home again, or they might want to rehydrate him a bit on a drip. But either way he needs to go back.

I would contact the ward again

Thanks yes I was thinking I might need to take him. I let him have his nappy off for a while and he did a small pee there. Unusual for him, his nappy is usually very full in the morning

Just take him, better to be safe than sorry in my opinion.

I'd take him in, OP.

I live in Switzerland. Here the child would be admitted for rehydration and observation as well as IV antibiotics if needed.
I find the NHS really lax.

Go back. He’s clearly very poorly, and there is nothing wrong with saying ‘I’m way out of my comfort zone, and need some support and reassurance that my child doesn’t need further treatment’

100% take him back to the ward now. Call them on your way in to advise you're bringing him back as opposed to calling and asking for permission to bring him in. You're doing great at managing this OP, you must be exhausted.

And yes exactly as @Springchickpea - I would be saying I was out of my depth and wanting him admitted as he is clearly not getting any better and you're not a doctor!!!!

I'm surprised they have not given iv fluids yet. My daughter did not look this sick when she had them.

@shenanigans5

Reading this thread I’m a bit worried for him. It’s a long time for a little one to be fighting a really nasty bacterial infection. Pen v is hard to get into kids and giving it with food/milk can reduce how effective it is. If you’re struggling getting it in and he remains unwell (high temp etc) today I think they should consider giving some iv antibiotics on the ward. A prolonged bacterial infection in a very young child is a sepsis risk.

I agree with this post. It should be on an empty stomach. It tastes so disgusting

Don’t be afraid to ask them to explain to you why they are not worried. Or why they think this is the best treatment plan. Or what else they would need to be seeing that would make them escalate to bloods and IV. A good doctor should be happy to explain their approach, especially if you are polite.