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!

Poor mite. You have open access, that is not given routinely and if you aren't happy with him then take him straight back. I've been there with a toddler with chronic chest infections

Thanks I called and a doctor will phone me back shortly. The nurse said there were only 2 in and busy doing ward round so hopefully it's not too long

My experience at weekends is that the doctors are understaffed and run ragged. On the whole they are more junior (some of my friends who are very senior drs do cover evenings and weekends, but usually either remotely and go in for big weekends, or on trauma/itu wards). General paeds is covered by specialist registrars who are highly qualified and knowledgeable but spread thin. They will be wanting to manage him at home as long as they can, and with the hope that most kids in his situation do improve. Sometimes they do become very unwell though. The horror stories of child death are almost always when a parent hasn’t wanted to bother the doctors, or hasn’t been able to access further consultation. Phone as many times as you need to, go back as often as you need until you know your child is well, and don’t underestimate the emotional toll this is having on you

@AlexaStop poor mite, I’d definitely be taking him back in for the dehydration

Sorry - go in for big emergencies

I would get a bag packed for both of you

It sounds like he should be in and being monitored

He's becoming dehydrated now, so I think he needs to go back to the ward. You've done well, but I think it needs to up a level now and have iv fluids and maybe iv antibiotics.

If he is dehydrating, you must get him seen. I know you are dosing him on lots of caplol and ibuprofen (as you should) but if there is not enough liquid in their system to process the medicines, they can get liver damage on the recommended max dosage. He is also on antibs which adds extra burden to the liver. I think its time to have him seen in person again, dehydration when taking lots of calpol is dangerous

Doctor wants to see him so we will be heading up just now. Thanks for all the support.

He's acting ok just now and temp is stable but he is only breathing through his mouth. He can't get a breath with his mouth closed.

Your doing an amazing job

Hope he gets seen quickly Alexa

Oh love him. As a sufferer of many bouts of tonsillitis I’m so sorry for him - he sounds like he could do with some fluids and IV abs. Hopefully the culture will be back soon.

Yes you are doing such a good job. What a vigilant switched on Mummy he has

Hope he is seen soon, the dry nappy will mean he needs fluids possibly iv and if he can’t keep the antibiotics down they might as isn’t we those that way too

Thinking of you both

*might administer that should read

I’d put money on pneumonia
We were admitted for almost two weeks
4 different antibiotics (iv) tried

Oh poor little boy you must be worried sick sending love x

On the ward waiting for doctor. Temp back at 39.

Please take him back. DS was like this with an ear infection and got sepsis and needed IV antibiotics. He could have died if he didn't get taken to hospital. Be safe not sorry.

What can I ask to make them check for sepsis? Would it be a blood test?

Just ask why they’ve decided it isn’t

@Springchickpea

Just ask why they’ve decided it isn’t

Agree with this absolutely

Good luck

Also ask about dehydration and rehydrating when he cant tolerate swallowing...is iv rehydration indicated as he is taking boat loads of NSAIDS (capol etc) and you are concerned about his liver overloading

Ask about blood tests for infection markers in his blood counts.

Ask if the culture is back yet.... if it grew fast, then it might be

Ask why they are sure its tonsillitis as it isnt responding to the antibs. Are they looking for other possible causes alongside the tonsil issue

Sending hugs

Oh and ask about his breathing being compromised when asleep and what are they going to do about that as you cant stay up all night watching him to make sure he keeps breathing

It may be worth asking for a CRP blood test which can signify how serious an infection is.
Ask them to talk you through the traffic light system for serious illness in a child and where they think your child is on it.

Example attached.

Well I'm not a HCP but I'd put him in the red category based on what OP's told us

Good luck OP, I'm sure they will take good care of him, especially with you fighting his corner.