Treating feverish children can be tricky

Dear Dr Donya,

I would like to get your advice regarding the fevers my year old daughter has been having.

For the last month she has been having fevers around 39-39.5 degrees Celsius almost every other day. Based on a doctor's advice we have been treating her with Tempra which generally brings it down but only temporarily, or when very hot one other powder which we mix with water and is stronger and more effective (not sure of contents!).

We have had the flu go through the family recently, she did have the usual symptoms two weeks ago but she does not have a very runny nose or coughing at the moment.

She is due for some more teeth but none imminent as far as I can see (up to now she has two upper and two lower only).

I am going to get her tested for malaria, dengue & typhus today. Do you have any other advice? Thanks in advance.

-- Alex

Dear Alex,

I have questions to ask before you take your daughter to for blood test. The fever pattern first. Is the fever every day or every other day and for how long? Because if she has a fever every other day, malaria may be the cause.

On the day she has a fever, how often is the paracetamol (Tempra) given? Is it less frequent now or still the same? The white powder, is it Aspirin? If it is, you should stop giving it to her.

Any travel during this period of time that she has fever? Any other symptoms such as diarrhea, runny nose, cough, red eye, loss of appetite, inactive, sleepless?

Dengue fever is seven to nine days of fever. For your daughter's history, I do not think it is dengue infection. Typhoid, yes, can cause a prolonged fever for two weeks and the infected person is sicker in the second week moreso than the first week. Bowel movements mostly change during infection. Tuberculosis, does she have BCG scar?

Have you ever taken your daughter to see a doctor to be rechecked again? Any ideas from her doctor?

-- Dr. Donya

Dear Dr Donya,

Thank you very much for the response. The doctor (not our usual doctor but will be from now on!), diagnosed an infected ear due to ongoing flu (he showed me the ear and it was obviously red inside behind and around the eardrum, although no discharge). He therefore put her on antibiotics and the fevers have stopped. I'm disappointed this wasn't picked up earlier by our previous doctor. At the same time we tested dengue, malaria and typhus - all were negative.

Yes, I was also worried about the white powder. Still a mystery I'm afraid. Again thank you for your response.

-- Alex

Dear Alex,

Thank you for the update and glad to hear that your daughter is better. Upper respiratory tract infections are still the most common for children. That is why, after two to three days of fever, parents should take a child back to see the doctor again if she still has a fever, because most of the time, in the first two to three days there is fever but there is no localized signs (means examination are all negative). After two to three days or 48 hours, if fever is still high, then symptoms or signs will be prominent, a second doctor is always lucky!

For the white powder if you don't know what it is, then you better not use it again. Good luck

-- Dr. Donya