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My child is suffering from viral fever, what to do?

Wednesday, 18 February 2004
Answered by: Satish Saluja
Consultant Neonatologist,
Sir Ganga Ram Hospital,
New Delhi
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Q. I have a 6 month old daughter who has been suffering from low grade fever since 3 weeks. For the first two days we had given here Adol suppositories (125 mg) and since there was no improvement the doctor recommend paracetomal syrup, Isoprinosine (contains Inosine Pranobex) and Asmafort (contains Ketotifen). The temperature continued and hence a routine blood test was done in which the WBC count was found to be 13,000 while the lymphocytes was at 84%. The doctor mentioned that there is an infection and recommended Cefzil (contains Cefprozil) antibiotic. Again with no visible signs of improvement I consulted another doctor who then asked me to discontinue the antibiotic and instead suggested another antibiotic Suprax 100 (contains Cefixime) along with paracetamol and cough syrup. The temperature however continued and this time my baby started passing semi-solid stools. Upon getting her stool test done (culture test), and the report showed gram negative bacilli with pure and heavy growth of Escherichia coli. My doctor recommended Zennat containing Cefuroxime. Since the past two days we are giving our baby only Zennat syrup and have stopped all other medicines. I must say her loose motion has stopped but the low grade temperature continues. I am extremely worried and seek your advise on the following: 1. Reason for continues low grade temperature ranging between 99 to 100? 2. Since there is an elevation in the WBC count and lymphocyte percentage, are these formed or unformed cells? My doctor mentioned that these are formed cells and hence nothing to worry. 2. What further test would you recommend to ascertain the reasons for the low grade fever? I must mentioned here that I have lost my peace of mind over the matter. Also, as per immunisation programme, my baby's vaccination was due last week for HBV third dosage. This has not been given due to the persistent fever. What is the consequence if the vaccination is not given on time?

A.  Going through the details of your daughters illness it appears that she had a prolonged viral illness from which she is recovering. It is not unusual in viral fevers to get high counts with increased lymphocytes. Just make sure you are taking body temperature properly and not unnecessarily adding to what you get on thermometer. If she is otherwise active, feeding well, I would suggest stop all medicines and observe her for few days and ignore 99 fever. If she is unwell repeat evaluation and investigations can be done. If the urine examination has not been done, get it done after stopping antibiotics for at least two days. Regarding hepatitis B vaccine the third dose can be given 6 - 9 months after the first dose, so it is not late.

A.  Going through the details of your daughters illness it appears that she had a prolonged viral illness from which she is recovering. It is not unusual in viral fevers to get high counts with increased lymphocytes. Just make sure you are taking body temperature properly and not unnecessarily adding to what you get on thermometer. If she is otherwise active, feeding well, I would suggest stop all medicines and observe her for few days and ignore 99 fever. If she is unwell repeat evaluation and investigations can be done. If the urine examination has not been done, get it done after stopping antibiotics for at least two days. Regarding hepatitis B vaccine the third dose can be given 6 - 9 months after the first dose, so it is not late.

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