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What is the cause for persistent fever in a child?

Q: My son is 33 months old. Invariably he gets fever every month fever and recovers after three or four days. Our local doctor prescribes Feppanil and sometimes Nise. What I want to know is that if he continues to have fever for one week, can he be given the above syrups and if so how many times a day? Some doctors say Nise should not be given. My child weighs 10 kg for the last six months and he continues to maintain the same. Even with fever, he is active. One doctor prescribed Spyzex for cough. In the instructions enclosed along with the bottle, it is meant for 3 months to 12 months baby. This syrup is manufactured in April 2002 and expires in 2004. We purchased it on 13.9.03. Will the medicine be effective? Kindly advise what precautions are to be taken during his fever and does he require any tests as every months he gets fever? The doctors say he is alright.

A:Fever in children can be due to different infections. It is possible to make a presumptive diagnosis by a good clinical examination and some lab tests in most cases. Most of the nonspecific fevers including those due to viral infections can be controlled with paracetamol preparations. Preparations such as nimesulide (Nise) are not recommended for use in children below 5 years of age due to their potential toxicity. It is difficult to make a comment on Spyzex without knowing the actual ingredients in the cough medicine. The medicine with an expiry date of 2004 should be effective in 2003 and can be safely given. The lack of weight gain is a matter of concern. Some very active children will not gain very much but do gain height at the same time. If your child is not gaining height as well as weight, then he needs evaluation for the possible cause. I would like to investigate him as he is underweight and has fever every month. The tests are essentially to rule out recurrent and chronic infections including primary complex. These include blood counts, ESR, urine microscopy, chest x-ray and Mantoux test. They are best done under the supervision of a pediatrician.

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