Very High fever for 10 days- any idea what this is?

[juls]

I'm posting because I want to know if any of you have had this kind of illness strike. My 4 yr old has had a high fever for 10 straight days.

 

Day 3: I took her to the doctor on day 3 and they noted a yucky throat, swollen glands and the high fever (it was over 104 in the office). The rapid and long term strep tests were neg. Mono was suspected.

 

Day 6: I took her back to the doctor. Symptoms were exactly the same and they did a rapid and long term blood test for mono. The rapid test came back neg and we are still waiting on the long term. It's my understanding that the rapid shows if she has mono right now and the long term shows if she has ever had it. Assuming I understood correctly, she does not have mono.

 

Today is day 10: She still has a very high fever when the Tylenol or Motrin wear off, last night it was 105.2 at 1 am! Most days its been in the 104-105 range.

 

She is drinking and eating soft foods. The doctor now assumes that this is viral, but I've been a mom for over a decade and I've never seen an illness linger so long with such a high fever. My dd is no different today then she was 10 days ago.

 

Has anyone seen an illness present this way?

 

Thanks,

Juls

[chiguirre]

My dd will spike high fevers, but never for more than a couple of days. I'd go back to the doctor and insist that they refer you to a specialist in infectious processes. I hope your dd is feeling better soon.

[Little Debbie]

My DD ran a high fever for 4 or 5 days that wouldn't come down even when I gave her advil...it would only drop to 101 or 102 degrees, otherwise it was 104 degrees or so. She didn't seem to be too sick other than that. I expected her to be absolutely miserable, etc, but she didn't act as bad as I thought she should have felt. I finally took her in to see the doctor. He listened to her lungs and sent us for a chest x-ray. She had pneumonia...go figure! I'm assuming they checked that out? I was just amazed since she still wanted to play and get out of bed even with such a high temp! I don't know if that helps you at all, but I hope it gets figured out soon. I hate it when my babies are sick...I'd much rather take their sickness on myself. :grouphug:

Deb

[Just Me]

Could there possibly be a sinus infection? I know you said her throat was bad. I only suggest this because I had a good friend who had surgery, then started running a fever. The doctors kept checking the surgery site, and couldn't figure out the problem. Then about a week later, they figured out that it was a sinus infection, and got her on antibiotics.

 

HTH, and I hope she feel better soon!

[Marie in Oh]

Hand, foot and mouth has been really bad this summer all over. Bad sore throat, headache, eventually maybe sores in mouth or hands and feet but not necesarily. My kids had it-- my oldest dd had a fever and sore throat for 7 days.

 

The sore throat could be a coincidince. I might have her checked for a UTI. I had one dd who had a fever for 10 days and that is what it was.

 

Hope you figure it out soon and dd gets better.

[Alice]

With most viruses fever doesn't last more than 5-7 days. At 10 days I'd be worried about something more.

 

Mono- Possiblity. The quick test is just a screen. The "long" term test is antibodies and can show either past exposure or a current infection. So Mono is still a possibility.

 

UTI-Less likely in a 4 yr old, as they usually complain of urinary symptoms but I'd definitely check that out.

 

At 10 days of fever IMO, she should have bloodwork done including a complete blood count and blood culture. Also a chest X-ray.

 

Another less common diagnosis in kids with prolonged fever is Kawasaki's disease which is a vasculitis. It's not super common but it should be thought about in any child with more than 7 days of fever. Here are the criteria from Dr. Greene.com:

 

A. Fever lasting for at least 5 days.

 

B. Presence of any four of the following five conditions:

 

 

Red eyes without discharge.

Changes of the mucus membranes of the mouth, including red throat or red and/or dry and cracked lips, or strawberry tongue (a white coat on the tongue through which swollen red bumps protrude).

Changes of the hands or feet, such as swelling and/or redness and/or peeling of the skin, usually beginning around the nails.

Rash on the trunk. May take many forms, but without blisters. Perhaps also present on the limbs or face.

Swollen neck lymph node or nodes.

 

C. Illness not explained by another known disease.

 

Almost all children with Kawasaki disease are quite irritable. Because blood vessels throughout the body can be affected to varying degrees, many other symptoms might or might not be seen. These include diarrhea, vomiting, abdominal pain, cough, runny nose, headache, arthritis, burning urination, mouth sores, sensitivity to light, nerve weakness, confusion, or seizures.

 

Even though the official definition of Kawasaki disease sounds straightforward, the diagnosis is not so simple. Any child who meets the criteria has already had Kawasaki disease for at least 5 days. Experts recommend initiating treatment before this time if the other criteria are met. One test can be quite helpful if Kawasaki disease is suspected. An ultrasound of the heart that shows coronary artery involvement is highly suggestive of the disease. A normal ultrasound does not rule out Kawasaki disease, however.

 

The tricky part is a certain percentage of kids don't meet the criteria...meaning they just have fever and some of the other symptoms but don't have the 4 out of 5 symptoms in Part B above. So, IMO, Kawasaki's has to be thought about in any child with prolonged Fever of Unknown Origin. You might ask your doctor about it. There isn't a blood test for it but an Infectious Disease specialist could help. Also we typically do an Echocardiogram on kids if we're thinking about Kawasaki's because a percentage have coronary aneurysms...if they see that the diagnosis is made. Even if we don't see that some ID experts will treat a child with unexplained prolonged fever for Kawaski's if other causes can't be found. The treatment works well, but has to be thought about to be given...it's IVIG and high dose aspirin (given in the hospital).

 

Hope I didn't scare you....praying that your daughter just has some bad virus that is sticking around. But IMO at 10 days other causes need to be searched for.

[Cathy in IL]

10 days is a long time for such a high fever. If my doctor could not give me an accurate diagnosis or a quick referral to a specialist, I would be heading to the nearest children's hospital ER.

[juls]

Thanks for the replies.

 

I don't think its a UTI (no complants and I've asked about peeing). There is no cough, congestion, red eyes or rash. Her hands and feet are normal. She is eating and drinking and she is not very irritable (occasionally) or fatigued. I have no idea what this is...

[Pajama Mama]

If you haven't left for the ER yet, can you call your child's doctor? Ask the doc to call ahead to the ER for you. The ped did that for ds once when he was really sick. We bypassed the long wait and were ushered right in. For course, ds is a special needs child so maybe that's why we were admitted right away. But it can't hurt to call and ask. 10 days with a high fever in a young child. They *should* see you right away.

[KidsHappen]

I am very anti-doctor and only take my kids in dire circumstances but at this point I would call the dr and ask for a chest x-ray. Pneumonia is a likely possibility. I can't tell you how many times my kids have had pneumonia and the only symptom was a high fever. Also has he been checked for measles, mumps, ruebella? My kids have had all of the above. Scarlett fever? How about menegitis? Have they done a white blood count? If you don't get some action on the part of your dr. go to the ER.

 

Be sure to keep child cool. Tepid baths, ibuprofen, popsicles. If a fever goes too high for too long, it can cause seizures. This happened to my brother as a baby and it was not pretty. If that happens do not try to drive him to the Er yourself, just call an ambulance as he may need other care that they can start right away. You do not need to worry about him biting his tongue or swallowing it. And if his fever is very high at the time cool him down as soon as possible but use cool water not cold as you don't want to send him into shock.

 

I don't mean to worry you about all of these things but I have had to deal with most of them and it is better to be prepared if need be. I hope that he starts feeling better soon! :grouphug:

[juls]

The ER did a urine test, strep test (again), chest x-ray and more blood work. Three doctors checked her out physically and found nothing more than a yucky throat and swollen glands.

 

Her blood work was the only problem. Her white count is elevated, and higher then it was four days ago. Her ESR and CRP tests were both high, meaning that there is inflammation and infection somewhere. Tomorrow I will try to get an appointment with the Infectious Disease guy. Anyone ever been to one? She will not be happy of they want more blood.

 

Juls

[Gretchen in NJ]

The ER did a urine test, strep test (again), chest x-ray and more blood work. Three doctors checked her out physically and found nothing more than a yucky throat and swollen glands.

 

Her blood work was the only problem. Her white count is elevated, and higher then it was four days ago. Her ESR and CRP tests were both high, meaning that there is inflammation and infection somewhere. Tomorrow I will try to get an appointment with the Infectious Disease guy. Anyone ever been to one? She will not be happy of they want more blood.

 

Juls

We were to one about two years ago, but we knew what the infection was. This just seems like a long time to have a fever.

[juls]

The ER did a urine test, strep test (again), chest x-ray and more blood work. Three doctors checked her out physically and found nothing more than a yucky throat and swollen glands.

 

Her blood work was the only problem. Her white count is elevated, and higher then it was four days ago. Her ESR and CRP tests were both high, meaning that there is inflammation and infection somewhere. Tomorrow I will try to get an appointment with the Infectious Disease guy. Anyone ever been to one? She will not be happy of they want more blood.

 

Juls

[ereks mom]

I'm posting because I want to know if any of you have had this kind of illness strike. My 4 yr old has had a high fever for 10 straight days.

 

My 3yo niece had an illness like this a couple of months ago. My sister took her to the doctor, who pronounced it viral and said it would resolve on its own. After 10+ days of this, my sister took her for a second opinion. Turned out that she had a severe, well-established ear infection & upper respiratory infection -- to the point that her hearing was affected, possibly permanently!

[Mom to Aly]

If you don't find anything out, I'd check walking pneumonia and UTI--I've never had any symptom with a UTI except fever when it gets really bad. & Walking pneumonia will often manifest only in tiredness and fever.

 

All my best...

[Alice]

Juls-

Any update? How is your daughter?

[Lizzie in Ma]

Twice with my older one and once with the younger. After a few days I always end up in the ER and it has always been a viral illness they can do nothing about.

It is scary and the longest is lasted was with my 2nd, 10 days exactly for the fever to break.

I hope your little one is better soon. How I dread the "fever of unknown origin" diagnosis. Especially after having had to hold them down for tests and be stuck in the ER for hours on end.

Do keep us posted would you?

[jmgconner]

Bumping up. Have you heard anything?

[TravelingChris]

WHen my now almost 15 year old was about 3, she had day after day of high fever. I took her back three times to the ER. Finally they figured out after others of us got sick and got diagnosed, that she and we had mycoplasmic pneumonia. We were put on antibiotics and cured. Mycoplasmic pneumonia is what is often referred to as walking pneumonia but with certain people, you can get very sick. All pneumonia is potentially very serious.

[Jennifer in MI]

Oh my goodness. I pray that she's okay. Any updates?

 

My ds always ran VERY high fevers when sick - we're talking 106 - 106.5. We would take him to Children's and it was always viral. His longest fever was 8 days. That poor kid was poked and prodded so much during that illness. But, he was fine. Does your dd tend to run high fevers?

 

Oh I pray that she's okay. Sick kids stress me out!

[summer]

She needs to be tested for strep again and UTI.

[summer]

About the UTIs...when I was little, 3, and 4 and so years old, I had problems with UTIs and kidney infections. I would not complain of symptoms.

[Tarheel Heather]

Wow, I hope you guys get some answers. :grouphug:

[cindyinTexas]

My doctor has a 3 day rule. If the fever is not better after that 3rd day he wants to see them because it is something more than viral. I trust him on this because he is not one to hand out antibiotics, he is very conservative. Heck it has been 8 years since we had any and that was because we all had strep. With strep that fever will not leave...........

Of course you cannot eat and want to cry every time you even think about swallowing your spit. I know TMInfo

[Didache Academy]

This may be a long shot, but has she recently been bitten by a tick? My soon-to-be 12dd had tularemia (rabbit fever) when she was 4. It sounds a lot like what you have been going through. A high fever for days on end that would lessen with antibiotics (she did test positive for strep as well, a secondary infection) but it always went right back up. Long story short, she was bitten by an infected tick. Fortunately two weeks into the ordeal we saw one of the few dr's in the state of NE that could identify it. A couple of days on the right antibiotic and she was back to herself again.

 

Please let us know what you find out.

[juls]

The ER at the Children's Hospital on Tuesday did lots of tests and found little. Her chest x-ray was negative, her urine cultures were negative, they repeated the strep test and it was neg and her Epstein-Bar test (mono) was neg. She's had no known tick bites, no pet exposure and no rashes.

 

Her blood work did show some action however. The white count was up (19,900) and the red count was down (3.74 x10e6). The white count had risen since the previous blood draw four days prior.

 

Of note, her Sed Rate (ESR) was exceptionally elevated at 114 and her CRP was 19. These indicate inflammation of some sort and indicated that it is not viral.

 

She also had a positive ANA test at 1:360. This can be indicative of an auto immune problem.

 

We see an infectious disease specialist this coming Tuesday. He will be begin the process of looking for infection, autoimmune issues or even

cancer. Infection is the highest possibility though at her tender age of four.

 

Now, the good news. I think her fever is finally changing. I have not given her Tylenol or Motrin for 24 hours now and her temperature is oscillating between normal and 101. This is a clear change. She still says her throat hurts and she still acts a bit sick. I'm looking at the bright side right now- perhaps this was a nasty bacterial infection (maybe of her tonsils?) that her little body has had to fight off without antibiotics. She's still asleep, I'm anxious to see how she is when she wakes up.

 

Of some note, she was sick with the same symptoms back in March although for a much shorter duration. Her white count was also elevated back then and the doctor gave us an antibiotic that did the trick. This time no doctor has given us and antibiotic at all. Perhaps that's all we are missing, but this go round I saw a different pediatrician at our practice and this one will hand out and antibiotic only when there is a solid reason.

 

Thanks for the concern and especially the prayers.

Juls

[Jennifer in MI]

Still praying. The fact that her fever is going down is very encouraging. What a fighter you have there!!!

 

I'll be praying. Please update on Tuesday! I'm sorry you have to wait so long.

[JudoMom]

The ER at the Children's Hospital on Tuesday did lots of tests and found little. Her chest x-ray was negative, her urine cultures were negative, they repeated the strep test and it was neg and her Epstein-Bar test (mono) was neg. She's had no known tick bites, no pet exposure and no rashes.

 

Her blood work did show some action however. The white count was up (19,900) and the red count was down (3.74 x10e6). The white count had risen since the previous blood draw four days prior.

 

Of note, her Sed Rate (ESR) was exceptionally elevated at 114 and her CRP was 19. These indicate inflammation of some sort and indicated that it is not viral.

 

She also had a positive ANA test at 1:360. This can be indicative of an auto immune problem.

 

We see an infectious disease specialist this coming Tuesday. He will be begin the process of looking for infection, autoimmune issues or even

cancer. Infection is the highest possibility though at her tender age of four.

 

Now, the good news. I think her fever is finally changing. I have not given her Tylenol or Motrin for 24 hours now and her temperature is oscillating between normal and 101. This is a clear change. She still says her throat hurts and she still acts a bit sick. I'm looking at the bright side right now- perhaps this was a nasty bacterial infection (maybe of her tonsils?) that her little body has had to fight off without antibiotics. She's still asleep, I'm anxious to see how she is when she wakes up.

 

Of some note, she was sick with the same symptoms back in March although for a much shorter duration. Her white count was also elevated back then and the doctor gave us an antibiotic that did the trick. This time no doctor has given us and antibiotic at all. Perhaps that's all we are missing, but this go round I saw a different pediatrician at our practice and this one will hand out and antibiotic only when there is a solid reason.

 

Thanks for the concern and especially the prayers.

Juls

 

Juls-

 

Don't let the doctors rule out arthritis because she is only 4. My ds6 started with high fevers (he did have a transient rash, though) when he was 2 and he would complain and cry about pain in his knees and it took us 2 years to get a diagnosis and start treatment to help him and his pain, because 2 year olds, especially 2 year old boys, don't have arthritis in general (the doctors we saw were all really wonderful, and our pediatrician is wonderful, but we call ds6 our "medical anomaly").

 

You might want to read here and here (this is they type of arthritis we think ds6 has). You might want to consider starting a health journal for your dd. Our pediatrician recommended it, and all of the doctors we saw appreciated it. I basically took his temperature 3 or 4 times a day, at the same time (first thing, lunch, dinner, bedtime) and made a note of how he was feeling (I did this for a couple of months). It helped to show patterns with his fevers and how they affected his behavior. I would also recommend that you get a copy of all lab work mailed directly to you, and take copies to any doctors you see along with the health journal.

 

(((Juls))). I hope you're able to find some answers soon.