Childhood Diseases

Posted by: Faisal | 2010/04/27


low grade fever for 20 days

Dear sir, i have a son of 12 months. When he was 5 days old, he was diagnosed with bi-lateral hydronephrosis and hydro-ureter ( moderate )due to PUVs. At age of 3 months valve abalation was carried out. The child has remained under close monitoring, After abalation no clinical or sub-clinical UTI was observed. (Fort nightly Urine tests). The child has remained on prolectic anti-biotic since birth ( Amoxil 20 mg/kg )for last 20 days the child is on septron. The ultra sound reports ( Every month since birth ) are showing improvement ( Moderate to mild). Since last 20 days the child is having low grade fever ( 99.4 - 100.4 Celcius). Fever is mostly observed during late night hours or early morning, during noon and evening child exhibits normal temp. Child is active but becomes lazy when having temp.Child has lost appetite prtially but is taking milk and soft eadables ( The quantity and frequecy is little reduced), child is curently 10.6 Kg ( Lost about 1/2 kg in 20 days ). At times fever is off for a day or two but again with small gaps child becomes feverish. Blood and urine tests were conducted twice. Latest blood test report is appended below:- WBC-8.3, RBC-5.7, HG-14, HCT-41.3, Plt-244. ANC-1.53, Lympho-5.44. Urine and blood culture showed no growth (-ve). Please advise what to do.

Expert's Reply



Thank you for sending such detailed information.Of course the most likely reason for your little son's fever is a urinary tract infection. All the tests you have sent me are normal which of course makes things difficult.His bllod tests do not show any sign of an infection. Another possibility is that your son is reacting to the antibiotics by developing a low grade fever. I suggest stopping the Septran first and seeing if his fever diasppears.If not then stop the Amoxil as well and see what happens to his fever.If there is no response to taking him off first the Septran and later the Amoxil then another attempt must be made to do a urine examination when he has the fever as well as a blood culture at the same time.Please let me know what happens here.

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