Persistant low grade fever in 21 month-old. - page 2

Hi! I'm a future nursing student starting a BSN program this Fall (yeah)! My daughter (21 months) has been running fever now (intermittant, as I think it goes down while she's sleeping) for 12... Read More

  1. by   Atlnurstudt
    Quote from jeepgirl
    100 rectal is a normal temp.
    Thanks, I thought so too but my friend who works in pediatric ICUs said that it's still considered a low grade fever(100)...it was always my understanding that 100.3 and up is fever.
  2. by   Atlnurstudt
    Update:

    Was 100.7 tonight. So frustrating. I wish it would be either definitely not fever at all, or a moderate fever so I have a little more clout when I talk to the doctor...it's just so on the line. If I ignore it though and it does turn out to be something, I'll never forgive myself...

    Carrie
  3. by   Jolie
    [QUOTE=Atlnurstudt]Thanks for all of the advice so far, I didn't even think of going to the ER. I did look up some info on endocarditis and that definitely seems possible. Would I be able to hear some sort of murmur if I listened to her?? Just wondering? They haven't done any cultures yet either...I'm going to take her temp again tonight (it was just 100 rectal this afternoon, is that still considered fever?). I will need to figure out a good time to go to the ER so that I don't have to wait forever. (I've never been coded a "green" before, and have waited up to 8 hours as a "yellow", heck when she came in on a helicopter, I'm assuming she was a "red" at that point, I still waited around 30 min. before I saw the surgeon). We do have an excellent children's hospital here in Atlanta and I LOVED my last doc. there, Dr. Judy Mills, the woman is a MD who treated us like a wonderful nurse would have, can't beat that!!!!

    Blessings,


    If you already have an established relationship with a physician there, then by all means take advantage of it! Call her office and request an urgent appointment. She and her staff already know you and your daughter, and they have a vested interest in seeing that she continues to do well. No need for the ER in that case!
  4. by   lpnstudentin2010
    it sounds kind of like a uti...ok i am not even a pre-nursing student yet so i have NOTHING to back this up except...a couple of years ago i had a uti...i was sleeping all the time but able to eat/watch tv/etc...is this a possibility
  5. by   jeepgirl
    Quote from Atlnurstudt
    Update:

    Was 100.7 tonight. So frustrating. I wish it would be either definitely not fever at all, or a moderate fever so I have a little more clout when I talk to the doctor...it's just so on the line. If I ignore it though and it does turn out to be something, I'll never forgive myself...

    Carrie
    I would go to the doc that went through her heart stuff... you know, this baby already probably made her wet her pants once, she'll be on top of it this time hopefully.

    we've had kids before that have had long, intermittant fevers of unknown origin. usually they only start to flip when it starts to become very very high....
    also, many times kids will drop down to being VERY low when they become septic. not a good thing.
  6. by   Atlnurstudt
    Hey,

    It was 100.8 today so my husband and I are going to take her in to the ER at the children's hosp. where she had her heart surgery tomorrow morning. Hopefully they will at least rule out endocarditis if nothing else.

    Carrie
  7. by   Jolie
    How did your visit go? Hope all is well! Happy Mother's Day!
  8. by   Atlnurstudt
    Hey!

    Well, we took her in. They did a ton of blood work, cbc, crp, sed rate, chemistries, mono spot, cultures. They did urinalysis and culture. And they did a chest x-ray. Everything so far is normal!!! Still waiting on cultures... Doc. wasn't concerned about endocarditis b/c he didn't hear a murmur and b/c its been going on for 3 weeks, would have gotten worse he said. SO...I'm supossed to go back to doc. tomorrow and keep trying to figure it out. He was suspicious of either cat-scratch disease or ebstein barr (apparently the mono-spot isn't particularily conclusive). Anyway...personally, I was only worried about her heart or something like leukemia, so at least the more critical things have been ruled out. I'm assuming at this point that it's either as a result of her UTI (there was a study done at Miami Children's Hospital that addresses persistant low grade fevers following an acute infection, most dissappeared within 6 to 20 weeks), or that it's some funky virus, or maybe some autoimmune thing that hasn't developed enough yet to figure it out (blood tests were reassuring in this case, however). So, we'll see! She was 100.7 today when I took it. I'm going to start a journal and change back to her old ped. (not thrilled about that but she knows her really well and that's very important at this point). I'm not worried so long as she's followed closely and all the blood work stays clear. I do feel much better having gone to the ER. I think it was the right decision concerning the circumstances with our doc. problems, and even the ER doc. agreed with me on that; he said that our ped. practice sounded exceptionally disfunctional.

    Thanks for listening...I'll keep ya'll updated!

    Oh, I got a little bit of a compliment from the ER doc., not deliberate on his part, but he asked me if I was "in medicine." So I felt pretty good about that since I haven't even started nursing school yet .

    Blessings,

    Carrie
    Last edit by Atlnurstudt on May 9, '05
  9. by   Atlnurstudt
    Well 5.5 weeks now and she still has fever (mostly only in the afternoon/evening). Switched back to old ped. Drew new blood work today including repeats of sed. rate and cbc (looking for IgM and IgG) and cultures. Also added mono and bodetella titers. Re-check in 1 week and go on from there (abdominal u/s, echo, infectious disease referal). Geez. Otherwise a happy and healthy kid.

    Hoping the blood work is conclusive this time,

    Carrie
  10. by   Jolie
    Thanks for the update! I hope this passes uneventfully.
  11. by   Atlnurstudt
    This is getting maddening. It's gone up this week. 101 to 101.5 everyday. Anyone know if this COULD be a normal temp. I checked in the middle of the night this last week and it was 95.6. Talk about a wide range. So far blood work has been normal and she had a normal echo on Tuesday. Temps were running btwn 100.4 and 100.8 before this week though. So it's gone up almost a degree this week. No other signs or symptoms as usual. All temps are rectal btw. Infectious disease isn't concerned but will want to see her if they continue. Also, they define fever at a higer temp. Anyone know what that temp. is?

    Thanks,

    Carrie
  12. by   NicInNC
    Quote from Atlnurstudt
    Hi!

    I'm a future nursing student starting a BSN program this Fall (yeah)!

    My daughter (21 months) has been running fever now (intermittant, as I think it goes down while she's sleeping) for 12 days. Highest it's been though is 100.7 rectal. Had her urine checked b/c she recently had a kidney infection but it was clear (this was on Sat.). I normally would maybe assume she just runs a higher temp since it's on the cusp of normal, but she normally runs a much lower temperature, in fact it's quite low when she's asleep or just woken up. It's been as low as 96.6 when I've taken it during the night (again, rectal). Her normal daytime temp runs around 98.9 (rectal). And with the UTI she ran around the same temps (highest 100.4) for the previous 5 days before it spiked and I took her to the ER at 105. So, as of late, 100.2-100.4 means something is going on, not that that can change and be "normal" for a kid, but it was about a month ago that she had the kidney infection and the 100.2-100.4 did mean her body was fighting something. She has no other symptoms but last night she slept for 16 hours straight and then today, after only being awake for 2.5 hours took a nap for another 2 hours. Both times I had to go in and wake her up. When she's awake she acts completely normal, eating, drinking, and playing fine. Oh...I have also noticed maybe 3 small bruises on her trunk in the last week. This is the first time I have noticed bruises on her trunk. They have now all faded and there are no new ones. She may be bruising more easily but I can't be for sure. She takes flovent 44 twice a day (for RAD) and Keflex once a day until we get her renal US and VCUG results back (tests were done on Mon.). Other history is a vascular ring repair (double aortic arch, a congenital heart defect) in Dec. (she is not at a higher risk for endocarditis than the gen. population, however). Her CBC a month ago showed eleveated WBCs 22,000 and an elevated CRP so I assume that since her WBCs weren't like "leukemia" high then that they wouldn't be now, so am I right to not be worried about that....

    I just took her temp again and it was 100.9 so it seems to be going up just a bit.

    Any ideas???

    Any help would be much appreciated!

    Carrie and Madeleine (21 months)
    I feel your frustration. My daughter got monthly HIGH fevers that would last for about 5 days every single month for a YEAR. The fevers would get up very high with her highest 104.7 that caused febrile seizures. The doctors ran so many tests and always assumed it was "just a virus". FINALLY a new young pediatrician joined the practice and we saw him. He immediately said something wasn't right and sent us to an infectious disease specialist. She was finally diagnosed with PFAPA. Most people have never heard of it. I posted about it in this forum about a month ago.

    Your daughters symptoms don't sound completely like PFAPA, but I just wanted you to be persistent that they take you seriously and address your concerns. If you can, see a different doctor in the practice and keep seeing others. There were times that I had my daughter at the office every single day. I spent a ton of money in co-pays by doing that, but I didn't care.

    I wish you luck in finding an answer.


    Btw....many times my daughter would have a fever of over 103 and she would act FINE.
    Last edit by NicInNC on Jun 13, '05
  13. by   NicInNC
    Quote from Atlnurstudt
    This is getting maddening. It's gone up this week. 101 to 101.5 everyday. Anyone know if this COULD be a normal temp. I checked in the middle of the night this last week and it was 95.6. Talk about a wide range. So far blood work has been normal and she had a normal echo on Tuesday. Temps were running btwn 100.4 and 100.8 before this week though. So it's gone up almost a degree this week. No other signs or symptoms as usual. All temps are rectal btw. Infectious disease isn't concerned but will want to see her if they continue. Also, they define fever at a higer temp. Anyone know what that temp. is?

    Thanks,

    Carrie
    Will your insurance pay for dna testing if it's being done to check for PFAPA, Familial Mediterranean fever, Cyclic neutropenia, Hyper-IgD syndrome, Epstein-Barr virus, etc. A lot of these disorders are found through dna testing. That's how they diagnosed my daughter with PFAPA.

    Also, ask your doctor about giving her a dose of Prednisone to see if that gets rid of the fever. In many periodic fevers, prednisone will decrease the fever within a matter of a few hours.

    Just some thoughts to ponder and ask your pediatrician about. Print this page out and take it to the Infectious disease specialist. It's one of the many the printouts that my daughters ID specialist gave me.

    http://www.aafp.org/afp/20030215/tips/25.html

    http://www.mc.vanderbilt.edu/reporter/index.html?ID=867

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