4+ day high fever in 3 year old

[Geofizz]

My 3 year old daughter, Karen, developed a fever quite suddenly Monday afternoon. The fever climbs high at night (>103) and bounces around during the day between 99 or so and 103+. She developed a stuffy nose Wednesday night, but besides that, we've seen no progression of symptoms for more than 4 days now. We've been very conservative in bringing the fever down with ibuprofen, but we have been giving her some at night because she is unable to sleep comfortably.

Karen ate a meal at 11 am on Monday morning. Much of this she threw up at 1:30 am Tuesday morning. Besides that, she's had no more than 1-2 bites of bread or crackers at a time since then. Karen is drinking
plenty of water and juice (apple and mango-lemonade). No more puking
besides that first one.

When her fever dips, she acts almost normally, just a little more lethargic than normal. She's talking and interacting just fine. If it
weren't for the lack of progression of symptoms I wouldn't worry.
However, after 4 days, I'm starting to feel like I can predict what the
thermometer will say just by reading the clock.

Her daycare said this seems to be going around, but kids are out for 2-3 days only. If she caught this from daycare, it has an incubation period of over 5 days, because we were on vacation from Thursday through Tuesday (yes, this started on vacation).

I'm taking Karen into her doctor today. I'm looking for some brainstorming about what this might be before I talk to him. Last
time Karen was sick, he diagnosed an ear infection in a kid I'm pretty
sure had rotavirus. He then prescribed cough medicine when he heard
her cough once, despite my telling him she didn't have a cough. Yes,
finding a new doctor has risen to the top of my to-do list, but for
today, this guy is who we've got.

Going through possibilities:

Karen is not complaining about any pain anywhere.

Karen was recently potty trained. While her wiping is good, it's not
perfect. She isn't peeing more frequently than normal (except at night
maybe? But I think this is because she's waking up and drinking quite
a bit). She says it doesn't hurt when she pees.

I haven't gotten a clear peak in her mouth, but from what I've seen, I
see no sores in her mouth indicating coxsackie.

I have little experience with sinus infections, but Phil seems to think
the nose would be running. At this point, she's very stuffed up, and
it runs clear only when she's been crying.

Any ideas? Any strategies on approaching this doctor to have him work
with me on this?

[kerc]

Originally Posted by Geofizz

I have little experience with sinus infections, but Phil seems to think the nose would be running. At this point, she's very stuffed up, and it runs clear only when she's been crying.

My experience with sinus infections is that if i need an rx to help it go away I also experience intense sinus pressure --- something so painful Karen would tell you about it.

Can you ask to see another doc in the same practice?

[schatz]

Hey Geo,

Just wanted to chime in here quick -- so sorry Karen is still under the weather. I don't have any advice other than it sounds like some random virus to me or a common one where some of the common symptoms aren't showing up as expected (eg., a virus that might normally have a rash combined with fever but in Karen only the fever is evident).

But, I just wanted to encourage you to take whatever that doc says with a grain of salt or see someone else if possible. I can't believe the guy would confuse rotavirus with an ear infection! My dd had rotavirus at 15 months and it was very obviously rotavirus.

Good luck!

Hope

[4under6]

My 7 yr old dd had a fever for 4 days, anywhere from 99 to 104, with no other symptoms besides a headache and was very lethargic. On the 5th day we took her in, and the Dr. listened to her chest, but said it was clear...but he said he had a feeling, and ordered a chest xray. Her lungs were completely filled with pneumonia! She has been sick for 12 days now. I had to bring her back in the other day because she was not getting better.
Thank goodness the Dr. listened to his instincts, and mine. I felt that this was worse than a virus.
I hope you get some answers, mama!

[Geofizz]

Sigh. I don't want to use the wide variety of 4-letter words available to me to describe that experience.

We have 2 interviews scheduled with other docs in September. Let's hope DD gets better on her own and that she doesn't get sick again for a few months.

[kerc]

so you've been to the doc? what did he say?

[Geofizz]

Yes, we spent an oh-so-enlightening 2 hours at the doctor's office.

Her tonsils are red, and the strep culture was negative. I got a prescription for penicillin, with no sort of discussion on what causes red tonsils besides bacteria, what the implications of letting her body fight it herself (except for hearing a long list of very slight probability, very dreadful possibilities), I got told that I shouldn't treat my daughter with any respect because "mom, you're the parent and she's 3." I got told that I needed to hold my daughter down on a table (not my lap) instead of allowing me to explain to her what would happen. DD got a swab shoved down her throat while being told "be a good girl and open up."

I did not get any questions answered, like "what causes red tonsils besides bateria?" or "if she was exposed to this at daycare, is it possible for a tonsilitis bacteria to take >5 days to cause an infection?"

I feel as though this is my worst day as a parent ever. I failed to stand up for my daughter and I subjected her to a hot waiting room for two hours and people with no respect for her health or for her as a person.

The prescription is still in my backpack. Do I fill it?

[Hollysmom]

Geo, I feel so bad for you and Karen. What an awful day. That Dr. sounds like a complete jerk. I don't have any advice on the prescription (sorry), but I hate Drs who treat patients like idiots and write a script (especially for antibiotics) at the drop of a hat. Just couldn't read without giving you a

[kerc]

i think you're doing ok on the worst day as a parent ever....no yelling at your kid, no spanking, etc.

This guy's a moron. You're an educated person who can rationally think about what's going on. For comparison, my doc always uses me to help communicate with Erin. There's a 2 minute conversation among us where he asks about erin, homelife, etc. He always remembers I'm a geologist and then he starts his exam with erin on my lap. When it becomes time for her to lie down or something he has us right there next to her holding her hand...not that you needed to know what a good doc apt can be like.

In this instance...
are you covered at urgent care? can you go there either for a second opinion and/or for emergency care if the fever is worse -- if you don't treat with anti biotics? -- in which case I wouldn't fill the rx. I would either go for a second opinion -- I know that I've been seen at an urgent care in dublin on a saturday-- or would wait it out.

On whether it could take 5 days for the infection to flare up -- is it possible she had the illness during your vacation and it wasn't too bad/she was able to supress it a little. so many people/new things around -- did she get worn down and it flared up?

Did they check white blood cells? Lungs are clear? ears look ok and she's not pulling on them?

She's still not eating anything right? Is there anything she will eat? I'd be worried since she's not a big eater that she's not getting much beyond juice -- no energy to fight the bug, you know?

Call daycare and see if they know the progression of the illness -- fever, barf, fever, gone?
fever, rash?

hmmm. I wouldn't fill the script. I'd wait it out. I'm all for giving antibiotics as needed, but I'd worry about a misdiagnosis and unneeded antibiotics. Anyone affiliated with your mw practice who does kids?

[Geofizz]

Thank you ladies for the support.

DH came to work for the rest of the day from home. Our plan is this: I went to fill the prescription, and I picked up some decongestent and batteries for our penlight. We're going to give it 24 more hours giving her the decongestent and continuing with the ibuprofen as we have been (over 103 when trying to sleep). I'm going to try to monitor the appearance of her tonsils myself in a less stressful environment. We'll go to urgent care tomorrow if she's significantly worse. If she's largely the same with no improvement, we'll start the antibiotics tomorrow evening or Sunday morning. A lot of this is based on the fact that I refuse to subject DD to any more stress like that today to get a second opinion.

Yes, we're getting kind of concerned that she doesn't have enough energy to fight this off at this point. I coaxed about 2 oz of chocolate milk down her this afternoon, and I got some special foods for her at the store. They're not high on nutritional value, but better than apple juice.

We have really good prescription coverage, so we decided spending $3 on a course of antibiotics we might not use is worth it to not have to try to fill it in the middle of the night. I spent about 20 minutes talking to the pharmacist about the antibiotics and many of my concerns. Can I transfer our care to a pharmacist? They seem to have respect for people and love to share information.

[kerc]

Originally Posted by Geofizz

A lot of this is based on the fact that I refuse to subject DD to any more stress like that today to get a second opinion.

I would have a hard time doing so as well. It sounds like you guys have a plan all set.

Does she do ice cream? popsicles? I wouldn't worry so much about the vitamins and mineral content of her food at this point as is she getting enough calories. She probably has some reserves stored away.

I hope she gets better soon.

[Geofizz]

LOL "not high on nutritional value" was ice cream sandwiches and canned peaches. Yeah, I'm looking for calories here.

DD saw the apples and oranges when I came home. She requested both and has eaten some of each. Whew.

[party_of_seven]

Geo, throw out the antibiotics and get yourself a copy of "How to Raise a Healthy Child In Spite of Your Doctor". Its a cheap book and a really easy read. You will look at your child's illnesses much differently after that. Have faith in her body. You are doing everything right. Give her time to heal.

I have been through the usual childhood illnesses with 4 kids now. A coupe of them have had episodes like you are describing....fever for many days, lethargic, upset stomach etc. Guess what? ....they got over it...with no special help. Maybe the stress of traveling has her system thrown off. Who knows. Give her plenty of vit c and rest. She will get better soon.

Just have faith in her body and support her immune system. Our bodies are amazing and can overcome a lot of illnesses all on their own if we don't contaminate them with chemicals and drugs.

Hang in there!!

[Hollysmom]

Originally Posted by Geofizz

Can I transfer our care to a pharmacist? They seem to have respect for people and love to share information.

That is why I always talk to my sister before and after we go to the Dr. I am going to tell her what you said and she will be thrilled. Too many people don't use their pharmacist when they should.

[Geofizz]

Yeah, I discovered that when I was living in AA. I asked the pharmacist about taking high doses of ibuprofen for tendonitis while exclusively breastfeeding Karen. She sat down with me with several reference books and talked through all the implications we could come up with as well as alternatives. I was so grateful, and when I asked her why she'd spent so much time with me, she said it was the first pharmacutical (sp?) related question not related to insurance she's answered in a month.

[schatz]

just checking in on monday a.m. -- for the rotten dr appt -- why are so many docs so arrogant? yeesh.

How's Karen doing now?

[Geofizz]

Originally Posted by schatz

How's Karen doing now?

Better-ish. I sent her to daycare because she doesn't have any of the "can't go to daycare symptoms" but the mommy in me knows she needs a few more days at home. I have so much work I have to get done, and Phil can't take any more days. I'm crossing my fingers that she makes it through the day. The daycare folks are wonderful. They make a point of talking to every parent about what was wrong when their kid's been out, so they could give me a list of diagnoses kids had got from the doctors. Everyone had the same syptoms (though Karen's fever lasted a bit longer than the other days -- 6 instead of 4 days). In all that, one kid had a positive diagnosis for strep, and others got "it's a virus, let it run it's course," but the most popular seemed to be our "diagnosis" of "it's an infection but I won't tell you what it is."

The daycare threw out every kid's toothbrush and asked that parents bring new ones (I'd brought a new one today on the assumption it was a bacterial infection), and they had scrubbed the center from top to bottom over the weekend. Every blanket was sent home to wash -- since Karen wasn't there at all last week, I had Karen's washed already. They also had notes in parent's boxes asking that you take extra care in cleaning sippies and pacifiers. I'm impressed at the measures they're taking based on a single positive diagnosis for strep.

[schatz]

good to hear your dd seems to be on the mend and that her symptoms were like those of the other kids. good luck in the hunt for a new doc.