Patient's Query
Hello doctor,
My 4-year-old daughter is currently in the hospital. We are awaiting MRI results. She has had a fever for three days and is unable to bear weight or walk properly. Doctors performed an MRI to rule out discitis and a spinal abscess. She was dancing and doing splits last week, but began complaining of leg pain the next day.
Her CRP is 66. Could you advise what this might be? I am worried about malignancy. Her WBC is in the normal range. Could a CRP of 66 be an inflammatory response to her aerobics and possible tissue damage?
Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
Thank you for sharing these details, and I understand how worrying this situation must be for you.
In a 4-year-old child with fever, refusal or inability to bear weight, and elevated CRP (C-reactive protein) (66), the doctors are appropriately prioritizing serious but treatable causes, which is why an MRI (magnetic resonance imaging) has been performed.
The most likely considerations in this scenario include discitis, vertebral osteomyelitis, spinal or paraspinal abscess, septic arthritis, or transient inflammatory conditions, especially given the acute onset after physical activity. A CRP of 66 indicates significant inflammation or infection and is not typically explained by routine exercise, dancing, or muscle strain alone, particularly when accompanied by fever and difficulty walking.
The fact that her white blood cell (WBC) count is normal does not rule out infection, as WBC can remain normal in conditions like discitis or early osteomyelitis, whereas CRP is often more sensitive.
Regarding your concern about malignancy, it is understandable, but based on what you have described, it is less likely at this stage that malignancies often present with more prolonged symptoms, weight loss, night pain, abnormal blood counts, or persistent symptoms over weeks rather than a sudden onset after activity.
The MRI will be key in clarifying the diagnosis, and most of the likely causes here are treatable with antibiotics and supportive care once identified. You are doing the right thing by being in the hospital, and early investigation significantly improves outcomes.
Please wait for the MRI results, as they will guide the next steps, and do not hesitate to discuss these concerns openly with her treating team. They are already following the correct and cautious approach.
I hope this helps.
Kindly follow up if you have more concerns.
Thank you.
Patient's Query
Hello doctor,
Still waiting on MRI results; however, a repeat blood test has come back, and her inflammatory markers are now double what they were 48 hours ago. CRP is now 165. They have taken a prick of blood from her finger to test for something. Any idea what this could be?
Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
I understand your concern.
A rapidly rising CRP from 66 to 165 in a child with fever and refusal to walk strongly suggests an active infection, most commonly conditions like discitis, vertebral osteomyelitis, or a spinal/paraspinal abscess, rather than muscle strain or inflammation from exercise. Such high CRP levels are not caused by dancing or tissue injury, and the pattern is not typical of malignancy, which usually develops over weeks to months and shows other blood abnormalities.
A normal WBC does not rule out these infections in children. The finger-prick blood test was likely done to look for bacteria or markers of severe infection or to check the baby's sugar level. MRI is the correct test and, once the diagnosis is confirmed, early IV antibiotics usually lead to full recovery without permanent damage.
I hope this helps.
Kindly follow up if you have more concerns.
Thank you.
Patient's Query
Hello doctor,
MRI has come back clear, and they have started administering antibiotics via IV(intravenous) fluids.
Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
I understand your concern.
What is the report of the MRI? Can you share, please?
I hope this helps.
Kindly follow up if you have more concerns.
Thank you.
Patient's Query
Hello doctor,
Unfortunately the hospital has not shared with me yet. But the report of her entire spine is unremarkable.
Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
I understand your concern.
There is no malignancy type lesion, and there is an infection that we are already suspecting.
I hope this helps.
Kindly follow up if you have more concerns.
Thank you.
Patient's Query
Hello doctor,
That is reassuring, then thank you so much. It just means we will need to wait for the antibiotics to do their thing?
Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Yes, now culture is more important. What is the bug of infection, and what will be the sensitivity of that bug to drugs? Hopefully, the antibiotic response will be within 48 hours. Keep me updated.
I hope this helps.
Kindly follow up if you have more concerns.
Thank you.
Patient's Query
Hello doctor,
And if the cultures all come back negative?
Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Culture can be negative, but a baby still can have an infection. Clinical response to medicine confirmed that some infection was a strong possibility of infection, as CRP is greatly raised, culture can also be negative in viral infection or reactive arthritis, which is our last possibility.
I hope this helps.
Kindly follow up if you have more concerns.
Thank you.
Patient's Query
Hello doctor,
I am just waiting on the revised set of bloods to come back.
Please help.
Thank you.
Patient's Query
Hello doctor,
She has a temperature again. Will the fevers subside after a couple of days of antibiotics? Also, she has lost some weight while in the hospital.
Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Yes first frequency and fever-free time will increase, which will show the response of the medicine.
I hope this helps.
Kindly follow up if you have more concerns.
Thank you.
Patient's Query
Hello doctor,
Temperature is 39.2 degrees Celsius now that they measured it.
Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Sponge plus Paracetamol.
I hope this helps.
Kindly follow up if you have more concerns.
Thank you.
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Answered byDr. Aaqib Javed
Medically reviewed byiCliniq medical review team
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