What could cause continuous fever in a 7-month-old?

Question

Hi doctor,

My son is 7 months old. He has had a fever for 8 days. His body temperature started from 105 degrees Fahrenheit on the first day, and now it has gradually reduced to 100 degrees Fahrenheit. This is the first time he has had a fever. I am giving him Crocin drops and Ceftriaxone.

On the first four days, the fever occurred every four to five hours, and now, after taking antibiotics, it occurs once every 10 to 12 hours. But the fever does not stop. The blood culture and urine culture reports show no growth in 48 hours. Blood report shows some kind of infection, with CRP 75 and now reduced to 55 in two days. I wanted to consult a doctor to understand the problem and the possible cause of the continuous fever. Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through the reports and history of your child, given by you (attachment removed to protect patient identity).

1. There seems to be a serious viral infection that the child has suffered, as the total counts are high, but without any neutrophilic predominance.

2. Another anomaly noted in the report is that the platelet count is very high. It is suggested to repeat CBC (complete blood count) when the child is completely normal. This will tell us if the thrombocytosis is congenital or acquired secondary to some inflammation.

3. The most common cause of high platelets in children of this age group is Kawasaki disease (a rare inflammatory condition of blood vessel walls in children).

4. Also, please see the following signs. Strawberry red tongue, edema and swelling of palms and feet, thrombocytosis, longstanding fever, and sudden onset of breathlessness.

5. If the above signs exist, then it indicates probable Kawasaki disease. This will require admission of the child to the nearest hospital with a complete workup, including a 2D echo, followed by treatment with Aspirin and other drugs as required.

6. Also, I would advise doing SGPT (serum glutamic-pyruvic transaminase), SGOT (serum glutamic oxaloacetic transaminase), and a chest X-ray to find out the extent of involvement of inflammation.

7. Continue your medications as advised by your doctor. However, you should be watchful for the following warning signs. Lethargy, refusal to feed, convulsion, breathlessness, and bluish discoloration of lips, palms, or legs. Such conditions require admission of the child to the nearest hospital on an emergency basis.

8. Another possibility that is highly unlikely could be a problem in the bone marrow that may be producing too many platelets. Again, this is less likely.

9. If the consulting doctor feels so, then they may do a bone marrow aspiration test if they feel it is required. This is to be considered if the fever does not subside even after two weeks of treatment.

10. Also, I would like to know of any other associated symptoms like cough, cold, rash, etc.

I hope this helps.

Kindly revert in case of further queries.

Thank you.