Dr. Faisal Abdul Karim Malim
Pediatrics
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Patient's Query
Hello doctor,
My daughter is 6 years old, and her weight is 48.50 lbs. She has a fever. Since morning it was 103, and after taking Crocin DSR, it came down to 99 and again went up to 102.5 degrees Fahrenheit. She has been passing stool almost five times since morning, and now at night, she has diarrhea. We just gave her Crocin. She looks normal since morning just that she is in bed. Is it symptom of COVID-19, typhoid, or dengue? We are worried. What medicine can I give her for diarrhea?
Hello,
Welcome to icliniq.com.
As per your description, this may be a symptom of COVID-19. Some patients with COVID-19 get fever with vomiting and loose motions. It would be advisable to do the COVID-19 test for the child if fever does not settle in a day or two. Until then, please do the following:
1. Check temperature with a thermometer.
2. Give the child syrup Crocin DS (250 mg/5 ml) 7.5 ml (four to six hourly) if the temperature is 100 degrees Fahrenheit or more. You can give syrup Ibugesic plus 7.5 ml (8 hourly) if temperature is 103 degrees Fahrenheit or more.
3. Give syrup Nutrolin B 5 ml once daily for five days for loose motions.
4. Give ORS (oral rehydration solution) 220 ml with each loose stool to prevent dehydration.
5. Watch for dehydration, lethargy, and refusal to feed.
6. You can give syrup Ondem (Ondansetron) 5 ml sos if there is vomiting.
Patient's Query
Thank you doctor,
I gave her Meftal P at 9 PM as fever was 103 degrees Fahrenheit, and it came a little down to 100.8 degrees Fahrenheit. Now again, after four and a half hours, fever raised to 104 degrees Fahrenheit. I just gave her Meftal P 5 ml now. What should I do to bring down the fever? Is Meftal P safe with COVID-19? I am worried if she may have dengue, and I am giving her Meftal P?
Hello,
Welcome back to icliniq.com.
Yes, Meftal P is safe in COVID-19. Do not worry. At such high temperatures, I would recommend syrup Ibugesic plus instead of Meftal P. Also, I would recommend doing CBC (complete blood count), CRP (C-reactive protein), PSMP, dengue NS1, IgG, IgM, x-ray chest, urine routine, and microscopy for the child since the temperature is very high. Decision regarding COVID-19 testing will be based on the fever's progress and based on these tests.
Patient's Query
Thank you doctor,
We got dengue, CBC, liver function test, kidney function test, dengue and typhoid tests. All are negative. But in liver function test, SGPT and SGOT are 40 and the reference range is less than 35. I am attaching the report. Is anything wrong with her liver? I am so worried.
Hello,
Welcome back to icliniq.com.
I have seen the reports (attachment removed to protect patient identity). The CRP (C-reactive protein) levels are quite high (120) (normal reading being 5). I am not worried much about SGPT or SGOT of the liver. They seem to be just fine. Do not worry about them.
Management will change as per the following:
1. Continue the previous medications as going on.
2. Start on syrup Zifi (Cefixime) 5 ml twice a day for five days.
3. Please do COVID-19 test for the child.
Patient's Query
Thank you doctor,
What is CRP and why it is so high? What does it mean ?
Hello,
Welcome back to icliniq.com.
CRP is C-reactive protein. It is an indication of high levels of infection (either bacterial or viral). It is high in your case because of probably high levels of infection. Hence, we have to start an antibiotic. I have started Zifi in your case. And to be sure, we are doing the COVID-19 testing also. If COVID-19 testing turns out positive, we will have to add syrup A to Z 5 ml once daily and tablet Limcee 500 mg half tablet once daily both for 10 days.
Patient's Query
Thank you doctor,
Once infection goes away, I hope level return back to normal? COVID-19 result will come tomorrow. Also, low lymphocyte in the CBC report means bacterial infection or virus infection.
Hi,
Welcome back to icliniq.com.
Yes, absolutely. The CRP levels will come back to normal once the infection goes away. A low lymphocytic count does not mean anything. A high neutrophil count means either early infection or bacterial infection.
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Pediatrics
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