Dr. Deepak Patel
Child Health
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My 6-month-old baby had a fever on the 3rd of this month, i.e., 27 days back. The CBC showed WBC was 23000, and then we admitted the baby to the hospital. As there was no fever, the baby was discharged after 7 days. As she got fever again, we went to another doctor. He started antibiotics Amikacin for three days by injection and then Cefixime and Potassium Clavulanate. Then, CRP and WBC went down. Now, CRP is 1.2 mg/dl, and WBC is again 23000. She got vaccinated on her right thigh two months before the first episode of fever. After a month of injection, she has got an abscess on her thigh, and now the abscess has got healed. Doctors are not certain about the problem or infection. The baby is active at present and not lethargic. She is responding to our call and smiling. Last night the fever was 100.2. I am very depressed. Kindly help.
Hi,
Welcome to icliniq.com.
I have read your query in detail.
The child had a fever with high CRP and TLC, Hb low and decreased oral intake (attachment removed to protect patient identity). This clearly indicates that the child had sepsis. Antibiotics were given intravenously and supportive treatment was given. Now, again the child has a fever and TLC and CRP levels are increased. This suggests that the previous infection is not fully resolved. The child needs to be given antibiotics for 10 to 14 days. If oral intake is poor or there is a decreased activity, the child needs to be admitted again. Repeat blood culture needs to be sent. I suggest you get the child admitted and put on intravenous antibiotics for 3 to 4 days. Further treatment will be based on blood culture report and subsequent TLC (total leukocyte count), CBC (complete blood count) and CRP (C-reactive protein) report.
I hope this will help in solving your query. Wishing your child good health.
Take care.
Patient's Query
Hi doctor,
As the antibiotics were used for 10 days, the doctor started B12 250 mg and Folic acid drops and tablets. He said that the body is compensating for anemia by producing more RBCs and WBCs. They did not ask us to admit the baby. Kindly guide us. Thank you.
Hi,
Welcome again to icliniq.com.
In sepsis, antibiotics need to be given for 10 to 14 days. Since they have already given antibiotics for 10 days, the antibiotic course was completed. If the child has decreased oral intake and activity, then the child needs to be admitted. In my opinion, since the child has developed fever also, there is a very high possibility of infection. Since fever is present, antibiotics should be changed or continued for some more time. It usually take some time for TLC and CRP to get normal, but fever should not be there in this scenario. The fever suggests infection. The blood culture should be repeated, and antibiotics should be continued or replaced.
Take care.
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Child Health
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