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Family Medicine  (Expert Forum)
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7 year old son with recurring fever
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
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MedHelp Member's Question

7 year old son with recurring fever

by Oliver5, Sep 03, 2006 12:00AM
My 7 year old son has had recurring high fevers every 3 to 5 weeks that last from 2 to 4 days.  (This past fever is the 5th one that has occurred).  He has been diagnosed and treated for strep and sinus infections, but nothing more.  The doctors have tested for mono, pneumonia, lyme disease - all which were negative.  What could possibly be wrong?  He has no other symptoms aside from the high fever. Any ideas would be appreciated.



Doctor's Answer

by Kevin Pho, MD, Sep 04, 2006 12:00AM
The strep and sinus infections themselves can lead to recurring infections.  I would assume that this has been ruled out.



Recurrent fever in children can have many causes.  I would suggest a broad workup including blood cultures, sedimentaion/ANA levels (looking for possible rheumatological disease), imaging studies (chest and abdomen CT), PPD testing (for tuberculosis) and an HIV test.  



These tests can be discussed with your personal physician, or in conjunction with an infectious disease evaluation.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Kevin, M.D.

kevinmd_
Member Comments (13)

by ozark, Sep 04, 2006 12:00AM
has he had a urine culture done?

by Oliver5, Sep 04, 2006 12:00AM
Yes, he has had a few urine cultures.  Ones in the past were normal. Most current one done,however,showed a slight trace of blood.  Will be retaking culture this week.



He has also had blood tests done(one indicated an infection diagnosed as strep), chest x-rays (normal result), and head x-ray (indicated a sinus infection).  Nothing accurate or conclusive has resulted from tests. He has been treated for each diagnosis(with antibiotics), gets well (episodes in between the time he gets fevers are illness free) and then gets sick (feverish) again.



Based on testing done by doctors, we get a different diagnosis each time he gets sick/fevers.  The only common symptoms are the fevers (very high), occasional headache (probably associated with the fever) and that he is low in iron (which probably isn't even a symptom, just thought it was worth mentioning).



Today when I looked in his throat, he had white dots on his tonsils.  Could his sickness be related to tonsils or even adnoids?



Thanks for your help.









by ozark, Sep 04, 2006 12:00AM
how long was he treated for his sinus infection? sometimes it takes a 3 week course to resolve it. does he have allergies? this can prolong sinus infections.  With a little blood in his urine thats good he is having it repeated.  Have they repeated the sinus ct to see if the sinuses have resoved?

by snowgoer, Sep 04, 2006 12:00AM
Make sure that you replace your son's toothbrush after being treated, this a very frequent cause of reinfection.....just a thought.

by rusalka, Sep 07, 2006 12:00AM
I agree with the doc complete run up of blood. His immune system is having trouble fighting things. IT may be an auto immune problem.  Poor little thing. It must be horrible. He musn't have any energy at all.  What about Lyme disease?  A little girl in our preschool had a problem like this with Strep and her blood took over a year to get back to normal but the year before she was treated for lyme disease.The strep ran right through her family.  Do change that toothbrush and do get more testing.  Lots of luck rusalka

by Oliver5, Sep 08, 2006 12:00AM
Thanks for all the insight.  Went to the doctors this week (again) and did a complete work-up.  He (once again) tested negative for lyme disease, mono, etc. They have done blood tests, urine culture, x-rays - nothing has been found. The only good thing that came out of this is that his white blood cell count is normal (per the doctor this indicates that nothing is seriously wrong with him).  I am really thinking it is head related (adnoids, tonsils) and we are therefore going to take him to a ear,nose and throat specialist.  Process is very frustrating - I feel so bad that I can't do anything to help the poor guy.



What are signs/symptoms of enlarged adnoids and how do they diagnose it?  My son has always been a stuffy kid, snores and within these past few months has been diagnosed once with strep and once with a sinus infection.  I'm thinking (hoping) his fevers are being caused by some problem with his adnoids or tonsils.





by chevn, Sep 11, 2006 12:00AM
Hi...your comments you posted caught my eye because my 7 yr old little girl has had a noticeable pattern of recurring fever for at least 2 yrs(at least that's when I realized there was a pattern).  She has no other symptoms, besides what I believe are induced by the fever..achy body, head ache.In between the cycles(3-4 wks) she is energetic, happy,healthy..& then it seems to hit her like clock work. She has a younger sister(17mo apart).They are constantly together,sometimes share a drink, yet my younger rarely if EVER gets sick.A brief history=@birth she was jaundice, but fine w/n a wk.Had 10 ear infections before she was 2..got tubes @ age2. Just this yr she's experianced burning in her throat(heartburn)out of the blue.

Family History= Father had childhood ulcers,IBS,diagnosed early w/ chrones, but later during appendectomy(age20) ruled it out, and acid reflux. Paternal gma=schogrens disease,Bruton's disease.Also, her paternal great aunt,& female cousine(age2) have been diagnosed w/ Bruton's disease. I'm taking her to the doc today, & asking for a complete blood cell count, because so far no testing has been done..always been diagnosed as possible viral infection-no big deal...So anyway, I appreciate the frustration you must have with wanting your little one to feel good & seeing a pattern that no one seems to know the cause of..Good luck and I'll post any worthy news of my little one. God Bless