4 year old with recurring high constant fever and abdominal pain

My 4 year old son has been suffering from high fevers from 101 to even 106 degrees F accompanied by a dull abdominal pain on the right side.  The fever stays high for hours even after tylenol.
He has been having these symptoms since he was 1.5 years old.
We can't figure out what triggers these symptoms.
He becomes lethargic and uninterested just before the symptoms occur.
He is very thirsty and i figure it is the fever.

What could this be? anybody else experience this?
thanks
worried daddy

[Bhupinder Kaur, MD]

Hello,

Fever has traditionally been defined as a rectal temperature over 100.4°F or 38.0°C.It is not life-threatening unless it is extremely and persistently high, such as greater than 107°F (41.6°C) when measured rectally.

The main causes of fever in children are bacterial or viral infections and specific treatment is required for that. As there is associated dull right abdominal pain,hence urinary infections,kidney infections ,tumors,appendicitis,worm or flukes infestation,
intussusception or malrotation,endocrine causes and hematologic causes like sickle cell anemia and Henoch Schonlein purpura can be suspected.

In my opinion, your son should be seen by a pediatrician right away.Various investigations are required to confirm a diagnosis.Keep giving adequate fluids and water to your child as thirst may be a sign of dehydration also.

I hope that helps. Please do keep me posted on how your son is doing or if you have any additional queries. Kind regards.

[DaddyX4]

Just came back from the hospital with my 4 year old. His fever wouldn't stop and it climbed to 103.5 c.
Was there for 13 hours with him while they ran some tests.
Couldn't get blood from him. Urine tests, xrays were done.
Xray showed possible early Pneumonia.
Doc gave some anitbiotics and say in 2 days he will be fine.
If he still has fevers, they say to bring him back. The other diagnosis is Kawasaki disease. Will monitor the next few days to see if the fever goes away.

Finally a diagnosis, but we need to confirm.

[Nina1119]

I am trying to find out what is wrong with my 18 month old grand daughter...She's had HIGH fevers off and on since 7 months of age...Currently in the hospital due to SPIKING Temps of 103 to 104.8 for the last 7 days about every 4-6 hours. Tylenol and Motrin were given at the same time to get it down from the 104.8, and now alternate every 4 hours regardless. She seems to be getting worse every day, she also becomes listless and lethargic when the temp. starts to go up. All the labs and X-rays and ultra sound seem to be normal or very close to it. Iron deficiency Anemia, Hgb 9.9, WBC at high end of normal, CO2 was 18 , straight cath for sterile urinalysis did not show protein or keytones, few leukocytes and small amt. blood . She has been getttin IV of 0.45 NaCl at 50 ml hour and 3 different antibiotics, but the temp. continues every 4-6 hours only up to 103.5 today, but she is looking worse and more lethargic and hard to arouse when the temp shoots up. The MD consulting Texas Children's Hospital because he can NOT come up with anything. This afternoon he called and said "They believe it could be Kawasaki's Disease, as well!!! But my daughter told him "NO that is not it. She is a nurse and has been searching the web for answers as well. Kawasaki's ....(Unknown cause, generally affects young children; most frequently affected are boys under the age of 2 years}...
Three phases of the disease:
1. Acute phase characterized by fever, conjunctival hypermia , swollen hands and feet, rash, and enlarged cervical lymph nodes. FEVER lastin longer than 5 days that is unresponsive to ABT, conjunctivitis, crusted and fissured lips, swelling of hands and feet, erythemia, lymphadenopathy {a condition  that causes swollen glands and can be caused by infection or cancer.}
2. Subacute phase is characterized by cracking lips, desquamation of the skin on the tips of fingers and toes, cardiac disease and thrombocytosis.
{Fever diminishes day 10-25, irritablity, anorexia, desquamation of hands and feet, arthritis and arthralgia, cardiovascular manifestations.}
3. Convalescent phase has lingering signs of inflammation.
Significantly increased platelet count. {Day 26-40: signs of illness are diminishing, and drop in ESR.}
Possible cardiac pathology including dysrhythmias, congestive heart failure and myocardial infarction
Coronary artery disease may lead to aneurysms and ishemic heart disease.

[Nina1119]

Continued from above......
I just wanted to say, your son should have the swollen hands and feet and they MUST PEEL that is one of the hallmark signs of this disorder.  I hope everything turns out OK for your son, and I PRAY that it is NOT Kawasaki's disease, the heart involvement and arthritis can be debelatating.  Doctor's are no different than us, and start trying to grasp at straws when they can't find the answer; BUT atleast they are looking still.
Hope everything works out for you and your family
Nina :)

[faith4me2]

A related discussion, fever was started.