Our 16 yr old daughter has a prolonged fever. The fever has lasted about 9 days of this writing. Our doctor has run various test including cbc (4.1); strep - negative; mono - negative; no stiff neck or difficulty breathing. Amoxicilin was prescribed on 1st visit, while awaiting strep test results, no longer taking. Child continues to take tyelnol for comfort but fever of 102 returns after a few hours. She normally has a normal low temperature of around 97. Our question is how long can we expect the fever to continue? What's our next course of action, if any?
There are many, many tests that one can consider in evaluating fever. The following is a list from UptoDate:
"We recommend the following laboratory tests for all children with FUO (fever of unknown origin):
* Complete blood count (CBC) and careful examination of the peripheral smear
* Urinalysis and urine culture
* Serum electrolytes, blood urea nitrogen (BUN), creatinine, and hepatic enzymes
* HIV serology
* Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)
* Serum antinuclear antibody in those over the age of five years
* Aerobic and anaerobic blood cultures
* Chest radiograph
* Tuberculin skin testing"
Imaging is normally done after the results of these tests and is based on clinical suspicion. Imaging the abdomen with a CT scan, ultrasound or MRI can be considered.
These options can be discussed with her personal physician.
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.
Lorin et al. "Approach to the child with fever of unknown origin", UptoDate, 2005.
An additional thought might be to try an alternative antibacterial therapy ... Something from the 'mycin class might be more appropriate. I'd consider BiaxinXL as a good start. A lot of children are not responding to AMOXIL therapy because of resistance.
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