Recurrent Fevers

Posted by ashleysb03 @ashleysb03, Apr 26, 2019

Hello! My six year old son is experiencing his 3rd “episode”’ with a fever in the last 6 weeks. He was originally diagnosed with strep throat on march 16- had 104 temp at this time. Took amoxicillin and after 4 days fever stopped. Then 4/6 he started fever again and went on a different broad spectrum antibiotic. He was fine until 4/26 and spiked 102 fever out of nowhere. No other symptoms and this is not typical for him. Any thoughts/similar experiences?

Hello @ashleysb03 and welcome to Mayo Connect.

I am sorry to hear of your son's recurring fevers. As a mother myself, I can understand how concerning this can be. Is your son very fatigued during these times of fevers?

Since this has been going on for a while now what type of tests has your son's pediatrician been doing to find the source of the fevers? Has he had a complete blood work-up, urinalysis, etc.? Has your son had any previous sports injuries or surgeries or other health problems?

These are just some thoughts, I hope that other Members of Connect might join this discussion and offer their thoughts as well.

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Thank you for your reply, @hopeful33250. He is fatigued with the fever and then perks up once medicine kicks in. We had some bloodwork done last time; no mono, blood cell counts were good, kidney and liver look good. I was thinking possibly blood culture may be the next step, as well as a urinalysis.
The fever has returned almost at the extact same timing each time from the day he started taking the antibiotic.
As far as any other injuries go, he hasn’t had any, but he does have a benign heart murmur and a chest wall deformity that is non invasive at this time.
The pediatricians first response is just to say it’s a virus he’s working through but it just seems all too coincidental to me.

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I agree with you about this seeming too coincidental, but I'm not a medical professional so this is just a gut feeling. If it were me, I would insist on urine and blood cultures. Sometimes UTIs can present without the typical symptoms or burning, etc. Is the heart murmur you mentioned been since birth?

The fact that the fever returns at the same time with each antibiotic start-up is interesting. Do you keep a journal of symptoms, fever, general activities, start-up of antibiotics, etc.? If not, you might consider a daily journal recording these things – even on good days.

If the fevers continue to be a problem, I would seek a second opinion with a well-known children's hospital in your area, such as a hospital connected with a university medical school or a Mayo facility.

If you are comfortable doing so, will you keep in touch and provide updates?

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@hopeful33250

I agree with you about this seeming too coincidental, but I'm not a medical professional so this is just a gut feeling. If it were me, I would insist on urine and blood cultures. Sometimes UTIs can present without the typical symptoms or burning, etc. Is the heart murmur you mentioned been since birth?

The fact that the fever returns at the same time with each antibiotic start-up is interesting. Do you keep a journal of symptoms, fever, general activities, start-up of antibiotics, etc.? If not, you might consider a daily journal recording these things – even on good days.

If the fevers continue to be a problem, I would seek a second opinion with a well-known children's hospital in your area, such as a hospital connected with a university medical school or a Mayo facility.

If you are comfortable doing so, will you keep in touch and provide updates?

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Absolutely. Thank you for your reply. We will most likely meet with his pediatrician on Monday.

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@ashleysb03

Absolutely. Thank you for your reply. We will most likely meet with his pediatrician on Monday.

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And actually his heart murmur has not been since birth but was discovered at 4 yrs old.

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@ashleysb03 – I understand your concern. 6 weeks is a long time. He needs an organized workup for this fever of unknown origin. I’m also surprised he has not been tested for a urinary tract infection. However, at this point he needs more than bits and pieces testing. The fact that the fever goes away while on antibiotics makes it look like it still is a bacterial infection. Your son should be completely examined again Monday. As mentioned before, you might have to get a second opinion from someone affiliated with or recommended by a Pediatrics department at a major university health center. Hang in there!

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@ashleysb03

Absolutely. Thank you for your reply. We will most likely meet with his pediatrician on Monday.

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One more thought, @ashleysb03. In this daily journal that I suggested you might also list foods eaten. While it seems unlikely that this could be related to a food allergy you don't want to discount any factor in his environment.
By the way, have you recently moved or is your son involved in any new activities, such as sports teams, groups, etc.?

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Thank you both for your thoughts! Update:
His fever persisted yesterday and I ended up taking him into our children’s hospital urgent care. They did a full work up; CBC/urinalysis/throat swab and stomach X-ray. They are going To culture each one of these too but the initial test came back fine. The X-ray showed he is moderately to severely constipated, which could explain the fevers. We started him on a laxative and will wait to hear about the other cultures.
@hopeful33250 we have not moved or changed anything.
I hope this answers some questions for us!

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@ashleysb03

Thank you both for your thoughts! Update:
His fever persisted yesterday and I ended up taking him into our children’s hospital urgent care. They did a full work up; CBC/urinalysis/throat swab and stomach X-ray. They are going To culture each one of these too but the initial test came back fine. The X-ray showed he is moderately to severely constipated, which could explain the fevers. We started him on a laxative and will wait to hear about the other cultures.
@hopeful33250 we have not moved or changed anything.
I hope this answers some questions for us!

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@ashleysb03 I am glad to hear that he had a complete work-up. I hope that the laxative treatment helps with the fevers. Will you consider the daily journals? It might offer some ideas.

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