Fever Fluctuations and Muscle Pain: Key Insights for Parents

Fever that subsides and then returns?

On the morning of June 14, I had a fever with an ear temperature of 38.2 degrees Celsius.
After taking an over-the-counter medication, my temperature remained between 37.5 and 38 degrees until around 5 PM on June 14, when it dropped to 36.5 degrees.
During this time, I took fever-reducing medication (10 ml of children's ibuprofen) twice more.
The next day, June 15, I took a rapid test which came back negative, but I did not undergo a PCR test.
Throughout June 15, my temperature was normal.
However, on the afternoon of June 16, I felt my temperature rising again, with an ear temperature peaking at 37.9 degrees.
I did not feel feverish, just warm.
After taking cold medication on the afternoon of June 16, my temperature ranged between 37 and 37.5 degrees.
By the early morning of June 17, I felt my temperature rising again, measuring 38.2 degrees at the ear.
I took cold medication once more.
Over these three days, aside from the fever, I have not experienced any symptoms such as sore throat, nasal congestion, or cough, and I have not had any known exposure or travel history to high-risk areas.
The only unusual symptom is that on June 15, when my temperature was normal, I began to feel pain in the inner thigh near the groin.
It is not a soreness but rather a pain that I can feel when pressing on it, and I also feel a bit of pain while walking.
This pain has extended in a line down to the knee and part of the calf, making it possible to walk but with a limp.
I would like to ask if I should undergo a PCR test if I still have a low-grade fever in the morning, whether the fever could be related to the thigh muscle pain, and if, unfortunately, the PCR test comes back positive, what impact it may have on my breastfeeding baby.
Thank you.

Q, 30~39 year old female. Ask Date: 2021/06/17

Dr. Hong Yuanbin reply Internal Medicine

Hello, based on your description, it is indeed important to first be cautious about COVID-19, so I recommend doing another PCR test for confirmation.
Additionally, you can also perform a PCR test for influenza.
Any respiratory infection, including COVID-19, influenza, or other viruses, could potentially cause the muscle soreness you described.
If you happen to test positive, it is advisable to stop breastfeeding.
As for the impact on children, there are currently no clear reports, making it difficult to assess.
Thank you for your question.

Reply Date: 2021/06/17

More Info

Understanding fever fluctuations and muscle pain in children can be quite challenging for parents, especially when symptoms seem to appear and disappear without a clear cause. In your case, the fever you observed, which fluctuated between 37.5°C and 38.2°C over several days, is a common occurrence in pediatric patients. It’s important to note that fever is a natural response of the body to infection, inflammation, or other illnesses.
When a child experiences fever, it is often accompanied by other symptoms, but in your situation, it appears that the fever was not accompanied by typical respiratory symptoms such as cough, sore throat, or nasal congestion. This can sometimes indicate that the fever is due to a viral infection that may not manifest with respiratory symptoms or could be a response to another type of infection, such as a urinary tract infection or even a mild gastrointestinal issue.
The muscle pain you described, particularly in the inner thigh and extending to the knee and calf, could be related to several factors. One possibility is that it could be a result of the body’s inflammatory response to the fever. Infections can lead to muscle soreness, and this is often referred to as "myalgia." It’s also possible that the muscle pain is unrelated to the fever and could be due to overexertion or even a minor injury that may have gone unnoticed.
Regarding your question about whether to pursue a PCR test if the low-grade fever persists, it is advisable to consult with your pediatrician. PCR tests can provide a more definitive diagnosis for viral infections, including COVID-19. If your child continues to have fluctuating fevers or develops new symptoms, a PCR test may be warranted, especially if there are concerns about exposure to COVID-19 or other infectious diseases.

As for the concern about breastfeeding if the PCR test returns positive, it is essential to follow the guidelines provided by health authorities. Generally, if a breastfeeding mother tests positive for COVID-19, she is encouraged to continue breastfeeding while taking precautions to minimize the risk of transmission, such as wearing a mask and practicing good hand hygiene. The benefits of breastfeeding often outweigh the risks, as breast milk provides essential nutrients and antibodies that can help protect the baby.

In summary, the fluctuations in fever and the associated muscle pain in your child could be linked to a viral infection or another underlying issue. It is crucial to monitor your child’s symptoms closely and consult with a healthcare professional for further evaluation and guidance. Keeping a record of symptoms, including fever patterns and any other changes, can be helpful for the healthcare provider in determining the best course of action. Always prioritize your child's comfort and well-being, and do not hesitate to seek medical advice if you have concerns.

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