Pediatric Fever: Symptoms, Treatments, and Rash Concerns

Q: Pediatric Fever: Symptoms, Treatments, and Rash Concerns

Hello： Based on the description, your second child appears to have roseola. <br>It is caused by infection with human herpesvirus type 6 and is most common in children aged two to three years, so older children may not exhibit typical symptoms. <br>One characteristic of this condi

Fever

Hello Dr.
Liang,
My child started having a fever on the night of July 25, accompanied by vomiting and leg pain.
Despite continuous use of anti-nausea and antipyretic medications, there was no improvement.
On the fifth day, we went to a large hospital for blood tests, which came back normal.
Later, after taking the anti-inflammatory medication Cefspan, along with Motilium for nausea and a gastric protectant, my child recovered.
However, on the same day (the fifth day), my second child also developed a fever.
The doctor mentioned that the symptoms were similar, and after taking the anti-inflammatory medication Racikan Pulv for three days, there was significant improvement.
Yet, on the third night, the fever returned, and despite taking antipyretics three times throughout the night, the fever did not subside until morning.
The next day, we returned to the hospital for a follow-up, and the doctor prescribed anti-inflammatory medications Racikan, Cefspan, and throat medication (Pulv Racikan).
That night, my child developed rose-colored rashes on the face and body, but by morning, the fever had completely subsided.
The doctor suggested that this was due to overheating in the body.

I would like to ask the doctor if this is roseola, considering that my first child did not develop any rashes after the fever subsided.
Also, should we continue the medication? (We are currently on vacation in Indonesia.)
Thank you for your assistance.

Fang Ming, 30~39 year old female. Ask Date: 2004/08/04

Dr. Liang Hongjian reply Pediatrics

Hello: Based on the description, your second child appears to have roseola.
It is caused by infection with human herpesvirus type 6 and is most common in children aged two to three years, so older children may not exhibit typical symptoms.
One characteristic of this condition is that after three days of high fever, the fever subsides, and a widespread rash appears simultaneously.
The rash typically resolves on its own within three to four days.
Management primarily involves supportive care, including increased fluid intake and symptomatic treatment.
Wishing you health and happiness.

Department of Pediatrics, Miaoli Hospital, Ministry of Health and Welfare, Liang Hong-Jian.

Reply Date: 2004/08/04

More Info

Understanding pediatric fever, especially when accompanied by symptoms such as vomiting, limb pain, and rashes, can be quite challenging for parents. In your case, it appears that your child experienced a series of concerning symptoms, including fever, vomiting, and limb pain, which ultimately led to a hospital visit. The fact that blood tests returned normal is reassuring, but it does not eliminate the need for careful monitoring and management of symptoms.

Fever in children can be caused by a variety of factors, including viral infections, bacterial infections, and even non-infectious causes. In your situation, the initial symptoms of fever, vomiting, and limb pain could suggest a viral infection, which is common in pediatric populations. The fact that your child responded well to anti-inflammatory medications like cefspan and motilium indicates that the fever was likely due to an inflammatory process, possibly related to a viral infection.

The appearance of a rose-colored rash, especially after a fever, raises the possibility of roseola, a common viral illness in young children. Roseola typically presents with a high fever followed by a sudden drop in temperature and the appearance of a rash. However, it is important to note that not all children will exhibit the rash, and the absence of a rash in your older child does not rule out a viral infection. Each child’s immune response can vary significantly, leading to different manifestations of the same illness.

Regarding the continuation of medication, it is essential to follow the advice of your healthcare provider. If the doctor has prescribed a course of antibiotics or anti-inflammatory medications, it is generally advisable to complete the course as directed, even if symptoms improve. This ensures that any underlying infection is adequately treated and reduces the risk of recurrence.

As you are currently in Indonesia, it is crucial to maintain open communication with your healthcare provider. If your child’s symptoms worsen or new symptoms arise, such as difficulty breathing, persistent high fever, or dehydration, you should seek medical attention promptly. Additionally, if the rash worsens or is accompanied by other concerning signs, it is advisable to consult a local pediatrician.

In terms of managing fever at home, ensure that your child stays well-hydrated and is comfortable. You can use fever-reducing medications as directed by your healthcare provider. Monitoring your child’s temperature regularly and keeping a record of any changes in symptoms can be helpful for follow-up consultations with healthcare professionals.

In summary, pediatric fever can be multifactorial, and while it can be distressing for parents, many cases resolve with appropriate care. The appearance of a rash after fever can indicate a viral illness like roseola, but individual responses can vary. Always consult with healthcare professionals for tailored advice and treatment plans, especially when traveling or in unfamiliar environments. Your vigilance and proactive approach to your child's health are commendable, and I wish you and your family a safe and healthy time during your travels.

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