Persistent Fever in Toddlers: Causes and Solutions

Persistent fever in children?

My daughter is about 2 years old.
On the night of December 3rd, she developed a fever at bedtime, accompanied by crying and vomiting.
We consulted a family physician who diagnosed it as a common cold, stating it did not appear to be otitis media since she had no ear pain or swelling.
Taking antipyretics seemed to worsen her vomiting, so we resorted to administering a suppository.
After about 4-5 hours, the medication wore off and her fever returned.
Her appetite and activity levels have decreased, and she wakes up at night to vomit.
The high fever persists.
We have seen our family doctor for two consecutive days, who only provided anti-inflammatory injections without administering any antipyretic injections.
After receiving the anti-inflammatory shot, her fever subsides, but it returns after 4-5 hours.
Please advise.
Thank you very much.
A worried mother.

wanna, 0~9 year old female. Ask Date: 2006/12/06

Dr. He Ciyuan reply Pediatrics

If you still have a high fever and persistent vomiting today, it is best to go to the hospital for further examination and treatment to rule out any other infections aside from the flu.

Reply Date: 2006/12/06

More Info

Persistent fever in toddlers can be a concerning issue for parents, especially when it is accompanied by symptoms such as vomiting, irritability, and decreased appetite. In your case, your two-year-old daughter has been experiencing fever since the night of December 3rd, along with crying and vomiting. Despite consultations with your family doctor, the diagnosis has been generalized as a common cold, which may not fully address the underlying cause of her persistent fever.

Fever in children is a common symptom and can arise from various causes, including viral infections, bacterial infections, inflammatory conditions, and even non-infectious causes. In toddlers, viral infections are the most common cause of fever, but bacterial infections, such as urinary tract infections or pneumonia, can also present with persistent fever. Given that your daughter has been experiencing high fever for several days, it is essential to consider further evaluation to rule out any serious underlying conditions.

The fact that your daughter is experiencing vomiting, especially after taking antipyretics (fever-reducing medications), is concerning. It may indicate that her body is reacting strongly to the fever or that there is an underlying gastrointestinal issue. The intermittent nature of her fever, where it subsides after receiving anti-inflammatory injections but returns after a few hours, suggests that the underlying cause has not been adequately addressed.

In cases of persistent fever, especially when accompanied by vomiting and decreased activity, it is crucial to seek further medical evaluation. Here are some steps you can take:
1. Seek a Specialist: If your family doctor is unable to provide a satisfactory diagnosis or treatment plan, consider seeking a pediatrician or a pediatric infectious disease specialist. They can perform more comprehensive evaluations, including blood tests, urine tests, and possibly imaging studies, to determine the cause of the fever.

2. Monitor Symptoms: Keep a detailed record of your daughter's symptoms, including the frequency and duration of her fever, any associated symptoms (such as vomiting, diarrhea, or rash), and her overall behavior and activity level. This information can be invaluable for healthcare providers in diagnosing her condition.

3. Hydration and Nutrition: Ensure that your daughter stays well-hydrated, especially since she is vomiting. Offer clear fluids like water, oral rehydration solutions, or broth. If she is unable to keep fluids down, this may warrant an urgent visit to the emergency department for intravenous fluids.

4. Avoid Overmedication: While it is important to manage fever, be cautious with the use of medications, especially if they induce vomiting. Discuss with your healthcare provider about alternative methods to manage her fever and discomfort.

5. Emergency Care: If your daughter’s condition worsens—such as experiencing difficulty breathing, persistent vomiting, lethargy, or if she develops a rash—seek emergency medical care immediately.

In conclusion, persistent fever in toddlers can be multifactorial, and it is essential to approach it with careful monitoring and appropriate medical evaluation. While viral infections are common, the persistence of symptoms like vomiting and high fever necessitates further investigation to ensure that any serious underlying conditions are identified and treated promptly. Your proactive approach as a concerned parent is crucial in navigating this challenging situation.

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