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How To Treat Fever And Mild Cough In A Child?

Posted on Tue, 17 Oct 2017

Question: My daughter aged 3 years is having fever since last 5-6 days. Along with this she had mild cough. She is very tired and low in activity since then. Already given T98 in regular doses. And since yesterday MOXCLAV BD 21218.5 mg started. But fever is still present. Urine test shows some infection and the urine culture report shall come in three days. She is very low in energy and we are very much concerned for the treatment. Kindly help. Is it typhoid, uti or else? Are we doing anything wrong or delaying proper treatment?

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
I would suggest to get blood tests done

Detailed Answer:
Hi

Thanks for asking on this platform

I have gone through the query and do understand your concern.
As fever is there for last 5-6 days and there are no obvious symptoms(apart from mild cough and Urine report) I would like to get blood test like complete blood count, C reactive protein and blood culture done to rule out bacterial infection.
Amoxicillin clavuunate combination covers most of the infection including UTI. So continue with the same.
Collect the culture report and if it's comes positive then antibiotic may need to be changed depending on sensitivity pattern.
I won't get overly worried as only one day back antibiotic has been started and there is no serious symptoms like rapid breathing, blood in urine, loose stool, headache or severe pain abdomen.
I hope this helps.
Please let me know if you have any more questions.
Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Pradeep Kumar Jain (2 hours later)

Sir. The detailed report including CRP and blood count was attached as pdf file. Plz see that. The urine culture report shall come on Monday next, i.e. on 25.9.17. She is having a lot of cough in the sleep and very tired. Also fever comes back after every six hours. Can we wait till the culture report? She is also having headache due to fever.

Answered by Dr. Pradeep Kumar Jain (6 hours later)

Brief Answer:
Please reattach the reports

Detailed Answer:
Hi
Sorry for delayed reply
I have tried a number of times but unable to find the attached report so request you to please reattach the report.
From the explained symptoms, to me it more appears like respiratory infection. Urinary infection may be an associated infection.
I hope the symptoms will start improving now as you have started the antibiotic. I would like to know if you are giving any medication for cough too.
I would suggest you to continue the same and monitor the temperature by making a chart so that you can easily assess whether the temperature is showing a declining trend, same as earlier or getting worsened.
Please get back to me with reports and other medications also if you are giving any.
Thank you

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Pradeep Kumar Jain (39 minutes later)

Sir, plz find the Pathology Report.pdf file as attached.

Answered by Dr. Pradeep Kumar Jain (9 hours later)

Brief Answer:
Have seen the reports,Continue the same medicine

Detailed Answer:
Hi

I have seen the reports.There is mildly raised CRP. Urine report is not very much suggestive of infection.
Don't worry much and continue the same medicine(antibiotic and cough syrup with paracetamol if required).I hope with same treatment she will improve within 2-3 days.
I shall be glad to help further if you need any.

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Pradeep Kumar Jain (29 minutes later)

Sir thanks for the reply. Today is the 8th day of her fever. She is always taking paracetamol in a 6-7 hours gap as often the temperature rises to 102-103. For the cough she is taking a ayurvedic medicine called "tulsi". As paracetamol she is taking "Dolodart" suspension. Can u suggest a better cough syrup? As the urine culture is coming in next three days so is it okay to have the fever for another 3-4 days? Any chances of typhoid or other illness??

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Still I would like to continue same to see the response after 3 days

Detailed Answer:
Hi,

This is a matter of concern that fever is still there. But as said earlier, we should wait at least 72 hours to see the response of antibiotic(unless the condition is severe enough to change/add another antibiotic).
To me chance of typhoid appears less but even if it is there the current antibiotic will help in that too.
I am sorry but as I am an allopathic practitioner I don't have much idea about the composition of tulsi syrup and I can't comment much.
I would prefer to give a cough syrup with combination of Ambroxol a mucolytic (sputum thinning agent) and Levosalbutamol (helps in relieving airway spasm) like Ambrodil s plus or mucolyte ls or ascoril s.
For this age the dose would be 5 ml two to three times a day.
Please get this medicine prescribed by a pediatrician as this is a prescription medicine.

I hope this helps.
Wishing for her good health.
Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Pradeep Kumar Jain (3 days later)

Sir, the urine culture report came negative as it didn't show any growth of bacteria after 48 hours. Her condition has improved since last three days(from Saturday). The fever is not there anymore. Currently she is taking Ascoril LS for cough(5 ml twice daily) and Moxclav BD 228.5 mg(5 ml thrice daily) only.

I am attaching the widal test report and bilirubin test report. Kindly comment whether there is any chance of typhoid or other diseases.

Answered by Dr. Pradeep Kumar Jain (5 hours later)

Brief Answer:
Complete 5 days of antibiotic and cough syrup

Detailed Answer:
Hi

Its good to know that child is doing better.I have seen the report and widal report is negative,serum bilirubin level is also normal.
As there is no growth in urine,I wont give importance to the previous urinary report.
Keeping respiratory infection in mind I would like to continue the antibiotic(Moxclav) and cough syrup for a total duration of 5 days.

Thanks and regards

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Above answer was peer-reviewed by : Dr. Vaishalee Punj