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Suggest Treatment For Fever, Pain Behind The Neck And Stomach Ache While Bending Forward In A Child
Posted on
Sat, 7 Jul 2018
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sat, 7 Jul 2018
Answered on
Tue, 8 Feb 2022
Last reviewed on
Question : My 4 ½ year old grandson is visiting for 2 weeks while his parents are in Mexico. I know from a past visit that my clinic won’t see him since he is not their client. I’m concerned that Urgent Care might overdo treatment, but I don’t want to ignore real problems. He said he doesn’t want to go to a doctor, that a doctor would make it worse. He thinks he got sick because he lost his pacifier during the night.
He is more clingy than usual, eats just a little (usually very big appetite), doesn’t want to do the active things he usually does, mostly wants to cuddle or lie down and read or sleep. He obviously doesn’t feel well, but he seems to be taking it in stride and is still his chatty self.
He has obvious swollen glands on both sides and says his neck hurts in back. Bending his head forward (to look at his belly) hurts, turning it side to side hurts a little. His fever mid afternoon was 102.1 taken orally.
Two days ago he had 4 poops, but hasn’t had any since yesterday morning. He said he woke up in the night and his stomach felt red, and he thought he might throw up (but he didn’t).
Today he ate yogurt, mango and granola for breakfast, slept several hours mid-day, ate maybe 4 Swedish Rye Crisps and drank some ginger tea with ice and water when he woke. He ate 4 more Rye Crisps and then 4 broccoli sprigs for dinner and a few spoonful of vanilla ice cream with chocolate sauce.
He’s asleep now.
What should I do?
He is more clingy than usual, eats just a little (usually very big appetite), doesn’t want to do the active things he usually does, mostly wants to cuddle or lie down and read or sleep. He obviously doesn’t feel well, but he seems to be taking it in stride and is still his chatty self.
He has obvious swollen glands on both sides and says his neck hurts in back. Bending his head forward (to look at his belly) hurts, turning it side to side hurts a little. His fever mid afternoon was 102.1 taken orally.
Two days ago he had 4 poops, but hasn’t had any since yesterday morning. He said he woke up in the night and his stomach felt red, and he thought he might throw up (but he didn’t).
Today he ate yogurt, mango and granola for breakfast, slept several hours mid-day, ate maybe 4 Swedish Rye Crisps and drank some ginger tea with ice and water when he woke. He ate 4 more Rye Crisps and then 4 broccoli sprigs for dinner and a few spoonful of vanilla ice cream with chocolate sauce.
He’s asleep now.
What should I do?
Brief Answer:
Looks like a viral illness or a CNS infection
Detailed Answer:
Hi,
By what you say - this looks like a viral illness or a acute CNS infection or meningitis (as his neck is hurting as he is bending down/ nausea / excessive sleeping).
But the first possibility is still viral illness.
I will explain you how a viral illness behaves so that you can be more confident.
Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active.
Paracetamol can be given in the dose of 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.
But as the other red flag signs of meningitis are there I suggest you take him to the urgent care and discuss what I have said with the doctor there.
Best regards - Dr Sumanth Amperayani
Looks like a viral illness or a CNS infection
Detailed Answer:
Hi,
By what you say - this looks like a viral illness or a acute CNS infection or meningitis (as his neck is hurting as he is bending down/ nausea / excessive sleeping).
But the first possibility is still viral illness.
I will explain you how a viral illness behaves so that you can be more confident.
Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active.
Paracetamol can be given in the dose of 15mg/kg/dose (maximum ceiling dose of 500mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.
But as the other red flag signs of meningitis are there I suggest you take him to the urgent care and discuss what I have said with the doctor there.
Best regards - Dr Sumanth Amperayani
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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