What Causes Neck Stiffness In Children?
Today return to ER fever going back up and rash. Doing more tests now. ??
Has had colds and a very bad cough in last few weeks. Just can't seem to get well!
I would like to get the throat examined to rule out tonsillar involvement
Detailed Answer:
Hello
Thanks for the query
I can understand your concern.The present condition where there is high grade fever,cough,throat pain,stiffness of neck with blood test positive for infection and CT scan and spinal tap test are negative,I would like to rule out scarlet fever first.
In scarlet fever there will be high grade fever with throat pain.The neck may get stiff because of inflammation of tonsils.The blood test will show neutrophilic leucocytosis with raised CRP. On the second day of fever there is appearance of red colored rashes.The rashes usually starts from the neck and face. It appears like a sunburn with very small bumps(red sandpaper). Gradually it involves the chest and back and finally to the rest of the body.
The diagnosis is usually made by examination of throat and swab test for streptococcus.
One should look out for other causes also leading to these symptoms.
There may be other causes of neck stiffness like aseptic or pyogenic meningitis.
As CT scan and spinal tap is normal and thus rules out pyogenic meningitis.
In septic meningitis these test may be normal and still there is infection in the brain.In most of the cases aseptic meningitis is due to viral infection,and viruses are known to cause rashes too.
So if the throat test is normal my second provisional will be aseptic viral meningitis.The point against is the blood test, as in viral infection the blood test should not come positive for infection.
Apart from these two there can be epiglottitis(inflammation of epiglottis,a curtain like structure in upper part of throat) and this can also be rule out by throat examination.
Retropharyngeal abscess may be the another cause and an lateral view x-ray of neck may be needed to rule out this condition.
Apart from the neck stiffness it is the type of rash which can also give clue to the diagnosis.Sometimes uncommon condition like Neisseria meningitis can be there(high grade fever,stiff neck with rash).
I request you to upload a picture so that I could better help you out.
Please ask,if you have any more doubt.
Wish your granddaughter a speedy recovery
Regards
I will continue the present treatment and will wait for reports
Detailed Answer:
Acetaminophen is needed round the clock if the fever is persistent. In case of fluctuating fever it should be administered only if temperature is more than 99.5-100 F.
It is better to stay in the hospital till the time symptoms are improved and a diagnosis is made with the help of reports.
If rashes have been fading away in 24 hours it is unlikely to be infective in origin.
So I would like to continue the treatment and will wait for the reports.
Regards