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What Causes Recurrent Fever And Slight Shivering?
Posted on
Tue, 16 Dec 2014
Tue, 16 Dec 2014
Answered on
Wed, 14 Jan 2015
Last reviewed on
Question : My daughter age is 10 years old on 4 th dec she having fever at that time we give crocin and fever goes down.But after couple of hrs again fever came after that we consult doctor he examine my daughter and say its viral fever continue with crocin three times a days.But after three days condition is same fever repeating with light shivering and its goes 102 then again we met the doctor than he suggest some blood test like malaria, Crp etc.other test comes negative but crp level comes 24 then he started cefedem 350 xp for 7 days along with multivitamin and crocin. After seven days treatment fever is again repeating yesterday i again do thee crp level blood test and in reports its remain same as 24. But in this i forget to tell one thing to my doctor that my daughter is patient of high allergy and during this december and january her alergy levels are very high on 2 nd dec.We recently test her ige serum level which comes 351 and my doctor give some medicine for that but due to this fever we not start that medicine. I want to ask one thing that crp levels are effected due to high ige serum levels because after starting that medicine which is given by doctor for ige serum my daughter fever comes normal from yesterday.
Brief Answer:
CRP level unrelated to Ig E level
Detailed Answer:
Hi
Welcome to Healthcare magic
Greetings of the day
Dear Mr XXXXXXX
CRP or C - reactive protein is an acute phase protein. It is usually raised in infection and is a non specific indicator of any infection. It could be raised in non specific viral fever too.
Ig E immunoglobulin is usually raised in Allergic condition and is an indirect indicator of allergy. CRP Is not affected or related to raised Ig e levels. Majority of viral fevers are self limiting and subside on their own. All that is required is supportive and symptomatic treatment.
If the following criteria are fulfilled there is no cause for concern
1. Appetite normal
2. Fever less than 101 degree Fahrenheit
3. No rash or skin eruption
4. No urinary complaints
5. Breathing rate and pattern normal
I hope I have resolved your query. In case you require any further assistance, I will be glad to assist you.
Take care
Best regards
Dr Deepak Kaltari
Consultant Pediatric Surgeon
CRP level unrelated to Ig E level
Detailed Answer:
Hi
Welcome to Healthcare magic
Greetings of the day
Dear Mr XXXXXXX
CRP or C - reactive protein is an acute phase protein. It is usually raised in infection and is a non specific indicator of any infection. It could be raised in non specific viral fever too.
Ig E immunoglobulin is usually raised in Allergic condition and is an indirect indicator of allergy. CRP Is not affected or related to raised Ig e levels. Majority of viral fevers are self limiting and subside on their own. All that is required is supportive and symptomatic treatment.
If the following criteria are fulfilled there is no cause for concern
1. Appetite normal
2. Fever less than 101 degree Fahrenheit
3. No rash or skin eruption
4. No urinary complaints
5. Breathing rate and pattern normal
I hope I have resolved your query. In case you require any further assistance, I will be glad to assist you.
Take care
Best regards
Dr Deepak Kaltari
Consultant Pediatric Surgeon
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
sir,
then why after 7 days antibiotic treatment crp level still showing 24. ya she is feeling normal in all those points which you mention.
then why after 7 days antibiotic treatment crp level still showing 24. ya she is feeling normal in all those points which you mention.
Brief Answer:
Raised CRP takes time to normalize
Detailed Answer:
Hi
Dear Mr XXXXXXX
CRP is only an indicator and not much weight age can be given on it. If child has clinically improved then no retesting is required
Raised CRP takes time to return to normal level even after child is clinically well.
Rest be assured there is no cause for concern.
Wishing you and your family a very happy and healthy life
Take care
Best regards
Dr Deepak
Raised CRP takes time to normalize
Detailed Answer:
Hi
Dear Mr XXXXXXX
CRP is only an indicator and not much weight age can be given on it. If child has clinically improved then no retesting is required
Raised CRP takes time to return to normal level even after child is clinically well.
Rest be assured there is no cause for concern.
Wishing you and your family a very happy and healthy life
Take care
Best regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Sir,
After 12 days of fever my doctor advice for Cbc,Malaria, Ige antibodies and blood culture. Cbc report comes yesterday night can you tell me whether this report indicate dengue fever or we need to wait for Ige antibody test report.Malaria report comes negative. Today afternoon i am going to consult my doctor.I need your suggestion .
CBC
Investigation Result Unit Range
Platelet Count(Optical/Impedance) 561 10³/mm³ 170 - 450
ESR(Automated - Westergren method) 88 mm/hr 0 - 20
Neutrophils 62 % 40 - 62
Lymphocytes 30 % 38 - 42
Eosinophils 03 % 02 - 06
Monocytes 05 % 0 - 3
WBC Count(Optical/Impedance) 4.75 10³/mm³ 5 - 15
Packed cell volume(Calculated) 34 % 35 - 45
Hemoglobin(Optical/Impedance) 11.4 gm% 11.5 - 15.5
Platelets: : Thrombocytosis noted.
After 12 days of fever my doctor advice for Cbc,Malaria, Ige antibodies and blood culture. Cbc report comes yesterday night can you tell me whether this report indicate dengue fever or we need to wait for Ige antibody test report.Malaria report comes negative. Today afternoon i am going to consult my doctor.I need your suggestion .
CBC
Investigation Result Unit Range
Platelet Count(Optical/Impedance) 561 10³/mm³ 170 - 450
ESR(Automated - Westergren method) 88 mm/hr 0 - 20
Neutrophils 62 % 40 - 62
Lymphocytes 30 % 38 - 42
Eosinophils 03 % 02 - 06
Monocytes 05 % 0 - 3
WBC Count(Optical/Impedance) 4.75 10³/mm³ 5 - 15
Packed cell volume(Calculated) 34 % 35 - 45
Hemoglobin(Optical/Impedance) 11.4 gm% 11.5 - 15.5
Platelets: : Thrombocytosis noted.
Brief Answer:
Not likely to be dengue fever
Detailed Answer:
Dear Mr XXXXXXX
From the CBC report it does not appear to be Dengue fever. Dengue usually causes fall in platelet counts, whereas the report shows increased platelet count. So it will be advisable to wait for other reports.
Do get back to me with details of other reports when available (Blood culture will take 48 hours for the report to be available).
Take Care
Best Regards
Deepak
Not likely to be dengue fever
Detailed Answer:
Dear Mr XXXXXXX
From the CBC report it does not appear to be Dengue fever. Dengue usually causes fall in platelet counts, whereas the report shows increased platelet count. So it will be advisable to wait for other reports.
Do get back to me with details of other reports when available (Blood culture will take 48 hours for the report to be available).
Take Care
Best Regards
Deepak
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Sir,
Today i got the urine culture report with below details. Apart from that blood culture report is negatie. Ig Antibodies test negative.
Gram stain: few pus cells and moderate gram negative bacilli seen
Organism Name: Ecoli
Methodology Name: XXXXXXX Bauer
Growth Observed: Yes
Colony Count: 10000 CFU/ml
Antibiotics Name Result
Gentamicin Resistant
Amikacin Sensitive
Nitrofurantoin sensitive
Norfloxacin Intermediate
Cefotaxime Resistant
Ceftazidime Rsesistant
Ciprofloxacin Resistant
Cefipime Resistant
Imipenem Sensitive
Ceftriaxone Resistant
Meropenem Sensitive
Cefoperazone+Sulbactum Sensitive
Piperacillin+Tazobactam Sensitive
Ertapenem Sensitive
Doripenem Sensitive
Aztreonam Resistant
Comment: ESBL Positive
Can you tell me what is the mean of this sensitive or resistant .Which antibiotic we need to give now and for how many days.Right now we give cefedom xp 350 mg shall we need to continue now. This urine culture test i done on saturday and we already stop the antibiotic last Tuesday.Fever is not there but light warm she is during night. Kindly suggest
Today i got the urine culture report with below details. Apart from that blood culture report is negatie. Ig Antibodies test negative.
Gram stain: few pus cells and moderate gram negative bacilli seen
Organism Name: Ecoli
Methodology Name: XXXXXXX Bauer
Growth Observed: Yes
Colony Count: 10000 CFU/ml
Antibiotics Name Result
Gentamicin Resistant
Amikacin Sensitive
Nitrofurantoin sensitive
Norfloxacin Intermediate
Cefotaxime Resistant
Ceftazidime Rsesistant
Ciprofloxacin Resistant
Cefipime Resistant
Imipenem Sensitive
Ceftriaxone Resistant
Meropenem Sensitive
Cefoperazone+Sulbactum Sensitive
Piperacillin+Tazobactam Sensitive
Ertapenem Sensitive
Doripenem Sensitive
Aztreonam Resistant
Comment: ESBL Positive
Can you tell me what is the mean of this sensitive or resistant .Which antibiotic we need to give now and for how many days.Right now we give cefedom xp 350 mg shall we need to continue now. This urine culture test i done on saturday and we already stop the antibiotic last Tuesday.Fever is not there but light warm she is during night. Kindly suggest
Brief Answer:
Continue same antibiotic
Detailed Answer:
Dear Mr XXXXXXX
Urine culture is done by innoculating on culture medium(it is medium which promotes the growth of bacteria if present in given clinical specimen). The aim of culture medium is to identify the bacteria causing urinary tract infection and also to know which antibiotic the bacteria is susceptible(antibiotic which will be effective in treating infection).
From the report ESBL( Extended Spectrum Beta lactamase ) bacteria are isolated. The report shows the following
1. Sensitive: It means the said antibiotic is effective in controlling or destroying the bacteria
2. Resistant : It means bacteria have developed a protective mechanism and said antibiotic is not effective in treatment of infection
3. Intermediate: Its midway between sensitive and resistant
Clinically change of antibiotic is only indicated when the symptoms or fever is not controlled after starting antibiotic. As you have started your daughter on Cefedom, continue to give it for 10-14 days. Change of antibiotic based on culture report is not indicated if there is improvement in her symptoms and there is no fever after 48 hours of starting of antibiotics.
I would also suggest you the following
1. Ensure good intake of water
2. Get a routine Ultrasound of KUB abdomen done( can be done later)
Take Care
Best Regards
Dr Deepak
Continue same antibiotic
Detailed Answer:
Dear Mr XXXXXXX
Urine culture is done by innoculating on culture medium(it is medium which promotes the growth of bacteria if present in given clinical specimen). The aim of culture medium is to identify the bacteria causing urinary tract infection and also to know which antibiotic the bacteria is susceptible(antibiotic which will be effective in treating infection).
From the report ESBL( Extended Spectrum Beta lactamase ) bacteria are isolated. The report shows the following
1. Sensitive: It means the said antibiotic is effective in controlling or destroying the bacteria
2. Resistant : It means bacteria have developed a protective mechanism and said antibiotic is not effective in treatment of infection
3. Intermediate: Its midway between sensitive and resistant
Clinically change of antibiotic is only indicated when the symptoms or fever is not controlled after starting antibiotic. As you have started your daughter on Cefedom, continue to give it for 10-14 days. Change of antibiotic based on culture report is not indicated if there is improvement in her symptoms and there is no fever after 48 hours of starting of antibiotics.
I would also suggest you the following
1. Ensure good intake of water
2. Get a routine Ultrasound of KUB abdomen done( can be done later)
Take Care
Best Regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Sir,
According to you cefedom is ok for this uti infection ? because when we started this antibiotic fever never come under control, for that we give crocin tablet 4 times a day .We started antibiotic from date 10 dec to 15 dec but fever return every time.After that fever comes down slowly now fever is not there but in urine culture which we done on 20 dec still shows bacteria so shall we give cefedom or some other antibiotic...
According to you cefedom is ok for this uti infection ? because when we started this antibiotic fever never come under control, for that we give crocin tablet 4 times a day .We started antibiotic from date 10 dec to 15 dec but fever return every time.After that fever comes down slowly now fever is not there but in urine culture which we done on 20 dec still shows bacteria so shall we give cefedom or some other antibiotic...
Brief Answer:
Nitrofurantoin needs to be given
Detailed Answer:
Dear Mr XXXXXXX
If urine culture is still positive inspite of being on antibiotics, then going by culture report Nitrofurantoin antibiotic is indicated for treatment. Its a prescription drug which can be brought by prescription from your child's Pediatrician.
No repeat testing is required if there is absence of fever.
Take Care
Best Regards
Deepak
Nitrofurantoin needs to be given
Detailed Answer:
Dear Mr XXXXXXX
If urine culture is still positive inspite of being on antibiotics, then going by culture report Nitrofurantoin antibiotic is indicated for treatment. Its a prescription drug which can be brought by prescription from your child's Pediatrician.
No repeat testing is required if there is absence of fever.
Take Care
Best Regards
Deepak
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
how much mg and dose we can give, my daughter age is 10years
Brief Answer:
Dosage is 7mg per kg in 4 divided doses a day
Detailed Answer:
Dear Mr XXXXXXX
The dosage is 7mg per kilogram of body weight given in four divided doses per day . It is to be given for 7-10 days.
Do get back to me anytime you need any further assistance.
Wish you a very happy Christmas and New Year.
Regards
Deepak
Dosage is 7mg per kg in 4 divided doses a day
Detailed Answer:
Dear Mr XXXXXXX
The dosage is 7mg per kilogram of body weight given in four divided doses per day . It is to be given for 7-10 days.
Do get back to me anytime you need any further assistance.
Wish you a very happy Christmas and New Year.
Regards
Deepak
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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