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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Caues High Fever And Decreased Urination?

My 4 month old nephew is presenting with fever of 102 and higher. On Friday October 14th he had 2 yellow and slimy bowel movements which resulted in a diaper rash which caused minor bleeding under his boy parts. Throughout the weekend he has not slept much and every time he is put on his back in his crib he immediately wakes up screaming. He is not eating more than 2 ounces of formula every 6 hours. His urination has decreased to 1 time in the last 12 hours and has not had a bowel movement since Friday. He had been to the urgent care and of course they said it is a virus and to let it take its course. I m concerned at this point. Could he have appendicitis or strep? I am lost as to what to tell these new parents who have not slept in days.
posted on Thu, 20 Oct 2016
Twitter Sat, 16 Feb 2019 Answered on
Twitter Mon, 18 Feb 2019 Last reviewed on
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General & Family Physician,  's  Response
Hello,

A few things stood out in the history you provided:
1. That he wakes up screaming after being put down on his back is sometimes a sign of an ear infection. When a person with an ear infection is upright, there isn't as much pressure on the ear drum. When lying down, that pressure increases. It's possible there wasn't an obvious ear infection when the baby was in urgent care before, but maybe now.

2. If he is having less urine output, he is getting dehydrated. He may not have been dehydrated when he was seen before.

3. With a fever of 102, and not taking in enough fluids, he should have a throat swab for strep.

4. It may have started with a viral infection, but as it sounds as though he needs to be reevaluated.

So - it is time to take him back in, and to be assertive about a throat swab and evaluation of his dehydration.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Bonnie Berger-Durnbaugh, General & Family Physician
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What Caues High Fever And Decreased Urination?

Hello, A few things stood out in the history you provided: 1. That he wakes up screaming after being put down on his back is sometimes a sign of an ear infection. When a person with an ear infection is upright, there isn t as much pressure on the ear drum. When lying down, that pressure increases. It s possible there wasn t an obvious ear infection when the baby was in urgent care before, but maybe now. 2. If he is having less urine output, he is getting dehydrated. He may not have been dehydrated when he was seen before. 3. With a fever of 102, and not taking in enough fluids, he should have a throat swab for strep. 4. It may have started with a viral infection, but as it sounds as though he needs to be reevaluated. So - it is time to take him back in, and to be assertive about a throat swab and evaluation of his dehydration. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bonnie Berger-Durnbaugh, General & Family Physician