Q: My child has a 5-day high fever (39.5°C) and a severe sore throat. CRP is 6.7. Doctors disagree on the cause. What could it be?

This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

Question:

My child's fever started on Tuesday evening with a sore throat. We went to a clinic on Wednesday, but the doctor said the throat didn't look bad enough to cause such a high fever. The fever continued up to 39.5°C through Thursday. On Friday, it seemed to get better, but by Friday evening, the high fever was back. We went to a children's hospital, and an X-ray led to a sinusitis diagnosis. However, other doctors have said that such a high fever is unlikely with just sinusitis. My child's main symptoms are the high fever and severe throat pain, with only minor sniffling. The inflammation marker (CRP) is high at 6.7 (normal is under 1). The hospital recommended admission to find the cause, but we opted for an IV drip and to monitor for one more day. What could be causing this persistent high fever when the only major symptom is a sore throat?

Answer:

It must be very worrying that the high fever has persisted for 5 days. I understand how heartbreaking it is to see your child struggle with a fever as high as 39.5°C.

To summarize the current situation:

• 5-day persistent high fever (39.5°C)

• Main symptoms: Sore throat, some nasal discharge

• Elevated inflammation marker (CRP 6.7)

• Diagnosed with sinusitis, but there is a difference of opinion

Here are some possibilities to consider with this pattern:

1. 【Viral Pharyngitis】 - High fever can last for 5-7 days, with sore throat as the main symptom.

2. 【Adenovirus】 - High fever persists for 5-7 days, may be accompanied by sore throat and conjunctivitis.

3. 【Early Kawasaki Disease】 - High fever for more than 5 days; other symptoms may appear later.

4. 【Bacterial Infection】 - Related to the elevated inflammation marker.

⚠️ Go to the ER immediately if:

• Difficulty breathing, trouble swallowing

• Decreased consciousness, severe dehydration

• A new rash appears or there are changes in the lips, hands, or feet

The doctor's recommendation for admission seems appropriate. An unexplained fever lasting more than 5 days requires a thorough examination, and early diagnosis is crucial for conditions like Kawasaki disease.

For now, keep your child comfortable with fever reducers and ensure they are getting plenty of fluids. Be sure to follow up for a re-evaluation tomorrow. Additional blood and urine tests can help identify the cause.

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

https://fevercoach.us