Q: My child has had a high fever for 5 days in the hospital. Blood tests show high inflammation, but doctors can't find the cause. What could it be?

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Question:

My child has been hospitalized for five days due to a persistent high fever. We went to a local pediatric clinic when their temperature hit over 39°C. Initial blood tests showed a white blood cell count of around 19,000 and an inflammation level (CRP) of 1.7.

My child doesn't have many other symptoms, just an occasional dry cough and some nasal congestion. A follow-up blood test showed the white blood cell count dropped slightly, but the inflammation level has now jumped to over 7. All PCR and flu tests have come back negative, and the doctor is unsure of the cause.

Even with IV and oral fever reducers, my child's temperature has only dropped to the 37s twice in five days. Otherwise, it stays above 38°C, and spikes to 39°C if there's a delay in medication. We are scheduled for more tests tomorrow, but I'm so worried. What could be causing this?

Answer:

It must be very worrying that the fever is continuing even after five days in the hospital.

Let's summarize the current situation:

* High fever (39°C) for five days → Currently hospitalized for treatment

* White blood cell count around 19,000 + Inflammatory marker (CRP) increased from 1.7 to over 7.

* All respiratory virus and flu tests are negative.

* Fever persists with only a temporary response to fever reducers.

Necessary Evaluations at This Stage

For a fever lasting more than 5 days, with rising inflammatory markers and no clear source of infection, the following should be considered:

Questions to Ask the Attending Physician

* Have the results of the urinalysis and urine culture been checked? (To rule out a urinary tract infection)

* Is a blood culture in progress?

* Did the chest X-ray show any signs of pneumonia?

* Has antibiotic treatment been started or is it being considered?

* Are non-infectious causes, such as Kawasaki disease or rheumatic conditions, also being evaluated?

Notify the Medical Staff Immediately If You See These Symptoms

* New onset of neck or joint pain, or a new rash.

* A sharp decrease in urine output, or no urination for more than 8 hours.

* Difficulty breathing or a change in lip color.

* The child is unusually lethargic or less responsive than normal.

Since Your Child is Currently Hospitalized

The attending physician is likely working step-by-step to identify the cause. Discuss with them whether the additional tests mentioned above are necessary, along with the results of Monday's re-tests, and whether it's time to start antibiotics or consult with a larger hospital.

If needed, please update us after you receive the test results—we can help organize the next steps together.

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