Q: My child has recurrent high fevers with tonsillitis and pneumonia. Should I see an ENT or an Infectious Disease doctor?

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 gets a high fever for 4-6 days every 2 to 4 weeks. Sometimes it's diagnosed as tonsillitis, and they've already had pneumonia twice in the last three months. I've often seen white patches on their throat. I'm planning to take them to a university hospital for a thorough check-up. I was told their tonsils are on the larger side, so I booked an appointment with a pediatric Ear, Nose, and Throat (ENT) specialist. Was this the right choice, or should I have scheduled with the pediatric Infectious Disease department instead?

Answer:

It's completely understandable to be worried about your child's recurrent high fevers. Experiencing pneumonia twice in three months, along with frequent bouts of tonsillitis, is certainly cause for concern.

---

## 【Summary of the Current Situation】

• High fevers lasting 4-6 days, occurring every 2-4 weeks.

• Recurrent tonsillitis, pneumonia (twice within 3 months), and tonsillar exudates (white patches).

• Previously told that the child's tonsils are large.

---

## 【Choosing the Right Specialist at the Hospital】

Pediatric ENT Appointment → Keep It

• This is the correct first step. An ENT specialist can directly evaluate issues like enlarged tonsils, recurrent tonsillitis, and other structural problems in the upper airway.

• They can also discuss the possibility and necessity of a tonsillectomy if indicated.

Regarding Infectious Disease (Pediatric ID)

• If the ENT specialist, after the initial evaluation, determines that an "immune system assessment or evaluation for a periodic fever syndrome (like PFAPA syndrome) is necessary," they will initiate a consultation with the ID department within the same hospital. This is a very natural and common process.

• Starting with the ID department might delay the crucial structural evaluation of the tonsils and throat.

Conclusion

→ Proceed with your currently scheduled appointment with the pediatric ENT specialist.

→ If the doctor believes a more in-depth evaluation of the immune system or infectious causes is needed, they will coordinate a referral to their colleagues in the pediatric Infectious Disease department.

---

## 【How to Prepare for Your Visit】

1. Symptom Diary: Keep a log of fever dates, highest recorded temperatures, response to fever-reducing medication, and any accompanying symptoms (cough, runny nose, sore throat, etc.).

2. Previous Medical Records: Bring records of the pneumonia diagnoses, including dates, names of antibiotics prescribed, and any X-ray reports if you have them.

3. A List of Questions: Write down your questions beforehand. For example:

• Would a tonsillectomy be beneficial in our case?

• Is an immune system workup necessary?

• Is there a possibility of a periodic fever syndrome, like PFAPA?

---

## 【Warning Signs (Seek Same-Day Care)】

If you notice any of the following symptoms before your scheduled appointment, do not wait. Go to the nearest emergency room for immediate evaluation:

• Difficulty breathing (e.g., chest retractions below the ribs, nasal flaring).

• Drooling or being unable to swallow saliva due to severe throat pain.

• Appearing extremely lethargic or not making eye contact.

• No urination for more than 8 hours.

---

You are taking the right steps. Starting with the pediatric ENT is the most logical approach, and they will ensure your child gets referred to other specialists if needed. Please proceed with your current appointment.

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