Q: My 33-month-old has a high fever, leg pain, and high WBC count after RSV and COVID. Are these results okay?
- Myeongchan Kim, MD
- 4 hours ago
- 3 min read
Medically reviewed by Sang Hyun Ahn, MD
Content edited by Myeongchan Kim, MD
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 33-month-old child developed a fever recently and was diagnosed with both RSV and COVID-19 at the clinic. They were prescribed steroids and antibiotics. We continued the antibiotics but stopped the steroids halfway as instructed. A few days later, a high fever started again. Yesterday, my child was lethargic and experiencing body aches, so we went to the ER.
The blood test results were:
WBC (White Blood Cell) count: 26,000
CRP: 3
ESR: 36
Are these levels okay? The ER's respiratory virus panel came back negative. They said my child has a swollen throat and bronchitis but sent us home without any new medication, stating we could stop the antibiotics since they had been taken for a while.
My child is still suffering from a high fever, coughing a lot, and now complaining of leg pain. I am at a loss for what to do. The ER told us to come back in two days if the fever persists, but my child is really struggling. Is it really safe to wait with those blood test results?
Answer:
It is completely understandable that you are very worried about your 33-month-old child, especially with the persistent high fever, elevated inflammation markers after RSV and COVID-19, and returning from the ER without a new treatment plan.
Here is an interpretation of your child's blood test results:
WBC (White Blood Cells) 26,000: This is significantly higher than the normal range (which is typically 5,000-15,000) and suggests a possible bacterial infection.
CRP 3: This indicates a mild elevation in inflammation (normal is usually <0.5).
ESR 36: This indicates a moderate elevation in inflammation (normal is usually <20).
Overall: These results collectively raise the suspicion of an underlying bacterial infection.
There are several concerning factors in your child's current condition: the high fever persisting despite previous antibiotic use, the new symptom of leg pain (which could indicate joint pain or localized infection), severe coughing with lethargy, and high inflammation markers without additional treatment.
Immediate steps you can take at home:
Manage the fever: You can alternate fever reducers (Acetaminophen and Ibuprofen) every 3 to 4 hours to help keep the fever down and ease body aches.
Hydration: Offer plenty of fluids, such as warm water or electrolyte beverages, to prevent dehydration.
Soothe the cough: Use a humidifier in the room to help ease respiratory discomfort.
Monitor the leg: Closely observe the area of the leg pain for any swelling, redness, or heat.
⚠️ Seek immediate emergency care if you notice any of the following:
Difficulty breathing, rapid breathing, or chest retractions (the skin pulling in around the ribs/neck).
Decreased consciousness, extreme lethargy, or lack of normal responsiveness.
Worsening leg pain, refusal to walk, or sudden limping.
Complete refusal to drink fluids resulting in decreased urination.
Given the significantly elevated white blood cell count and your child's persistent, severe symptoms, I highly recommend that you do not wait the full two days. Please visit your pediatrician tomorrow morning for a thorough re-evaluation and to discuss an appropriate treatment plan.
For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.
