“My daughter has a persistant fever. What should I do?”
My daughter has been having persisting fevers. She was tested for some infectious diseases and malaria but they are negative. When should the next test be?
6 Answers
A work up for fever would be necessary. The temperature should be carefully monitored. There are several causes to be determined.
A child with persistent fever (fever being 100.5 or above) should be followed frequently by a physician until a diagnosis is made or until the fever resolves. Some physicians will do many tests at the first visit with fever and other physicians will do tests in a stepwise fashion.
Knowing the age of your daughter would be helpful and any other symptoms, since the differential for prolonged fever is quite large. It is likely she should follow up with her current doctor or if they are stumped with a specialist, especially if it has been more than 1-2 weeks.
The best thing is to record the fever over a period of time from your observation and have a primary care doctor run a series of tests for other conditions which cause persistent fever, including some autoimmune diseases, and then make a referral to the appropriate specialist.
Persistent fever in any child should be evaluated by a doctor, preferably a pediatrician as it is not normal. There are many causes of persistent fever. Need a detailed history, thorough physical exam, and may need tests as indicated like blood and urine tests, a chest X-ray, etc.
If the fever has been present for greater than 10 days without finding out what it is, this is called fever of unknown origin. More extensive tests like cultures, X-ray, echo, viral like ebv cmv. Sometimes they have to be hospitalized for scans and blood cultures when fever spikes. Sometimes the fever goes away and a cause is not found, sometimes it is a common infection that presents differently, and sometimes it is very rare or even rheumatologic like lupus or rheumatoid arthritis that present as fever.
