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Dr. Shahzad MD
Dr. Shahzad MD, Board Certified MD
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Experience:  MBBS, MD, FCPS.
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8 year old started with headache, sore throat, vomiting, fever

Resolved Question:

8 year old started with headache, sore throat, vomiting, fever of 102.5 with sore on tongue. Strep test x2 were negative. Over 5 days fever is between 102.2 to 102.8 with increasing number or red sores on back of mouth, white sores on roof of mouth, huge white puffy lesion on tongue, white tongue with bright red oral mucosa, swollen, puffy gums that bulge out and up teeth. Went to RN clinic x2 and an urgent care clinic that gave antibiotics for ear infection. Child not eating at all, lost almost 10 of body weight (6#) and is lethargic. When he takes Ibuprophen he becomes Perrier for an hour or so before he gets lethargic again. Doctor at urgent care clinic says it is viral but he seems to not be improving.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Shahzad MD replied 1 year ago.

Dr. Shahzad MD :

Hi there. Thank you for your question. I will be helping you out with your queries

Dr. Shahzad MD :

welcome

Dr. Shahzad MD :

since how long in total is he having these symptoms?

Customer: Since Tuesday. So 5 days
Dr. Shahzad MD :

Have the symptoms improved any? or no improvement whatsoever?

Customer: The headache and sore throat have improved but the number of lesions on the roof I'd the mount, the blisters on the tongue and throat have worsened. Plus he now has inflamed puffy gums that are swelling over his braces. Plus his tongue got white while the edges and the gums and oral mucosa are cherry red. He has refused most food but did take in some day 1 and 2 but minimal bites days 3,4,5. He is increasingly irritable and also is more lethargic. Fever has not reduced at all.
Customer: Roof of the mouth
Customer: He also has some bug bite we notice on his arm which occurred before Tuesday. It has gotten bigger. No "bulls eye" mark. It is getting larger and more bumps are spreading around the bite
Dr. Shahzad MD :

ok

Dr. Shahzad MD :

The oral blisters that he is having means that he is most likely either having an infection with cocksackie virus or with HSV type 1 virus.

Dr. Shahzad MD :

When you took him to the doctor did he having blisters then?

Customer: So herpes or " foot- mouth" viruses?
Dr. Shahzad MD :

yes

Customer: He had blisters on the back of his throat when he went to the Urgent Care Clinic Thursday ( which were not there Tuesday) tho the throat was re and inflamed
Customer: Red
Dr. Shahzad MD :

ok

Dr. Shahzad MD :

I think that you should give ibuprofen 8 hourly and tylenol syrup 6 hourly, both.

Dr. Shahzad MD :

Plus if his symptoms does not improve in the next day or two or his condition deteriorates I would again take him to the ER

Customer: Entire mouth is involved in some way - back of throat and tongue have blisters, roof of mouth has more than 12 white "something's" , the gums got suddenly puffy and cherry red, the tongue got white and swollen...... All in 24 hours
Dr. Shahzad MD :

I think that with these symptoms I would have him examined today

Dr. Shahzad MD :

just to make sure that he is okay

Dr. Shahzad MD :

Sometimes these viruses can cause one to have inflammation of the meninges of the brain

Dr. Shahzad MD :

which can cause one to be lethargic

Dr. Shahzad MD :

so I would want that to be ruled out as well

Dr. Shahzad MD :

Plus for the fever I would give tylenol as well along with ibuprofen

Dr. Shahzad MD :

viral infections can take up to a couple of weeks to go away completely

Customer: My question is that if viral there is no treatment unless on of the antivirals such as acyclovir is used but is that ever used for herpes or cocksakie? I could see I'VE but he does get adequate water. He is refusing anything else.
Customer: What about antivirals?
Dr. Shahzad MD :

Antivirals are of no help in these viruses

Dr. Shahzad MD :

Antivirals are only given when there is infection of the brain with the viruses or genital involvement or serious infection

Customer: Ok. We will go to ER in the morning if it is not improving. I have no experience with either of these viruses. How long is the course of infection? What about school? Out till s/s gone?
Dr. Shahzad MD :

Usually 10-14 days

Dr. Shahzad MD :

It should go away in up to two weeks time

Dr. Shahzad MD :

in the next few days symptoms should start settling

Dr. Shahzad MD :

The doctor should give a leave from school certificate or a paper

Dr. Shahzad MD :

Infection can be transmitted to other children so cannot go to school now, plus he is also not fit for school with the high fever

Customer: Ok. He has no stiff neck but is getting more lethargic ( thought it was lack of food). But meningitis scare the heck out of me so we will check it out
Dr. Shahzad MD :

Being lethargic is common with a viral infection

Dr. Shahzad MD :

Most likely its not meningitis

Customer: Ok, thank you!
Dr. Shahzad MD :

But just to be dead sure I would just want him to be examined

Dr. Shahzad MD :

You are most welcome

Dr. Shahzad MD :

Hope he gets well soon

Customer: We, also.
Dr. Shahzad MD :

Take care

Dr. Shahzad MD :

Good bye

Dr. Shahzad MD :

Rate me for my services by clicking on one of the smilies below

Dr. Shahzad MD :

Thank you

Dr. Shahzad MD, Board Certified MD
Category: Medical
Satisfied Customers: 5019
Experience: MBBS, MD, FCPS.
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