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Dr. Gupta
Dr. Gupta, Pediatrician
Category: Pediatrics
Satisfied Customers: 7840
Experience:  MD, practicing Pediatrician with 19 years of experience. Member American Academy of Pediatrics.
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Im not sure whether to take my daughter in to the ER or just

Resolved Question:

I'm not sure whether to take my daughter in to the ER or just take her back to her pediatrician in the morning. I can't get her temp below 102 (it's reached 104.4), even when alternating Tylenol and Ibuprofen ever 3 to 4 hours. She's 5 years old. She says it hurts to put her chin to her chest and has said this since yesterday, but when we were at the pediatrician's office this morning, she didn't complain of it hurting. I called her doctor's nurse line since I can't get her temp down, and because my daughter complained of a tender neck when they asked me to tell her to put her chin to her chest, they told me I need to bring her to the ER tonight. She's current on all of her vaccinations.
Submitted: 1 year ago.
Category: Pediatrics
Expert:  Dr. Gupta replied 1 year ago.

PediatricMD :

Hello & welcome to Just Answer!

If you have any questions after reading my answer, be sure to let me know.

PediatricMD :

I am sorry to hear about your daughter's problems

PediatricMD :

Given her age, the persistent high fever, and the fact that she is having pain while touching her chin to her neck, there is a possibility of serious illness

PediatricMD :

like inflammation of the covering of the brain (viral meningitis),

PediatricMD :

or problems in her throat like an abscess (pus collection)

PediatricMD :

I would certainly encourage you to get her evaluated in the ER

PediatricMD :

since these conditions require early evaluation and treatment to prevent complications

Customer:

she was evaluated by her pedi this morning...negative for both flu and strep...no throat abscess

PediatricMD :

I understand, but given the fact that the fever is persisting, and her neck pain/ stiffness has returned, it would be prudent to get her evaluated in the ER,

PediatricMD :

it may be nothing, just a viral infection, but the question is that do we want to take a risk of a late diagnosis of a potentially serious illness,

PediatricMD :

I understand this is a hassle, and the chances of a serious illness are small

PediatricMD :

BUT they are present, & I would to exclude this with another medical consultation

PediatricMD :

I hope that you understand...

PediatricMD :

Is there anything else that you would like to know?

PediatricMD :

Please do remember to leave a positive feedback

Customer:

when children present with symptoms of viral or bacterial meningitis don't they typically 'act' sick? i.e. lethargic, loss of appetite etc?

PediatricMD :

Yes,

PediatricMD :

they do,

PediatricMD :

bacterial meningitis is a much more 'sicker' version & hence quite unlikely,

PediatricMD :

However we have seen cases of mild viral 'meningismus' where the child may be fairly well preserved,

PediatricMD :

all this may be just bodyaches related to fever, BUT one cannot be certain without a physical examination

Customer:

what type of examination would they do at TCH (aside froma spinal tap) to rule out meningitis that her pedi wouldnt have done this morning?

PediatricMD :

the main investigation would be spinal tap

PediatricMD :

but depending on the examination, if the doctors feel, they might keep the child under observation for a day or so to monitor any worsening of symptoms depending on severity

Customer:

ok. thank you for your help.

Dr. Gupta, Pediatrician
Category: Pediatrics
Satisfied Customers: 7840
Experience: MD, practicing Pediatrician with 19 years of experience. Member American Academy of Pediatrics.
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