Ask a Pediatrician Online and Get an Answer ASAP
Where to go next?(apologies for the long submission, but I want to be thorough). Last Thursday (July 25th) I received a call from the nurse at my son's camp (he's 6). He was complaining of nausea - but never got sick and returned to activities. My wife picked him up and upon returning home, he fell to the floor with intense abdominal pains and shortness of breath. My wife called the paramedics and he was brought the hospital. The situation calmed down for a while and until it was followed by a separate episode (intense pain - whole body tensing and unable to catch his breath). As soon as things settled down, the staff put in an IV (presumably for hydration), ordered a urine test to see if there was any blood particles, a blood test (not sure for what) and performed a stomach X-ray. All were clear, though the X-ray showed some fecal build up. He was observed for another 4 hours, and ate a meal with no repercussions. We returned home and all seemed relatively normal. The next day (Friday, July 26th) he seemed alright, had a normal bowel movement, but showed a light fever 100-101. We administered children's Tylenol and he was good through bedtime. At approximately 10-10:30 PM he awoke with a cry and appeared slightly disoriented. I took his temperature with two different devices, which was registering 104+. I immediately administered children's Motrin and stuck him in a luke-warm bath. For the next 20 minutes, his temp would fluctuate from 103-105+. I called the after-hours line of our pediatrician and the RN told me to bring him to the hospital if it hit 105 again. Which it did. Upon arriving, we were taken in (temp now about 102.3) and he was given liquids and Tylenol. Reviewing his charts form the day before the PA ordered a chest X-ray to rule out pneumonia and a "full" urine test (I guess the previous was a dipstick?) At any rate, similarly to the day before, all test came back clear. He felt better and we went home. Sunday he had a light fever 99-100 but was otherwise normal including a normal bowel movement. Monday (July 1st) we kept him out of camp and brought him to our pediatrician's office. There they discovered an ear infection, but too were baffled by the stomach pain. They suggested that it could still be very bad constipation (though he had had movements). They wrote an RX for antibiotics and suggested a child's laxative. Tuesday-Friday, he returned to camp, but Friday (July 5th) evening and today his fever has returned 100-103, with light stomach pains/headaches here and there and reduced appetite. He is currently sweating it out in bed (has now returned to 99). We are planning on returning to our PED's office Monday, unsure of where to go from here. Any ideas on what else this could be? Lyme Disease (we were up in East Lyme CT a few weeks back)? Gall bladder issues? Something parasitic? Are there any particular tests we should push for? This is scary and were looking for answers....
I'm happy that you have asked me to assist you with your child and hope that you can benefit from my many years of helping parents like you.
Without a tick bite Lyme is unlikely and even with a bite it is still very rare, despite all the publicity this time of year about it.
It sounds like he has a viral gastroenteritis and even though he's not had diarrhea or vomiting the cramping is most likely due to that. Gall bladder disease is almost unheard of at his age so that is not a concern.
The fact that his symptoms have come and gone and were accompanied by fever, with a normal blood count and urine test, means that a virus is most likely the cause and not anything serious. I would follow up with his pediatrician on Monday unless he develops any new symptoms tomorrow.
Gotcha. Is there anything you think we should be on the look out that should/would trigger any additonal concern?
I work exclusively in pediatric urgent care and can tell you that we see lots of stomach virus this time of year.
It might be a good idea to get a prescription for something for cramping (hyoscyamine) but no additional tests are really indicated since he's been evaluated already.
Ok. That's reassuring. We will continue to ride it out... assuming we are alternating between NSAIDs (at recommended dosage) when he is feverish - you think it's ok to continue to make him feel comfortable?
Sure. Be sure you are giving him the correct dose of ibuprofen and tylenol. Here is a link to our website with a dose chart:
ok. will do. we'll follow up with our ped Monday and inquire on the hyocyamine as well.
Thank you Dr.
You are quite welcome and I understand how worried you are but he should be fine in a day or so.
Appreciate it - have a great night.
Please let me know if you have any further questions later.
Will do - thanks again!
I trust I've answered all your questions and if so I hope you will return to chat to rate my answers favorably. In any case I wish you and your family well.