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Ask Dr. Yogindra Vasavada Your Own Question
Dr. Yogindra Vasavada
Dr. Yogindra Vasavada, Pediatrician
Category: Pediatrics
Satisfied Customers: 3091
Experience:  M.D.(ped) passed at first attempt, in practice continuously for last 37 years. Certi. in Comp
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My 4 year old daughter was sick 3 times over the holidays and

Customer Question

My 4 year old daughter was sick 3 times over the holidays and she's never been I'll since she was born (apart from a UTI at 6 weeks). She was given amoxicillin 3 times and it seemed to work for her colds/flu. However, since the last round of antibiotics in February, she has spiked a fever every now and again and I've used Tylenol to bring it down. She says she feels fine. She has always been hot blooded since birth, but since February has been complaining of being cold a lot and her skin is cool to the touch. She also has extreme fatigue (she can sleep 11 hours and then wakes with bags under her eyes and yawns all day and says she's tired and asks for a nap - she hasn't napped in 2 years). I took her to the doctor about 10 days ago and he thought it was nothing to worry about and ordered blood tests, all of which came back normal. She has still been spiking a fever, cool skin and says she's cold, fatigue - and yesterday she started complaining of a sore throat, sneezing, congested. Tonight she was again saying she was cold but her body was very hot to the touch, but she had goosebumps. Her hands and feet were cold to the touch, as well as her cheeks, but the rest of her body was very hot. I took her temperature and it was 102.4...I again gave her Tylenol and some nighttime cough and cold medicine. I spoke to the nurse at her pediatricians office today and she said I'm doing all the right things and the office will call me in the morning but I'm worried as this is so out of character for her. Obviously I'm monitoring her temperature through the night. Can you perhaps share your thoughts?
Submitted: 6 months ago.
Category: Pediatrics
Expert:  Dr. Yogindra Vasavada replied 6 months ago.
Hi, Sorry about this health issue. Perhaps more investigations of immune system of your daughter are warranted, like immune globulins, cell mediated immune system etc to rule out any issues there.Meanwhile please get three urine samples tested for any urinary problem. Multivitamin, minerals like calcium, iron may be offered if not already on.In case of any deficiency, immune globulin shots may be required.
Customer: replied 6 months ago.
She had a whole slew of blood tests, COMP METABOLIC PANEL (CMP), CBC AND AUTO DIFF WBC COUNT, CMV (CYTOMEGLOVIRUS IGM AB), EBV ACUTE INFECTION ANTIBODIES, CMV (CYTOMEGLOVIRUS IGG AB), LDH BLOOD, auto diff (which I'm assuming is something for the auto immune system). She is on multivitamins. So those are the tests she's had done and they all returned as normal. Your answer is very vague and not really that helpful - I would have thought you'd be able to tell me if I need to take her to the ER, continue what I'm currently doing or do something different. Obviously I'm taking her into her pediatrician tomorrow - that's a given!!! I feel like I could have got more information from looking things up for myself. Would not have paid $43 for your opinion or 'advice' if I'd have known how vague the response would be. I was told before I paid the money that the answer would be detailed and it's not. You haven't addressed any of the symptoms at all or even her current fever. Most of what you said has either been done by her doctor or things I already knew. I was hoping to get an informed opinion from a doctor for right this moment in time - not what I should do - which is basically take her to the doctor! That's a given.
Expert:  Dr. Yogindra Vasavada replied 6 months ago.
The immune system assessment is done by an infectious disease specialist and does not come in general bunch of automated results. Auto diff is white cell differential and absolute cell counts. Please persist with your pediatrician and perhaps get referral to infectious disease specialist. Failing which one can consider giving Immune globulin shot every 2-3 weeks empirically and see response.
Customer: replied 6 months ago.
So in your opinion it might be an immune system issue? What symptoms is she displaying that you think that is the case? If she does have something like that, will it be a lifelong issue?
Expert:  Dr. Yogindra Vasavada replied 6 months ago.
Repeated febrile episodes and other general symptoms point to this possibility. Some types have low resistance for viruses, fungi or bacteria selectively. Lymph node enlargement can occur commonly.If genetic in nature, the condition may be lifelong, but otherwise with maturity of other organs and growth, such condition can heal itself (child can grow out of it).Good luck to her.