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About Dr Graham Smith
Expertise
I am accredited in general paediatrics and paediatric nephrology and and am happy to answer questions on both topics. It is not possible or safe to assess acutely sick children through this medium. Such children should be taken to their own doctor, where a full history can be taken and an examination carried out.

Experience
I have been a consultant paediatrician and paediatric nephrologist for 13 years. I have been involved in paediatrics for 22 years.

Organizations
Royal College of Paediatrics and Child Health
British Association for Paediatric Nephrology
European Society for Paediatric Nephrology
International Pediatric Nephrology Association

Publications
Archives of Disease in Childhood
British Medical Journal
Pediatric Nephrology
Current Paediatrics
Nephrology, Dialysis and Transplantation
Nephrology and Urology

Education/Credentials
MA (Cantab)
MB BS (London)
MRCP
FRCPCH

You are here: Experts > Kids > Health for Kids > Pediatrics > Is a 2nd opinion in order?

Pediatrics - Is a 2nd opinion in order?

Expert: Dr Graham Smith - 10/15/2009

Question
I'll keep this as brief as possible. My question is, should I seek the opinion of another doctor?

To make a long story short, my 11 month old has had a fever of 100.7 every day for just over 2 months, even with a 10-day round of amoxicillin. He has no symptoms at all except that he seems a little more tired than usual when it's close to nap time or bed time. He wakes up in the morning with no fever, and it gets higher throughout the day. My pediatrician called it a "fever of unknown origin" after asking me a million questions (all with normal answers) and then ran several blood/urine tests. The only abnormal result was his lymphocytes. Normal is 19-48 and his was 74. The doctor told me that the elevated lymphocyte level was fine, and his 6 ounce weight loss this week was also fine. He said he could think of no other reason for the fever, so we'll just say my son's temperature is naturally 100.6 rather than 98.6. I wasn't satisfied, so I asked him to run a mono test anyway. I won't have the result until Monday.

Am I crazy? Should I take my son to another doctor, or is it really normal for a baby's temperature to suddenly go up to 100.6 and stay there?

Answer
I am not sure what units the value of 74 is in. It is an odd story but I am not sure you can just disregard the raised temp, if it is real. Is there any evidencs of inflammation eg raised CRP / ESR? If you are worried I would get a second opinion, ideally from a paediatrician with an interest in infectious diseases or immunology.

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