Pediatrics/recurrent fever in toddler girl
Hello Doctor, My 3 year old daughter has been having monthly bouts of high fever since Jan 2012 (over a year now). She only has fever, nothing else. Physical exams reveal nothing else. Only about 10% of her fever bouts also presented other Sxs such as runny nose, congestion, cough, sore throat.The fevers last from 5 to 9 days and leave completely only to return a few weeks later.Jan 2012: EEG= N and blood test showed only high amylase and high platelets. I began to see a pattern 6 months ago but ER doctors and walk-in clinic Doctors dismiss us and say that they are viral infections. She has a twin brother who is never sick and never catches her 'viruses.' Mono and Step are always ruled-out# In Jan 2013 another fever bout led me to ER where CBC was done again# Following this, she was dismissed with cystitis and antobiotx# Urinary reflux was ruled-out with a renal echo and Regressive Uretro-Cystography= N. I recently gathered all her med records. The Jan 2013 CBC shows high sed rate of 80mm/hr, RBC low, HB low,HT low,CRP high 163 mg/L. We are in Québec so everything is in french. I also read "Ombres de Gumprecht" present, which are Gumprecht Shadows. This alarms me but only me. Can they be related to anything else than ALL? Her fevers are now every 3 weeks. She is normally active, smart and eating well in between fevers. She is small though, in the 8th percentile for her age. At my request a follow-up CBC will be done this week. I don't know what else to do. What are your thoughts? Thank-you very much .
I would have a CBC done with a pathologists consultation, to carefully have someone skilled, not a machine, look at this. Other things cause smudge cells other than ALL, but have someone skilled directly look at the smear and give their opinion.
Have your doctors explored some of the arcane illnesses known collectively as the "pediatric periodic fever" disorders?
To think it is viral thing and a twin in the same house doesn't get ill is a bet far-fetched to me. It would be good to get a sed rate and CRP in a state between the fever events, to assure that they return to normal.
You need a good pediatrician to help you and perhaps the services of a good, university centered pediatric infectious disease specialist.
Hope this helps and feedback re the resolution to me is always appreciated.
Good luck, Dr. Olson