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Forum Name: Pediatric Topics

Question: 6 year old fever up and down

msazard - Sun Jan 14, 2007 6:51 pm

My 6 year old son was taken to the ER on last Tues. They said he has streep throat. They didnt do a swab test. He was given KEFLEX. I have also been alternating Tylenol and motrin. His temp seems to go down then back up again since then. The highest being 103 and the lowest being 96. 7. I don't know what to do. Do I need to take him back to the doctor/ Shouldn't the Antibiotics have worked by now? Now he also has a Cough that doesnt' seem to be getting better.

Dr. Chan Lowe - Tue Jan 16, 2007 3:11 am

While it is relatively common practice to prescribe Antibiotics for "strep throat" without doing a throat swab, it may not be the best method. Studies have shown that clinicians are not very accurate in visually diagnosing strep throat. Often, we think it is strep and it turns out not to be, or we do not think it is strep and it turns out to be. Add to this that treating strep throat caused by group A Streptococcus bacteria prevents rheumatic Fever from following the infection but treatment does not shorten the course of the illness at all. Given these things there are several reasons that your son may still be having Fevers: 1) He may actually have a sore throat from a virus or other type of bacteria called an atypical bacteria (formally known as mycoplasma) that is not susceptible to cephalexin (Keflex). In this case, the Antibiotics are not treating anything and the infection will run its course. Fortunately, viruses and mycoplasma are not followed by rheumatic Fever and generally run their course then go away. 2) He may, indeed, have strep throat and the illness will still run its course-even though the Antibiotics are protecting him from rheumatic Fever. Symptoms of true strep throat include high Fevers, very painful throat, and general lack of a Cough. The Cough really is the thing that separates strep from other causes. Viruses generally can cause a bad sore throat but often cause a Cough (as does mycoplasma). Unfortutely, this is not 100% If his Fevers do not improve in the next 1-2 days, you should have him reevaluated to see if something else may be going on. Hope this helps. Keep us updated on how he's doing.

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