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Forum Name: Pediatric Topics

Question: 16 mo old loosing weight, diarehha, & tempature for 1 1/


 alicecody - Fri May 20, 2005 9:35 pm

I have a 16 month old daughter that started having diarreha March 28th then fever started April 3rd by April 5th she was running 102.6 and the doctor put her in the hospital because she was very lathargic. Her WBC 27,000 ESR 83 chest x ray okay abdomen x ray okay nasal swab came back okay. They started her on IV antibiotics and she stayed in the hospital until April 9th. She had antibiotics every day and her white cells went down. They also did a tick bite test on her that was normal. She continued to run a fever but it became low grade so they let us leave the hospital and sent her home with 10 days of augmentin. She continued to have diarreha but the doctor thought it could be from the meds. 4 days after being off the augmentin she started running a fever again and still had diarreha. The doctor prescribed Alinia for the diarehha which was to be taken for 3 days 2 x's daily. on the third day she developed a rash so the dr said to discontinue the meds. Her fever started again and diarrhea was still there. They ran the wbc again and they were normal he sent us home and said lets check her agian in another week. Sorry she also had stool culture and urine culture while in the hospital that were normal and then another stool culuture after the hospital that was also normal. There have been so many appointments I may be getting them a little confused but at the last appointment on May 18th she had lost a pound and is still running a intermitent fever and having diarreha. The doctor was already concerned about her weight because she has not gained any since she was 8months old and she is 16 months but know she has lost a pound. At 8 months she weighed 20.8 and now she weighs 19.0. She is 30in tall. He also checked for strip and that was normal. He also did a CHem 14 and her plattlets were high and her lymphocytes were 65% and ESR 28. He has even told us that he did not know what could be wrong with her and was not sure what to do next. He said he was not sure what kind of specialist to send her to but picked a pediatric GI but it will be at least a month before they can get her in. Her doctor is a general practioner. Because of our insurance we are at the mercy of our dr and the specialist. The only way I could get something done faster is to take her to the emergency room but I am afraid they would not realize the importance of her condition since she is stable at this point. The doctor made the comment that she does not look bad and she will smile a little and I am like I do not want to wait until she looks like she is dying before something is done. I am a mother of 3 kids aged 10, 8, and 16 months. So this is not me being a nervous first time mother her behavior and health is not normal. Also I know why she is not gaining weight she will not eat. I am still breastfeeding her, I stopped nursing her during the day to try to wean her per the doctors idea that maybe that would make her better but since she lost weight I started nursing her whenever she wants. Sometimes she does not even want to nurse. I do not know what to think but I am very worried please let me know what you think. Thank You!!!
 Dr. Heba Ismail - Fri May 27, 2005 1:45 pm

Hello Allie,
You've been very informative, but I have a few questions to ask.
Before this whole story started, was she doing well?
Is there any history of recurrent chest infection?
Any abnormal hair loss or skin lesions, other the than drug allergy?
Also, is the diarrhea loose and watrey or large, fatty and foul smelling?
Kindly reply to these questions before we can discuss the lab workup done.
 alicecody - Fri May 27, 2005 9:58 pm

This is the first time she has ever been sick enough to need antibiotics. After she was born and we brought her home she seemed to have a snotty nose a lot but that was the only symptom and my mother thought that maybe it was our wood stove so we did not think much about it. Other than that she had a few other times I took her to the doctor but was always told that it was just a cold and it would need to just run its course and she always got better. Nothing really significant. I have not noticed any hairloss, but she has always had problems with her skin. She scratches a lot like she itches and causes sores or a rash but this is usually in the diaper area on her lower back. She has had watery stools and she has had some that have some consistency to them some are foul smelling some are not so bad. Since I posted this she was admitted to the hospital on Saturday night the 21st and stayed until tuesday. They ran a lot of blood test I am not even sure what all tests they ran but they did an HIV test which was negative and a cystic fibrosis test which was negative. When they admitted her the wbc was 28,000. They found a small spot on her lung that the ER doctor said was pnemonia but the drs that saw her after she was admitted did not want to call it pnemonia. They discharged us without a diagnosis and did not give her any antibiotics (which I was fine with) I agree with them that we need to see how she does without antibiotics confusing things. They want us to take her to a Pediatric GI I have made the appointment but it will be June 21st before they can see her. I just hope I can keep her from getting very sick or losing anymore till then. Any advice would be great!!
 Dr. Heba Ismail - Wed Jun 01, 2005 11:40 am

Dear Allie,
I guess we'll just have to wait and see what the GI specialist says. She may even need to have an endoscopy done, to see what is wrong with her intestines.
I do have a suggestion though, and that is to give her supplemental zinc. Sometimes, the diarrhea can start because of an infection and then after the infection is treated, it will go on because of zinc deficiency.
 alicecody - Fri Jun 03, 2005 10:38 pm

The diarreha has been gone for a week now but now she has not pottied for 5 days. Her platelets have been high for 2months but on this last CBC they were really high 771,000, wbc 21,700 and ESR 45. So now the dr has ordered a blood smear but we have to wait 4-5 days for the results of it. She ran a fever of 100.7 to 101.7 for 7 days straight but for the last 2 days she has been fever free but that is how it seems to work she will run a fever and then it goes away for couple of days and then it is back. She has this rash that started when she went into the hospital on 5-21-05 and it is still around it is red dots that pop up anywhere on her body. At first they thought it was heat rash but it is lasting too long for that but they have not diagnosed it yet. Any thoughts would be great.
 Dr. Heba Ismail - Tue Jun 07, 2005 11:15 am

Allie,
The increased platelet count is reactionary or occurs secondary to any infection or inflammation. So is the increased WBC count and ESR.
I believe she has some undiagnosed infection or inflammatory process going on in her intestines.
Any history of recent exposure to animals or recent travelling, and I don't mean just her, but any family member in close contact with her?

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