ZocdocAnswersWhat should I do about fever and abdominal pain in my 4 year-old?

Question

What should I do about fever and abdominal pain in my 4 year-old?

hi, I am worried about my son. He is 4 year old with no past medical history, up to date immunizations. About 10 days ago we came back from vacation from Russia. Since then he has been having on and off fever and stomach pains. For the first few days fever was low grade but for the last 2 days it stays high 38.5-39.2C. we went to ER but CBC and urine were normal. They discharged with viral syndrome. The next day our pediatrician saw bright purple tonsills in his throat and prescribed amoxicillin. He does not complain of sore throat or pain in throat.She said that is is angina and pain in stomach is due to swallowing infection. She did not do a throat swab or culture though. He has had 2 doses of amoxicillin already and no improvement. He is weak, no appetite, and fever very high with max at 39.2. Please advise, I am worried. Thank you.

Answer

I'm sorry to hear that your son is so sick. Unfortunately, this scenario of unexplained abdominal pain and fever is fairly common in young children, and sometimes several visits to the doctor are necessary to sort out what might be going on. It is certainly the case that the most likely possibility is a run of the mill viral infection. I say this simply because viral infections are very common. Also I notice that your doctor mentioned "angina" - which I bet was actually "herpangina" which is a very typically viral illness which includes blisters in the mouth. In fact, if your child has blisters in the mouth, that would be fairly encouraging as it would make the likelihood that this is a common illness much higher. Nevertheless, if the fever and weakness are continuing then it might be worthwhile to seek a repeat evaluation. Danger signs would be lethargy, inability to take or keep down oral liquids, and decreased urination, as these would all indicate that your son is getting dehydrated. At the very least, I would recommend calling your pediatrician to let them know that things don't seem to be getting better. If you are very concerned, then a repeat evaluation in the emergency room would be appropriate.

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