Compromised Circulation and Pneumonia Concerns
A 12-year-old girl, measuring 5 feet 7 inches tall and weighing 100 pounds, has been diagnosed with several health conditions including Ehlers Danlos syndrome, ADHD, POTS, anxiety, and a leaking mitral valve. This week, she visited urgent care twice. Initially, she tested positive for Flu B. However, she returned today as her fever did not subside despite alternating doses of Tylenol and Ibuprofen every four to six hours. A chest X-ray revealed indications of pneumonia, leading to a prescription for Amoxicillin-clavulanate (875-125 mg) — of which she has taken one dose. Approximately thirty minutes after administering the antibiotics, I measured her temperature using a new forehead thermometer from Costco, registering at 103.9°F. To help manage her fever, I placed her in a lukewarm bath. During this time, she showed me her palms, which appeared to have poor blood refill when pressed. The bath effectively lowered her temperature to 101.5°F, but I remain quite worried about her condition. Though she is experiencing nausea, she is willing to drink water with some encouragement. At what stage, if any, should I consider taking her to the emergency department?
Answers (1)
3/29/2025, 4:20:38 AM
OpenHealth AI
It's understandable to be worried about your daughter's health, given her underlying conditions and recent symptoms. The combination of pneumonia, fever, and poor circulation can be concerning, but there are important steps you can take to monitor her and determine when further medical attention is necessary.
Key Points
- Monitoring Temperature and Symptoms: It’s important to carefully observe her symptoms, especially her fever and circulation.
- Understanding Blood Refill Issues: Poor blood refill in her palms may indicate decreased circulation, potentially worsened by fever or dehydration.
- When to Seek Emergency Care: Knowing when to escalate care is crucial, particularly with her complex health background.
Explanation
The fever and pneumonia can exacerbate her other health issues, like POTS (Postural Orthostatic Tachycardia Syndrome) and the leaking mitral valve. The fluctuating fever is common in pneumonia, but persistent high fevers, such as the 103.9°F you noted, along with symptoms of poor circulation (like the blood refill issue you observed), can indicate that her body is struggling to cope.
Next Steps
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Continue Monitoring:
- Regularly check her temperature every 2-4 hours.
- Monitor her hydration closely; consider setting a timer to remind her to drink fluids consistently.
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Check for Other Symptoms:
- Look for signs of worsening: increased difficulty breathing, chest pain, persistent vomiting, or lethargy (not waking up easily or not responding normally).
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Use of Antipyretics:
- Continue administering Tylenol or Ibuprofen as directed, but be cautious of alternating them without observing her condition closely.
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Immediate Actions if Conditions Worsen:
- If her temperature exceeds 104°F, displays signs of dehydration (dry mouth, decreased urine output), experiences increased difficulty breathing, or if you notice worsening circulation issues (such as cold or discolored extremities), seek emergency care promptly.
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Follow-Up On Current Symptoms:
- If the crawling sensation in her palms persists, or if there's a marked decline in her overall condition or responsiveness, don't hesitate to contact your healthcare provider or go to the emergency department.
Your daughter's health and comfort are the priority, so keep a supportive environment for her during this recovery process. Watch her closely and remain in touch with her healthcare support as necessary.
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