Presence of Ketones in Urine amidst High Fever with No Other Symptoms
My nearly two-year-old has been experiencing intermittent fevers since November 2024, some reaching significantly high temperatures, yet showing no accompanying symptoms. We have ruled out various conditions, including: - Ear infections - Sore throat or strep - COVID-19, RSV, and pneumonia - Gastrointestinal upset - Symptoms typically associated with cold or flu Each test has returned negative results. Recently, his fever spiked to 105.7°F, prompting me to take him to the pediatric emergency department. During our visit, they performed a catheterization to obtain a urine sample, which had not been done previously. The urine test results were mostly normal, with the exception of ketone levels, which measured at 10. Is this level of ketones within a normal range? I understand that ketones can appear during fever, but is it common for them to be this elevated? We have a scheduled appointment with an immunologist next week to explore this further, but I would appreciate any guidance or shared experiences from others who may have encountered a similar situation.
Answers (1)
8/1/2025, 9:20:52 AM
OpenHealth AI
It's understandable to be concerned about your toddler's fluctuating high fever and the presence of ketones in their urine. I'll break down the key points and provide some actionable steps you can take to address these concerns.
Main Points:
- Elevated ketone levels in urine (like the 10 mg/dL you mentioned) can occur during illness, especially with high fever, but they can also indicate dehydration or insufficient carbohydrate intake.
- It's essential to closely monitor your child's hydration and overall condition while waiting for further evaluations from the immunologist.
Explanation:
Ketones are chemicals produced when the body breaks down fat for energy instead of carbohydrates. Elevated ketone levels can occur due to various factors, including:
- Fever and illness: During a high fever, the body can use fat stores for energy, leading to increased ketone production.
- Dehydration: High fever can lead to fluid loss, contributing to elevated ketones.
- Inadequate carbohydrate intake: If your child has reduced appetite or is not eating well due to the fever, it can also raise ketone levels.
Next Steps:
-
Ensure Hydration: Monitor and encourage oral fluid intake. Offer water, electrolyte solutions, or diluted juice frequently to prevent dehydration. This is a priority since dehydration can worsen ketone levels.
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Nutrition Considerations: If your toddler is willing to eat, focus on providing balanced meals that include carbohydrates, as these can help lower ketone levels. Offer easy-to-digest options like bananas, rice, and applesauce.
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Temperature Monitoring: Keep an eye on his fever and any patterns. If the fever persists, note any changes (like duration or intensity) to share with the immunologist.
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Keep to Appointments: Prepare for your upcoming appointment with the immunologist by documenting all related symptoms, fever patterns, hydration levels, and dietary intake. This information will be helpful for the assessment.
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Watch for New Symptoms: While awaiting your appointment, remain vigilant for any new symptoms that could develop, including changes in behavior, lethargy, or signs of dehydration (dry mouth, decreased urination).
Reassurance:
While it is concerning to see such high fevers and ketones, many factors can contribute to these symptoms. The impending consultation with the immunologist will provide you with deeper insights and potential next steps for your child's care. Make sure to communicate openly with them regarding your observations. If anything changes or if you notice severe signs or symptoms, do not hesitate to seek further medical advice.
Please feel free to reach out if you have more questions or need further assistance as you navigate this situation.
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