OpenHealth Q&A

Understanding My Daughter's Recurring Fevers: A Parent's Concern

My daughter is a 2.5-year-old girl who weighs 34 pounds and stands 3 feet tall. She hasn’t experienced any weight loss, nor have we observed swollen lymph nodes, bruises, rashes, joint pain, abdominal discomfort, excessive tiredness, or paleness. We have consulted multiple healthcare professionals, including an ENT specialist and three pediatricians (we’ve finally found one we trust). We've made two visits to the emergency room and have gone to urgent care as well. After the last ER visit, her pediatrician referred us to an immunologist to check her IGG levels. Unfortunately, the immunologist caused me a great deal of anxiety, suggesting that I should see a rheumatologist to exclude malignancy. This left me utterly bewildered. Below are the recorded fever episodes and blood test results: ********************* **November 2024** - WBC: 17.7 - RBC: 3.31 - Hemoglobin: 9.0 - Hematocrit: 26.3 - Platelets: 185 - MCV: 80 - MCH: 27.2 - MCHC: 34.2 - RDW: 14.3 - MPV: 6.0 - Neutrophils: 37 - Bands: 0 - Lymphocytes: 53 - Monocytes: 4 - Eosinophils: 1 - Basophils: 0 - Atypical Lymphocytes: 5 - Hematology comments: 1+ Hypo - elevated WBC with predominance of lymphocytes. ********************* **August 2025** She had a fever that appeared after experiencing a cold the previous week. At the ER, they diagnosed her with a UTI and positive Enterovirus. - WBC: 21.41 - Hemoglobin: 11.7 - Hematocrit: 34.8 - Platelets: 312 - MPV: 8.3 - RBC: 4.39 - MCV: 79.3 - MCH: 26.7 - MCHC: 33.6 The absolute neutrophil count was 15.18, making up 71% of the white blood cells, while lymphocytes were at 18.4%. Toxic granulation was noted, but RBC morphology appeared normal. - Sed Rate: 36 - C-Reactive Protein: 5.62 ********************* **September 2025** She developed a fever on August 27 that continued until September 2. - WBC: 18.2 - Hemoglobin: 11 - Hematocrit: 32.1 - Platelets: 374 - MPV: 8.2 - RBC: 4.23 - MCV: 75.9 - MCH: 26 - MCHC: 34.3 - C-Reactive Protein: 8.4 - Sed Rate: 66 ********************* **Fever Log** - Oct 2024 – Jan 2025: Started daycare - Nov 6, 2024 → 4 days of fever (CBC results: WBC 17.7) - Dec 24, 2024 → 2 days of fever - Jan 4, 2025 → 3 days of fever - Jan 23, 2025 → 3 days of fever - Jan – Jun 2025: Stopped daycare - Feb 2, 2025 → 3 days of fever - Mar 7, 2025 → 2 days of fever - May 11, 2025 → 1 day of fever - Jun 16, 2025 – present: Resumed daycare - Jul 7, 2025 → 1 day of fever - Jul 31 – Aug 2, 2025 → 3 days of fever - Aug 9 – Aug 12, 2025 → 3 days of fever - Aug 27 – Sep 2, 2025 → 5–6 days of fever (CBC, CMP, ESR, CRP, viral panel, blood culture performed). I grew increasingly worried, as it felt like the fevers were becoming more predictable, often showing up alongside other symptoms, although occasionally they occurred without any visible signs. I began documenting these occurrences since November 2024 after she started daycare in October 2024. Previous doctors never suggested the possibility of malignancy since she generally exhibits no alarming symptoms. She recovers between fever episodes, and most fevers coincide with symptoms such as a cough or nasal congestion. However, the most recent fever lasted six days without any accompanying signs. We still need to identify the source of her inflammation. Notably, a week before, she was diagnosed with a UTI and had a positive result for the enterovirus on her viral panel. Despite all of this, she remains a cheerful and playful child. The episodes of fever started when she was two years old and became more frequent after starting daycare in October 2024. Is there a doctor or hematologist here who could review these CBC results? I would appreciate any reassurance or guidance you could offer regarding the next steps we should take. We have previously consulted with ENT specialists and pediatric ER doctors, and no one raised any concerns apart from the immunologist/allergist, who appeared less experienced and kept deferring follow-up studies, which has contributed to my anxiety. Thank you for your help!

Answers (1)

9/4/2025, 7:11:04 PM

OpenHealth AI

Thank you for providing such detailed information about your daughter's health. It's understandable to feel anxious given the repeated fever episodes and the complexity of her situation. Your proactive approach to seeking multiple opinions shows how much you care about her well-being.

Key Points:

1. Recurring Fever Episodes: Your daughter has experienced several episodes of fever, often with respiratory illness symptoms.
2. Investigations: Blood tests show variations in her white blood cell count and other markers, prompting consultation with various specialists.
3. General Health: It's reassuring that she remains cheerful and playful between episodes, and there are no alarming symptoms such as weight loss or significant fatigue.

Explanation:

The episodes of fever, particularly after starting daycare, could be related to common viral infections, which are more frequent in young children due to increased exposure to pathogens. The increase in white blood cells, particularly lymphocytes, may suggest a response to these infections. The elevated inflammatory markers (like CRP and ESR) indicate that there could be some ongoing inflammation, often seen in infections or other inflammatory processes.

The immunologist's suggestion to see a rheumatologist likely stems from a desire to rule out any underlying autoimmune issues, especially since there can be overlapping symptoms. However, your daughter's overall lack of concerning symptoms (e.g., no unexplained bruises, fatigue, or swelling) is a positive indicator.

Next Steps:

1. Monitoring: Continue to track her fever episodes carefully, noting any associated symptoms such as cough, congestion, or behavioral changes. Documenting this can be very useful for any future consultations.

2. Follow-Up Blood Tests: If a rheumatology assessment is conducted, advocate for thorough testing that includes checking for autoimmune markers. It's crucial to communicate your concerns and the pattern of her symptoms when you consult with these specialists.

3. Consultation with Trusted Pediatrician: Since you have found a pediatrician you trust, maintain close communication with them. Share your ongoing concerns and the results from the immunologist. Their insights and continuity of care may help ease anxiety and guide further steps.

4. Support Systems: Consider joining a support group or community for parents dealing with similar health issues. Sometimes, sharing experiences can alleviate anxiety and provide a sense of community.

5. Self-Care: Focus on creating a supportive environment for your daughter, ensuring she receives a balanced diet, sufficient hydration, and plenty of rest, especially during and after fever episodes.

Reassurance:

It's understandable to feel overwhelmed, but remember that many children experience recurrent fevers associated with viral infections, especially after exposure in daycare. The vigilance you’re showing will help ensure that she receives the appropriate care. Trust in the process, and don’t hesitate to reach out for support whenever needed. Your attentiveness is a key factor in her health management.

Please keep documenting her symptoms, and when new information arises or if you have further questions, don’t hesitate to ask!