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mild fever with tummy ache in 7 year old for 4 days
concernedad posted:
My son is 7 years old and has a mild fever for 4 days now. He was awoken to extreme stomach pain. We assumed viral so we waited a couple of days. on the 3rd day his pain was prominant so we took him to the ER. The ER physician conducted physical tests, CT scan, Xrays, UTI test and blood work. The leg push method of him lifting it in the air while the physician resisted was negative, CT was negative, Xrays were negative, UTI negative, Blood work displayed an increase in neutrophils. His temp is normal in the mornings and raises up to around the low 100s during the day. Appendicitis hasnt been ruled completely out but i do not want him to have needless surgery. What could be causing his mild fevers and stomach pains. He otehrwise is a happy, healthy child but we are becoming very concerned as we have been told that evem the CT scan isnt 100% accurate. I cant seem to find the answers we need to combat his problems. Please advise.
Roy Benaroch, MD responded:
It's been a few days, how's he doing now?

It's tough for me to add much here-- the doctors you've been seeing have done all of these tests and imaging studies, and they're the ones who know the information about your child and ought to be the ones answering your questions. They ought to know far better than I what's going on.

I will say that often the approach to illness is to first "rule out" the serious stuff-- like appendicitis. Though a CT isn't 100% accurate, it's pretty close, especially when done at a place with experience and good radiologists. If the CT and all of these other things were normal, it's quite unlikely that this is anything serious. The next reasonable step is to talk about comfort care, what things to look out for, and to give it some time to see if it gets better. If it doesn't get better, there are more invasive and repeat tests-- but really, it turns out that it's usually best to hold off on those things for at least a little while, depending on how the child is doing. Frustrating, I know, to not have an exact answer, but until someone invents a magic "diagnose anything" scan that's the best we can do sometimes.