My child has a “virus” but is not getting better… What now?
This winter we are seeing a ton of kids with fevers and cold symptoms….cough, runny nose, and sinus. Most viral illnesses can cause a fever and often we have no idea which virus is causing the illness.
Hey Moms… we know this winter has been rough. Give yourself and your family the gift of peace of mind around all health related concerns. My patients just call or text DIRECTLY to my cell whenever they have a question. I take the time to understand their concerns and answer all of their questions. Every time.
I was told it is “a virus”…. What should my child be tested for?
If your child is experiencing a high fever with cough and flu symptoms you probably want a prompt evaluation for both covid and the flu. The flu is at higher levels this year and the reported symptoms are more severe. Flu can be treated with antiviral medication… but only if it is diagnosed and treated within 48hours of onset of symptoms. We all know that COVID is still circulating…. and of course you’re going to want to know if your child is positive before any family gatherings.
RSV and other common upper respiratory viruses are not commonly tested for because even if they are positive, the information will not change the plan for children receiving care at home.
Sometimes… The fever is not caused by a virus at all…
If your child has a high fever with a sore throat without a cough… you likely will get a strep test to ensure there is no strep throat.
My child is not getting better… when should I be concerned?
The course of any viral illnesses can last 1-2 weeks. Fevers can usually be controlled with medication, like Children’s Tylenol, when given in the correct dose. Fevers generally resolve within 5 days. The cough may linger around for a while afterwards.
Children who have had recent viral upper respiratory infections are at greater risk for developing a secondary bacterial infection. Generally, these occur when the cold is clearing up and the child is improving.
If your child develops a high fever at the tail-end of a “cold” or a worsening cough… then it might be time to take that kiddo in for another exam. Typical bacterial infections that occur at the end of a viral upper respiratory illness can include ear infections and pneumonia. These infections generally occur after the immune system has been weakened by the viral illness.
Signs that may warrant further evaluation with your doctor
Persistent fever 102 for more than 2 days /recurring/not controlled with medication
Fever that is above 104 at any time
Child looks very ill or drowsy or is not consolable
Signs of dehydration (dry diapers/not peeing, dry mouth and lips despite giving pedialyte)
Very sore throat, bad headache or vomiting
Has a weakened immune system (children with underlying chronic conditions)
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This cold and flu season, I am getting a lot of questions about sinus infections.
So today, we are reviewing which treatments work best.
What is a sinus infection?
The sinuses, air-filled pockets in bones of the face, form the top part of the respiratory tract. A sinus infection occurs when the tissue in the sinuses swells and leads to a buildup of mucus, pain, and discomfort.
Viruses cause 9 out of 10 sinus infections in adults. Here we discuss symptoms and treatment options for Viral Sinus Infections.
Pain or pressure in your sinuses Facial pain is a common symptom of sinusitis. You have several different sinuses above and below your eyes, as well as behind your nose. Any of these air-filled cavities can hurt when you have a sinus infection. You may feel pain in your forehead, on either side of your nose, in your upper jaws and teeth, or between your eyes
Tenderness in the face Your face may also be tender to the touch due to the built-up pressure. This tends to occur at the bridge of the nose or under the eyes, and can occur on the forehead and cheeks.
Runny nose and postnasal drip When you have a sinus infection, you may need to blow your nose often because of nasal discharge. This discharge comes from your infected sinuses and drains into your nasal passages. The discharge may also bypass your nose and drain down the back of your throat causing irritation or sore throat. This is called postnasal drip, and it may cause you to cough. It can also cause your voice to sound hoarse.
Sinus headaches Persistent pressure and swelling in your sinuses can give you symptoms of a headache. Sinus pain can also cause earaches and pain in your teeth, jaws, and cheeks. Sinus headaches are often at their worst in the morning because fluids have been collecting all night long.
What can I do?
Most cases of acute sinusitis get better on their own. Self-care techniques are usually all you need to ease symptoms. In general, antibiotics are not needed and do not help symptoms (as it is usually caused by a virus anyway).
Consider the following options:
1. Pain medication Over the counter anti-inflammatory medications such as ibuprofen can provide relief of headache, facial pain, and sore throat if they are not contraindicated.
2. Intranasal steroid sprays These reduce inflammation and decrease swelling in nasal passages. This can be particularly helpful for patients with allergic symptoms as well. Commonly we use fluticasone nasal spray.
These are typically Pseudophedrine or Phenylephrine. They can relieve congestion and pressure but may cause a rebound effect when stopped. There are contraindications for some patients with high blood pressure and other risks.
4. Nasal Irrigation Using a neti pot with sterile intranasal saline is highly recommended for most. These generally provide safe and effective temporary relief.
Signs that you should seek care
Consult your doctor if you have:
a high persistent fever (>102F)
symptoms that have lasted for more than 10 days
symptoms that are getting worse
As always, it’s recommended that you check in with your physician when you are sick for a personalized diagnosis and treatment plan to best suit your individual needs.
Are you looking for a physician who is always available and easy to reach that will answer all your health care questions? Reach out today to schedule your FREE initial consultation with Dr Diaz. Space is limited