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Paediatric

Question 1

My Son aged 1 year and 9 months is always having fever in every two weeks. He also has snoring sound while at sleep, a sound like congested nostril. Your advice is much highly appreciated.

Answer 1

We would need to know more about your child’s symptoms.

Does he have any other symptoms besides fever in these recurrent episodes of illness?
How long have this recurrent fever been going on?
Young children often may have frequent fevers due to repeated viral infections. This happens especially if the child attends a child care centre where cross infections among susceptible children is very high.

When did you first notice your son to snore and does it happen only when he has a fever?
He could be having recurrent tonsillitis with associated enlargement of the adenoids. We would advise you to seek help from a paediatrician to ascertain the cause of your child’s problems.

 

Question 2.

My baby develops nappy rash on her genital. After applying creams prescribed by the paediatrician, her rashes have healed. However, the scar still remains even after some months have passed. May I know if the scar will heal by itself after some time or is there anything that can be done to remove the scar?

Answer 2.

Typically, nappy rashes should not leave any scars after they are healed. Some babies may develop post-inflammatory pigmentation changes on their skin after a skin infection but these should also eventually heal. You need not worry if the ‘scars’ are merely discoloration of the skin but if they are ‘unsightly’ scars it would be wise to seek the advice of a paediatrician or dermatologist.

 

Question 3

Hi, my boy aged 3++ years old has been having fever for the past 3-4 days. At first he complained of pain in his mouth. We saw ulcers. Took him to his paediatrician and he said it is nothing serious. Fever should subside within 48 hrs. After 3 days of fever, we continued giving him his medication.

Then I noticed he have watery eyes and lack of energy and most of all he lost his appetite. He didn’t even want to finish his milk. We even saw spots on his neck, back, head, face but none on his hands or leg. Took him to the hospital and they ruled out HFM and said it is a viral infection. But also took blood test to rule out dengue. Blood platelet count is 150.

When he got home at night, his fever has soaring high at 38.9. He looked so weak. He couldn’t even hold his milk bottle to drink. Finally he slept the night. Wriggling from time to time. In the morning, his fever is still there but not too high. He still has no appetite. Took him for another blood test today and it is still 150.

Answer 3

There are many causes of fever with rashes and mouth ulcers in childhood. Commonly they are due to viral infections but sometimes they are associated with infections due to bacteria and other agents. Fever and rashes and mouth ulcers can also be caused by allergy to the medications your child has taken or by rarer conditions such as Kawasaki Disease which will need a more detailed evaluation and specific treatment as it may involve the heart. Without seeing your child, we would not be able to make a conclusive diagnosis here.

You have said that your child’s platelet counts were 150 – here we presumed you meant 150,000 because 150 would be extremely abnormal. A platelet count is just a screening test and not a specific test for dengue fever or for other diseases.

He is unlikely to have the severe form of dengue fever if his platelet count is 150,000 per ul. If your child’s condition is due to one of the usual viral fevers he may be ill for a few days but will usually recover subsequently. However if he has high fever for past few days and is too lethargic even to feed; we would advise that you bring him to the hospital for admission.

There, a doctor should be able to sort out his problems and provide him the necessary treatment and supportive care.

 

Question 4

My son aged 6 years is healthy and active. However, since birth he has only one testis in his scrotum and the other one has not descended properly. Will this give him any problems later in adulthood and is surgery required?

Answer 4

Undescended testes are called cryptorchism. This condition has to be differentiated from retractile testes whereby the testes are located within the scrotum but are retracted up especially during cold weather..

This can be differentiated by a doctor’s examination. When the baby is in the womb, both the testes are in the abdomen near the kidneys. They will slowly descend until at birth they will be inside the scrotum.

Sometimes, one or both fail to descend into the scrotum. It is very rare for both the testes to fail to descend into the scrotum. The testis that has failed to descend is usually found in the abdomen or inguinal canal.

The problems that may occur are:

  1. Fertility: But if the testis that has descended is normal, there I no problem in having offspring.
  2. There is a greater risk to develop testicular cancer. You should take your son to a paediatrician for examination. Surgery may required to bring the testis down into the scrotum.

 

Question 5

How to treat the problem of serious worm infestation amongst children and can the dose for the deworming be given more frequently (every 6 months)?

Answer 5

You should bring your child to a doctor to determine whether he is really having a serious worm infestation. Usually once the doctor has determined that your child has a worm infestation deworming medication will be given.

If very serious, usually associated with signs like abdominal distention, difficulty in defaecating, lethargic, pale and failure to thrive like other children, your child will be referred to the relevant specialist.

It is better to follow the recommended schedule for deworming except if advised by a doctor who has examined your child.

Last reviewed: 30 January 2012

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