Patient :My son has been sick for 13 days now. He was initially sent home from school on a Friday with chills and a low grade fever. On Saturday he broke out in a rash on his entire body. The rash was not bumpy, only splotchy. I gave him Benadryl and the rash was gone the next day. He was taken to the doctor where the did a swab test and it came back positive for strep. He was given amoxicillin to take for 10 days. After taking the amoxicillin for a few days, he didn't show any signs of improvement and he actually seemed worse to me. He had continuously had a fever ranging from 99-103.4, even with alternating Tylenol and Ibuprophen, since the Friday he was sent home and now he had developed a severe cough and nasal congestion. It was now Friday again and we decided to take him to the ER. The ER doctor said it still just looked like strep and gave him an oral steroid and a penicillin injection. The doctor said he should feel significantly better the next day. Still no improvement. At this point my child had lost 6 pounds. He wasn't eating, I had to force him to drink, he didn't get out of bed, and he just about cries every time he has to swallow. He can't breathe out of his nose and his breathe is just awful smelling. We called his primary physician on Sunday and she told us to go ahead and take him back to the ER just to make sure he wasn't dehydrated. At the ER the did blood work, chest x ray, and a cat scan on his neck to make sure he wasn't developing an abscess. Everything came back good. He tested negative for Mono. They ended up running an IV to give him "Maintenance fluids" but said there was nothing else they could do and they sent him home with a prescription for Tylenol with codeine. On Monday we took him to his primary physician for an ER follow up. She ended up changing his antibiotics. She prescribed him Zithromax and gave him a steroid injection. It is now Wednesday. My child has been laying in bed for 13 days. His fever is almost continuous, his tonsils have been swollen with pussy white splotches on them these entire 13 days, he's not eating, barely drinking, he's in near tears because his throat hurts him so much. There is no improvement what so ever. Please tell me what is wrong with my son. Why is he not getting any better? What do I need to do now?
Symptoms: Lethargic, fever for 13 days 99-103.4, cough, nasal congestion, not eating
Hello. Welcome to Ask The Doctor.
We are here to help you. The history is classically suggestions of Streptococcal Sore throat Tonsillitis associated with Sinusitis and Bronchitis. The best antibiotic in such case scenario is Augmentin that is a combination of Amoxycillin and Clavulanic Acid. This had has effectivity against Strept. In his case since his fever has been persisting since long, I would recommend use of Augmentin and Azithromycin (Zithromax) altogether. Since he is unable to eat and drink properly he must be dehydrated. You should make sure he drinks plenty of oral fluids and especially warm fluids.
Now as far as his chest congestion and sinus congestion is concerned then since X-ray and CT Scan are clear so Pneumonia is unlikely. You should give him steam inhalation and ask him to do warm saline gargles and gargles with betadine gargles. In case of coughing and chest congestion he should be taking Anti-allergic like Levocetirizine and a Bronchodilator cough syrup containing Salbutamol or Terbutaline.
In case of severe throat pain gargling with steroids like Prednisolone also helps a lot. He can always take throat lozenges for symptomatic relief. I can understand his agony but he should start improving soon as he receives the above-mentioned treatment. I hope my answer will help him in getting better.
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