My son is 16 months old. At 13 months, he had a 4 day period of inexplicably high fevers (103-106). There were ABSOLUTELY no other symptoms and aside from the one seizure and a little bit of sleeplessness, his behavior was perfectly normal. We ended up a the pediatric hosptial after a febrile seizure, and x-rays, UTI test, bloodwork, EVEYRTHING came back normal. They administered IV antibiotics just to be sure.

Now, EXACTLY 3 months later, he is having the same fevers. He has spiked up to 106.9 degrees. In a lukewarm bath and with children's motrin, we see this come down quickly. He is perfectly normal until about 105. He has been to the doctor twice this week, he is fever-free during the day but hits 102 out of nowhere by 5:30pm and then usually 105 by 7 p.m. Again, it is brought down easily, he is eating, playing, laughing, etc.

WHAT could we (and doctors and the ER) be missing? I need to know what to ask our pediatricans to think about/test for... is there some rare childhood disease that can cause this? Should we get tested for blood disorders (and if so, would they have shown up on his bloodwork before?) Should we think about arthritis or something of the sort? KAwasaki disease? I'm not asking for a diagnosis, I would just like help knowing what to ask my pediatrician to DO. I feel helpless and really scared.

PS... my son is very small. Born at 8lb 4 oz and off the charts on length, he did not really grow much and is 19 lb 15 oz at 16 months and is in the 10th percentile for height. Other than the fevers, he is INCREDIBLY healhty (small thyroglossal cyst and a small umbilical hernia, no symptoms) and strong. His diet is mostly veggies, beans, and lean meats, so he does not gain weight. He is still breastfed and refuses most dairy products, though he has just started yogurt in the past week. Just in case any of this helps!

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replied September 17th, 2009
I understand your frustration and concerns. Fevers can be very concerning in children. The height of a child's fever is not always the best indicator of whether there is a serious underlying problem or even if a child needs to be evaluated. It is important to look at other factors like how a child behaves and if other symptoms accompany it. You certainly did the right thing by evaluating him initially.

In regards to the second occurence 3 months later, you've had two evaluations with labs which makes a serious underlying illness unlikely.

Periodic fevers are not generally common. The best described condition associated with periodic fevers is called Periodic fever with aphthous stomatitis, pharyngitis and adenitis - PFAPA for short. Bouts happen in most cases at roughly monthly intevals. Other forms of periodic fevers are much less common in children and typically have rashes or arthritis that accompany them.

I hope this information helps. The most important thing that I stress with parents who have a child with illness or other disturbing symptoms is to maintain contact; so, I encourage you to continue communication with your pediatrician regarding your concerns. I suggest that you and his pediatrician continue in the evaluation process if these symptoms don't improve or resolve.

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