Q: A father’s question: “I thought my son was getting better: he has the flu and a strep throat! But now his fever is back, and he is not eating. What is going on?”
A: First of all, your child and family are dealing with two illnesses at once -with two different causes and two different treatments required. This makes sorting out any given symptom very difficult. No wonder you are confused and concerned in this situation!
Let’s break this into smaller pieces:
Most generally, a child whose illness begins with a fever that lasts a day or two and then decreases is a child whom you might reasonably expect to stay fever free for the rest of his illness. The return of a fever after a full day (24 hours) without one is usually a signal that something new is going on. What is up?
If a strep throat has been diagnosed and treated with antibiotics, then it is very unlikely that a child’s fever after a day or two is from the strep. Antibiotics usually make a child with strep feel better within 24-48 hours; as he improves, his fever drops.
If the “flu” has been diagnosed, the time course of a fever is much harder to predict. Sometimes the flu (a viral infection) can be bi-phasic which really means that you begin to get well and then get sick again– even having a second bout of fever!
But this is an unusual pattern.
Much more common in a child with almost any kind of flu is that he would have a fever at the beginning of his illness. The fever might last a couple of days. If it reappeared after having been much lower (or gone), then its recurrence might well indicate that a complication was developing.
What kind of complication might your child be getting if he has had the flu, seemed to be getting better and then spiked a “new” fever? The most common complications in this setting -assuming a respiratory flu with cold and cough symptoms-are ear infections, sinusitis, and pneumonia. Which is the most likely in your child depends on many factors including his age and unique medical history.
Your observation that your son is getting worse instead of better is concerning and certainly warrants getting in touch with your child’s pediatrician.
Thanks for sending along your question.