fevers but no sign of illness

[Guest guest]

Rebekah has run fevers for her entire life, but rarely has any respiratory

symptoms. So, when we take her to the doctor, we get diagnoses like " Ma'am,

she's teething " or " She has a virus " .

Does anyone else have a kid who runs fevers but doesn't have an obvious

infection? We keep getting the " HEENT: normal " (heart, eyes, ears, nose,

throat are normal) written into the chart. Where are common infections

outside the respiratory system and ears?

Pam

wife to (15 years)

mother to , 8, Hannah, 5, Rebekah 2, and Leah (5-11-2001)

Rebekah has IgA and IgG deficiency- final diagnosis pending

[Guest guest]

Thanks for the reply about fevers. Rebekah tends to have short duration

fevers in the 102-103 range. Sometimes the fever only last 6 hours. Other

times it goes for 3 days. Last winter, when she was the sickest, they would

last for 30 days.

They never did a CBC or a urine culture, so we don't know the source of the

infection. The new pediatrician found a bladder infection. We had a kidney

ultrasound and a VCUG which were normal: no kidney disease or structural

abnormality.

Prior to the IVIG, I would have said that Rebekah's normal temp was 99.5,

but since the treatment, she has been in the 98's all day! Yee haw. She

did have what looked like a severe migraine about 48 hours after treatment.

Pam

wife to (15 years)

mother to , 8, Hannah, 5, Rebekah, 2 and Leah (May 11th, 2001)

Re: fevers but no sign of illness

Pam,

Again, I'm a " big person " (28 y/o with CVID, I'll send an explanation

message as to why I'm here and introduce myself soon...), but I tend to

run fevers quite frequently, without an obvious localized infection.

I've always had a rather " robust " fever response, as my doctors and I

like to say... it's not unusual for me to have fevers of 105-106 with a

bad infection (sepsis, pneumonia, meningitis, or similar) and 103-104

with a bad sinus infection. And usually, two days after getting IVIG, I

get a fever of about 102-103, which is accompanied by a nasty headache,

and that lasts for about 36 hours. Not everyone gets that, but some do,

and if it's something that happens every month, the same way each time,

[Guest guest]

Thanks for the reply about fevers. Rebekah tends to have short duration

fevers in the 102-103 range. Sometimes the fever only last 6 hours. Other

times it goes for 3 days. Last winter, when she was the sickest, they would

last for 30 days.

They never did a CBC or a urine culture, so we don't know the source of the

infection. The new pediatrician found a bladder infection. We had a kidney

ultrasound and a VCUG which were normal: no kidney disease or structural

abnormality.

Prior to the IVIG, I would have said that Rebekah's normal temp was 99.5,

but since the treatment, she has been in the 98's all day! Yee haw. She

did have what looked like a severe migraine about 48 hours after treatment.

Pam

wife to (15 years)

mother to , 8, Hannah, 5, Rebekah, 2 and Leah (May 11th, 2001)

Re: fevers but no sign of illness

Pam,

Again, I'm a " big person " (28 y/o with CVID, I'll send an explanation

message as to why I'm here and introduce myself soon...), but I tend to

run fevers quite frequently, without an obvious localized infection.

I've always had a rather " robust " fever response, as my doctors and I

like to say... it's not unusual for me to have fevers of 105-106 with a

bad infection (sepsis, pneumonia, meningitis, or similar) and 103-104

with a bad sinus infection. And usually, two days after getting IVIG, I

get a fever of about 102-103, which is accompanied by a nasty headache,

and that lasts for about 36 hours. Not everyone gets that, but some do,

and if it's something that happens every month, the same way each time,

[Guest guest]

How low are their neutrophils?

Pam

wife to (15 years)

mother to , 8, Hannah, 5, Rebekah, 2 and Leah (May 11th, 2001)

Rebekah--IgA and IgG deficient

Re: fevers but no sign of illness

and ph run lots of fevers without any signs of infection becuase

they have neutropenia (low neutrophil counts). Before was diagnosed,

he had many, many unexplained fevers of 104, 105 for over a week.....

Now that we know, when they get high fevers, we have to do CBCs, blood

cultures, etc....

OTOH, they also get major infections without any temperatures.....

buldging ear drums from infection without fever... all part of the

neutropenia.

Pattie

fevers but no sign of illness

Rebekah has run fevers for her entire life, but rarely has any

respiratory

symptoms. So, when we take her to the doctor, we get diagnoses like

" Ma'am,

she's teething " or " She has a virus " .

Does anyone else have a kid who runs fevers but doesn't have an obvious

infection? We keep getting the " HEENT: normal " (heart, eyes, ears,

nose,

throat are normal) written into the chart. Where are common infections

outside the respiratory system and ears?

Pam

wife to (15 years)

mother to , 8, Hannah, 5, Rebekah 2, and Leah (5-11-2001)

Rebekah has IgA and IgG deficiency- final diagnosis pending

[Guest guest]

It cycles.. 's ANC dips below 500 quite frequently and ph usually stays

around 900-1000. Their total WBC is between 2.9-3.1.

Re: fevers but no sign of illness

and ph run lots of fevers without any signs of infection becuase

they have neutropenia (low neutrophil counts). Before was diagnosed,

he had many, many unexplained fevers of 104, 105 for over a week.....

Now that we know, when they get high fevers, we have to do CBCs, blood

cultures, etc....

OTOH, they also get major infections without any temperatures.....

buldging ear drums from infection without fever... all part of the

neutropenia.

[Guest guest]

What's ANC? Sorry for all of the stupid questions!

Pam

wife to (15 years)

mother to , 8, Hannah, 5, Rebekah 2, and Leah (5-11-2001)

Re: fevers but no sign of illness

It cycles.. 's ANC dips below 500 quite frequently and ph usually

stays around 900-1000. Their total WBC is between 2.9-3.1.

Re: fevers but no sign of illness

and ph run lots of fevers without any signs of infection

becuase

they have neutropenia (low neutrophil counts). Before was

diagnosed,

he had many, many unexplained fevers of 104, 105 for over a week.....

Now that we know, when they get high fevers, we have to do CBCs, blood

cultures, etc....

OTOH, they also get major infections without any temperatures.....

buldging ear drums from infection without fever... all part of the

neutropenia.

[Guest guest]

THANKS! I'll have to go look up the neutrophil levels for Rebekah. The

report just listed them as Low. Seems it was 27 (so I guess that would be

2700?) I'll have to check.

Pam

wife to (15 years)

mother to , 8, Hannah, 5, Rebekah 2, and Leah (5-11-2001)

Re: fevers but no sign of illness

oops! Sorry about that! ANC= Absolute Neutrophil Count

a normal ANC is usually 2000 and above.. although most people would have a

3,000 ANC or so. If you are above 1500, they consider that to be *okay*

depends ont eh books you read and the docs you talk to... soem docs say

anything below 2000 is neutropenia, some use 1800 as the cut off and oters

say 1500 is the cut off.....

in any case.. below 500 youa re susceptible to the bacteria in your own

body, between 500-1000 you are at moderate risk and above 1000, you are

still at risk, but are considered to be better off.

In Shwachman_Diamond Syndrome, they beleve that not only do they have

decreased nuymbers of neutrophils, but the neutrophils do not function

properly, so that puts them at a greater risk. so even with a normal ANC in

and SDS child, they are at risk for infection.

Hope I did not babble too much!

Pattie

Re: fevers but no sign of illness

and ph run lots of fevers without any signs of infection

becuase

they have neutropenia (low neutrophil counts). Before was

diagnosed,

he had many, many unexplained fevers of 104, 105 for over a

week.....

Now that we know, when they get high fevers, we have to do CBCs,

blood

cultures, etc....

OTOH, they also get major infections without any temperatures.....

buldging ear drums from infection without fever... all part of the

neutropenia.

[Guest guest]

oops! Sorry about that! ANC= Absolute Neutrophil Count

a normal ANC is usually 2000 and above.. although most people would have a 3,000

ANC or so. If you are above 1500, they consider that to be *okay* depends ont

eh books you read and the docs you talk to... soem docs say anything below 2000

is neutropenia, some use 1800 as the cut off and oters say 1500 is the cut

off.....

in any case.. below 500 youa re susceptible to the bacteria in your own body,

between 500-1000 you are at moderate risk and above 1000, you are still at risk,

but are considered to be better off.

In Shwachman_Diamond Syndrome, they beleve that not only do they have decreased

nuymbers of neutrophils, but the neutrophils do not function properly, so that

puts them at a greater risk. so even with a normal ANC in and SDS child, they

are at risk for infection.

Hope I did not babble too much!

Pattie

Re: fevers but no sign of illness

and ph run lots of fevers without any signs of infection

becuase

they have neutropenia (low neutrophil counts). Before was

diagnosed,

he had many, many unexplained fevers of 104, 105 for over a week.....

Now that we know, when they get high fevers, we have to do CBCs, blood

cultures, etc....

OTOH, they also get major infections without any temperatures.....

buldging ear drums from infection without fever... all part of the

neutropenia.

[Guest guest]

The ANC would be the percentage of neutrophils (found on the differential report

to the CBC) multiplied by the WBC.

Macey's runs about 1500 but they're ok with that. Cutoff for her is 750. Her

WBC runs around 7.1 and her neutrophil %

runs around 25%. 7.1 (aka 7100) x 25% = 1775 ANC

Hope that helps.

Ursula Holleman

Macey's mom (6 yr. old with CVID, asthma, sinus disease, GERD, Sensory

Integration Disorder, Diabetes Insipidus, colonic

inertia)

http://maceyh.home.att.net

/

[Guest guest]

to get eh Absolute neutrophil count you multiply the percent of segs and bands

times the total WBC.

if the total WBC is 2700 and the percetn segs + bands is 27, tehn the ANC woudl

be 729

the normal percent according the the lab book I have for children is 38.5-71.5

percetn for boys and 41.9 to 76.5 percent for girls here's what the lab book

says about figuring the ANC:

" Interpreting WBC differential values The differential count measures the types

of white blood cells (WBCs)

as a percentage of the total WBC count (the relative value).; The absolute value

is obtained by multiplying the relative value of each cell type by the total WBC

count.; Both the relative and absolute values must be considered to obtain an

accurate diagnosis. For example, consider a

patient whose WBC count is 6,000/ul and whose differential shows 30% neutrophils

and 70% lymphocytes. His relative

lymphocyte count seems to be quite high lymphocytosis), but when this figure is

multiplied by his WBC count (6,000 x 70%= 4,200 lymphocytes/ul), it is well

within the normal range. This patients neutrophil count, however, is low (30%);

when this figure is multiplied by the WBC count (6,000 x 30%= 1,800

neutrophils/ul), the result is a low absolute number, which may mean depressed

bone marrow. "

Pattie

Re: fevers but no sign of illness

and ph run lots of fevers without any signs of infection

becuase

they have neutropenia (low neutrophil counts). Before was

diagnosed,

he had many, many unexplained fevers of 104, 105 for over a

week.....

Now that we know, when they get high fevers, we have to do CBCs,

blood

cultures, etc....

OTOH, they also get major infections without any temperatures.....

buldging ear drums from infection without fever... all part of the

neutropenia.