Question
The baby has a high fever of about 38.5°C at night, maintains good appetite, but has poor sleep, accompanied by diarrhea and vomiting. The child has been feverish since the evening of January 14, and there has been no improvement by the 15th, with vomiting as well. Past treatment and effects: Continuously using the antipyretic drug nimesulide.
Answer
This condition may be due to an increase in the release of endogenous substances such as prostaglandins caused by viruses, bacteria, and their metabolic products, affecting the body’s temperature regulation center, leading to a lower set point for temperature regulation. The normal armpit temperature for adults is 36-37°C. Since children are in a stage of development with vigorous metabolism, their body temperature is usually higher than that of adults. For children with fever, in addition to antiviral and antibiotic treatment, temperature control is also necessary. Theoretically, it is suggested to use medication only when the body temperature exceeds 38.3°C, but in clinical practice, antipyretics are usually administered when the child’s body temperature exceeds 38°C. You can use combined preparations containing ibuprofen or nimesulide. At the same time, prepare a box of pediatric antipyretic suppositories for rectal administration before bedtime to prevent high fever seizures caused by night-time temperature rise. During treatment, drugs such as ribavirin may be used, as well as antipyretic analgesic anti-inflammatory drugs such as penicillin derivatives, cephalosporins, ibuprofen, acetaminophen, etc. For patients with excessive histamine secretion, antihistamines such as chlorpheniramine may be needed, while pseudoephedrine can help relieve nasal congestion symptoms. The above suggestions are applicable to “my baby has fever and diarrhea and vomiting.”