Hello doctor, My 5 years old son got sick 2 and a half weeks ago. For 1 week he had high fever (up to 39 degrees Celsius) which we reduced with fever reducing syrup (Noraphen). Blood test showed that there is a chance for parvovirus (borderline result). After a week the fever stopped, and for a week everything was fine (except our son feeling weak). After that symptoms of allergy and red stains on his arms and legs appeared, which matched the definition of parvovirus indeed, as his treating physician confirmed. These symptoms disappeared after 2 days, but now his fever is back to 38.1 degrees Celsius, which worries us. Let me sum it up: 1-7 days - fever up to 39 degrees Celsius which reduced by Noraphen. 8-14 days - no fever. 15-16 days - allergic response. 17th day - fever is back. I have attached the entire report. Kindly advice.
Hello. I have gone through your son's history and the report (attachment removed to protect patient's identity), and would like to make my suggestions and comments about him as follows:As per your description, the clinical picture very much matches that of a viral infection, borderline report of IgM parvovirus and itchy rash increase the possibility that it may be actually parvovirus infection.So far I would reasonably agree with the treatment that your son has received. Treatment of most viral infections is treatment of symptoms only,  Paracetamol for fever, antihistamines for cough and cold and other conservative measures. There is no specific treatment for many viral infections and most of the viral infections recover by themselves if the child's immunity is normal.The pattern of fever that you have described is known as "biphasic fever" pattern. This is commonly seen in many viral infections, where initial high fever is followed by a period with no fever which is followed by a second period of fever. It is important to note that fever during the second period is lower than that in the first period and also the second period is short lasting when compared to the first period.Considering this pattern, I would suggest you not to worry too much. But of course be cautious and monitor temperature of your son. As current fever (38.1) is lower than that in the first week (39), it could be a pattern of the viral infection. However, if the fever rises to the same or high (39 or more than 39) or  if it lasts longer or if your son develops any new symptom, I would suggest you to get your son examined by his paediatrician again. In that case, his doctor would examine him again and may think of a complication or alternative diagnosis. Currently, I would suggest him Paracetamol for control of fever along with adequate fluids to maintain hydration as well as adequate rest. I would like to mention here that rest and hydration are the most important aspects of treatment of any viral infection.