A 2-year-old boy (Weight: 9 kg; Length: 81 cm) presented with high fever of two days duration. The child was apparently well prior to fever onset. The patient was treated with paracetamol; however, the fever continued to be high for the last two days. The child continued to look sick and was lethargic. He refused to eat and consumed only small amount of liquids. He vomited once when fed. He had no other symptoms.
On initial physical examination, the child’s temperature was 103oF, pulse was 140/min, and the respiratory rate was 30 per min. He looked sick, was irritable and exhibited signs of mild dehydration. Examination of the ears, chest, and other systems was normal and there were no signs of skin rash. The patient’s past medical history showed that he had
recurrent fever (3-4 days in duration) over the last few months; however, the fever got better with antibiotics. There were no significant symptoms during the episodes of fever.