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Abstract: It is important to seek immediate medical attention to clarify the cause of pediatric fever in order to avoid other diseases. For example, the child in the case presented with a high fever with sore throat, headache and other uncomfortable symptoms. After careful examination, the child’s tonsils were red and swollen, and a high number of white blood cells as well as neutrophils and C-reactive protein was examined, confirming the diagnosis of acute suppurative tonsillitis. After 5 days of combined treatment with cefodizime sodium and other drugs, the child’s fever subsided, sore throat disappeared, and appetite improved, and her condition recovered significantly.
Basic information】Female, 8 years old
Disease Type】Acute purulent tonsillitis
Hospital】Nanjing Hospital of Traditional Chinese Medicine
Date of Consultation】May 2022
Treatment plan】Medication (intravenous drip cefodizime sodium, oral Qingkailing granules, ibuprofen, cefdinir dispersible tablets)
Treatment Period】5 days
Effectiveness】Significant relief, fever subsided, sore throat disappeared
I. Initial interview
The child was 8 years old, a little girl who came to the emergency pediatric department after screening at the fever clinic because of persistent high fever, sore throat, headache, malaise, occasional abdominal pain, and 2 days of unresolved stools. The child had been in relatively good physical health and had no hereditary diseases. After careful physical examination, the child was found to have coarse breath sounds in both lungs, no dry or wet rales, marked pharyngeal redness and swelling, and erythema of the tonsils with purulent discharge. In combination with the routine blood report, the child’s white blood cell count, neutrophil count and C-reactive protein count were all high.
II. Treatment history
Since the cause of acute purulent tonsillitis is bacterial infection, antibacterial drugs should be applied in a timely manner for anti-infection treatment, otherwise the child’s sore throat and fever will not subside for a long time, and it may even cause complications such as acute glomerulonephritis and rheumatic fever, so the child was given cefodizime sodium intravenous drip treatment in a timely manner, and Qingkailing granules were used to clear the heat and detoxify the fever. After the child’s body temperature exceeded 38.5℃, ibuprofen was applied for antipyretic treatment.
III. Treatment effect
After intravenous injection of cefodizime sodium and oral administration of Qingkailing granules and ibuprofen, the child’s fever subsided after 3 days of medication, the sore throat symptoms were significantly relieved, the abdominal pain disappeared, the appetite improved significantly, and the stools resumed, which suggested that the current treatment plan was very effective. However, since the treatment course for acute suppurative tonsillitis is longer, the child’s family was instructed to continue oral treatment with cefdinir dispersible tablets for 5 days after the end of intravenous infusion, so as to completely eliminate the bacteria and prevent recurrence of acute suppurative tonsillitis due to bacteria remaining in the tonsillar fossa. If other uncomfortable symptoms appear during the drug treatment, you should go to the hospital for a review in time.
IV. Precautions
We are very happy that the patient’s symptoms have been significantly relieved and the disease has been effectively controlled after this treatment, but the following points should be noted.
1. After the fever has subsided, the child should pay attention to a light diet at home, and eat less cold, spicy and fried food in general. In hot weather, it is also important to avoid cold drinks to help reduce the recurrence of acute suppurative tonsillitis.
2, during the treatment of the child, pay more attention to hydration, appropriate to the child to drink more warm water, to help the child’s condition as soon as possible to improve.
3. pay attention to the child’s health protection, wear a mask when going out, especially in densely populated public places, to avoid cross-infection.
4. If other symptoms of discomfort occur during the medication, seek immediate medical examination and treatment to avoid serious adverse reactions.
V. Personal insight
Acute purulent tonsillitis is one of the important causes of high fever in children. In the case of a child with persistent high fever, headache and obvious sore throat, parents should promptly ask the child to open his or her mouth to check whether the tonsils are purulent. It is best to visit a nearby hospital in time to allow the doctor to conduct a professional examination, as well as necessary auxiliary examinations such as blood routine and C-reactive protein, to help the doctor make a reasonable formulation of the treatment plan and correct the child’s condition in time. If acute suppurative tonsillitis is not treated in time, it may cause fever to continue to recur, aggravate the child’s sore throat, and affect eating, and in serious cases, cause other adverse reactions, and should maintain good habits in daily life to avoid recurrence.