Pediatric Problem Solving -Case 6

17-08-2008
Pediatric Problem Solving – Case 6
A 3 years old boy came to the outpatient's clinic complaining of mild fever, runny, nose, malaise and vomiting. On throat examination there was hyperemia of the throat.
What is the most likely medicine to be given

A-Oral Amoxicillin

B- Paracetamol

C- Multivitamin

D-Acetylsalicylic acid. Explanation of the case
 Choice (A): points against: A mild infection (only runny nose, some hyperemia, mild fever, malaise), therefore most probably viral not bacterial infection. So exclude oral amoxicillin.
 Choice (B) the right choice: points with: All the child needs in this case is supportive measures like an antipyretic (paracetamol). Viral infections resolve spontaneously in a few days .
 Choice (C): points against: Child is feverish, vitamins may increase load (bacteria can use some vitamins/iron causing more problems)
 Choice (D):points against: Child 3 years old with mild throat infection most probably viral, so don not give acetylsalicylic acid as it may cause Reye's syndrome.
It is acute fatty hepatoencephalopathy with peak incidence in children ranging between 6-12 years old, occurs with viral infection e.g. influenza, measles.