Patient's question:
Child 1 is 18 years old and has been experiencing monthly tonsillitis with high fever of 39-40°C. During this period, there was no cough or runny nose, and bowel movements were infrequent. What can be done? The symptoms often recur around midnight, showing as fever in the child's forehead, then back, and neck. Trace element tests and health check-ups were normal. The vaccination was originally scheduled for early February, but due to continuous illness, it has not been administered since early February.Past treatment history and outcomes:
Late January: The child was admitted to Nanjing Children's Hospital for 5-7 days for follow-up treatment. After being treated with cefixime and qingyanping for inflammation, the fever subsided, and the child was discharged. CRP was 40. During this period, X-rays, CT scans, blood cultures, and ECG results were all normal.
Early March: The child was admitted to Nanjing Mingji Hospital for 4 days for follow-up treatment. After being treated with azithromycin for inflammation, the fever subsided, and the child was discharged. Blood culture results were normal.
The child is allergic to penicillin and cephalosporins.
What kind of help is desired: To speculate on the cause and formulate a countermeasure. Looking forward to your reply!
Doctor's answer:
Tonsillitis is the inflammation of the tonsils. In clinical diagnosis, it is divided into acute and chronic types. The main symptoms include sore throat, fever, and discomfort in the throat. This disease can lead to local or systemic complications such as those affecting the ears, nose, heart, kidneys, and joints, so it should be taken seriously. The primary blood pathogen of tonsillitis is Streptococcus hemolyticus, while other pathogens such as Staphylococcus, Streptococcus pneumoniae, Haemophilus influenzae, and viruses can also cause it. Erythromycin ethylsuccinate (Rifadin), a macrolide antibiotic, is more stable in stomach acid compared to erythromycin and is not easily destroyed by stomach acid, allowing it to fully exert its therapeutic effect.