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Monday, May 20, 2013
High Fever and High WBC
We had my son in the ER last night for a spinal tap. His dr. wanted to rule our menengitis because he has had 106 fevers, hypersensitive, sensitive to light, severe headaches...all tests came back normal. His WBC is over 18,000. They said it is just a virus. Can a virus cause his white cells to be so high?
I know you must be very worried! The WBC can be high if you catch a viral illness early in its evolution. We also look at the breakdown of the types of white blood cells to see which ones are high. In viral illnesses, lymphocytes will be high in number rather than PMNs. It is very reassuring that the spinal tap came back negative for PMNs, which means it is a viral meningitis.
That doesn't mean he feels any less awful, and it is certainly scary for parents. The headaches can last for quite some time even when the fever goes down, so don't be worried if the headache symptom continues. The good news is that children with viral meningitis who stay well hydrated very, very rarely have any problems once the illness is over.
If your son is home with you, the most important thing you can do for him is to offer lots of fluids often. Don't worry about him eating. Fever normally dulls appetite. Another strategy that meets both needs for nutrition and fluids is to offer him Ensure or similar products. They are complete liquid meals and can be frozen into slushes or "ice cream" that may be more appealing to a sick child. Also keep the fever-reducing medication going around the clock at the appropriate dose and frequency to help him feel more comfortable. Less than the recommended dose does not work and too much can be harmful to his liver and/ or kidneys, so just the right dose on schedule is best.
I am sure the emergency room nurses and his doctor have mentioned that he should return to the hospital if he stops taking fluids, stops urinating, is difficult to arouse, or vomiting often, especially if the fluid he vomits is green in color and he wasn't consuming a green-colored beverage or food. If your son does not improve in a day or two, it would be a good idea to check back in with the doctor. If he has not had his H1N1 vaccine, be sure to sign him up for it once he is well.
I hope feels better soon!
Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University