Hi again Natalie,

I didn’t realize that your daughter’s illness has been going on so long. Our endo’s hospital has an endocrinologist on-call at all times to call for information and help if our own endo is not available. (as kids usually get sick it seems, only on evenings and weekends ).

What does your daughter’s pediatrician think about the virus or whatever it is? Irregardless of a diagnosis or not, if your child has fluctuating temperatures, it does seem that she is fighting something. If its not a truly high fever, I personally wouldn’t give fever-reducing medication, but I would definately give extra hydrocortisone to help her body deal with the stress of the illness. Long-term low grade stress can "wear down" her immunity - although she isn’t in adrenal crisis, she is probably struggling on her usual daily dos of hydrocortisone. I’m certainly not an expert and you should always check with your child’s endo, but since s/he is away I would take the advice of most of the parents on this board and at least double dose until you can consult with the medical doctor.

I consulted one of my books written by Dr. Robert S. Mendelsohn, M.D. (one of America’s leading pediatricians) regarding fevers. This applies to children without CAH - CAH, of course, was not discussed in his book. He writes,"Unless your child’s fever is accompanied by additional symptoms, such as vomiting or respiratory difficulties, it need not be a cause of concern, even if it reaches 105. More important in determining whether a fever is the result of a mild infection like the common cold, or a more serious one such as meningitis, is the overall appearance, behaviour, and attitude of you child." He also writes, "Untreated fevers cused by viral and bacterial infections do not rise inexorably and will not exceed 105 degrees. Our bodies have a built-in mechanism, not fully explained, that will prevent an infection-induced temperature from reaching 106 degrees. Only in the case of heatstroke, poisoning, or other externally caused fevers is this bodily mechanism overwhelmed and inoperative. If your child contracts an infection, the fever that accompanies it is a blessing, not a curse. It occurs because of the spontaneous release of pyrogens that cause the body temperature to rise. This is a natural defense mechanism that our bodies employ to fight disease. The presence of fever tells you that the repair mechanisms of the body have gone into high gear." He goes on to say, "If your child has a fever resulting from infection, resist the temptation to use drugs or sponging to bring it down. Let the fever run its course. If parental sympathy impels you to do something to relieve your child’s discomfort, sponge him off with tepid water or give him one dose of acetaminophen of the strength recommended for his age. Do nothing beyond that unless the fever persists for more than three days, or other symptoms develop, or you child looks and acts really sick. In that event, see your doctor."

NOw since your daughter’s illness has lasted so long, it seems that her body might need some extra help - she’s not clearing whatever it is on her own. Maybe because she needs the extra hydrocortisone dosing and/or because of an underlying infection. I would definately talk to your endo. nurse at least.

I will definately check with our endo again about our using or not using fever-reducing medications for our SWCAH son. I know I have said in the past that I do not use them, but that was quite a while ago. He did’nt say anything to me about it then, but after hearing all of your responses and the worry ofa hypoglycemic reaction too, I will double check.

Don’t know if any of this will help you or not Natalie. I would have her checked by a doctor though, even if you can’t see your endo right away. TAke good care and I hope your daughter rides out this illness quickly. Jill T.