High White Blood Cell Count and 106F in Fever

My son had the same symptoms. When the fever broke, he had a rash and that's how we knew it was roseola. I know it is scary to see that fever so high. Good luck and hope he gets better!

he had some sort of infection. that is what the high white cell count means. You may never know what was going on.

Hi G.,

The very high fever and elevated white count are indicators of a significant infection (bacterial, fungal, parasitic or viral). The fact that your son responded so well to antibiotics suggests that he was indeed fighting a bacterial infection, in all likelihood, even if cultures were negative.

There are many other places where an infection could have occurred besides in the lungs or urinary tract, although these are common locations, and the negative blood test suggest that he likely was not septicemic. BUT, what most doctors don't realize is that culturing for bacterial infection fails 30 - 50% of the time for a host of reasons. First and foremost, if you don't happen to collect bacteria in the sample, nothing will show up in the culture. And, if the lab doesn't culture for atypical pathogens (as can occur with some forms of meningitis and pneumonia), cultures will be negative. But, as I mentioned before, there are lots of other places infections can hide, such as in the colon, kidneys, or joints.

The real question, is how did he contract the infection? If your son had diarrhea for weeks, it's possible your son picked up a parasite, like Giardia, from the water or someplace he was playing, and then damage caused by the parasite allowed a bacterial infection to start in his intestinal tract. Seems like kind of a long shot, but it could kind of match up with the history. Just curious, was your son ever seen by an infectious disease specialist? An ID specialist might be able help your doctor puzzle this out.

If the antibiotics have eradicated the infection, there's no reason to believe the infection will return. There is a blood test (procalcitonin [PCT]) that can be used to help determine if the infection has cleared. Tell your doctor to check out the results of the ProHOSP and ProRESP studies (Schuetz P, Christ-Crain M, Thomann R, et al. JAMA 2009;302(10):1059-1066 and Christ-Crain M, Muller B. Swiss Med Wkly 2005;135:451-460.) for more information. Then, check around some of the major hospitals in the area with ICUs to see if there's a laboratory that runs the test. More than likely, though, you'll have to pay out of pocket because most insurance companies are not reimbursing for this test yet, and definitely not for this purpose, because it is still not FDA approved (it's currently approved to help diagnose sepsis).

Definitely keep an eye on your son for a recurrence of infection, and development of other infections. Some children have primary immune deficiencies that make them more susceptible to infection. These are rare disorders, but something to think about if a child seems to get a lot of infections, especially "mysterious" ones.

I hope your son continues to improves, and that this was an unusual, one off event.

I just read SH's response. She's spot on about keeping your baby hydrated when diarrhea hits. Has it subsided now? If not, and if he's having a difficult time digesting breast milk (pretty unlikely) or formula (more likely), it's important to rehydrate him with an electrolyte solution, not water. You can buy pre-made pedialyte or make your own. The World Health Organization (WHO) recipe for oral rehydration solution is:

1/2 tsp NaCl (sodium chloride, aka table salt)
1/2 tsp NaHCO3 (sodium bicarbonate, aka baking soda NOT powder)
1/2 tsp KCl (potassium chloride, aka salt substitute)
2 Tbsp sugar
1 liter water (a quart + about 2 Tbsp)
You can keep this chilled in your fridge and give a Tbsp at a time or as much as the patient will drink voluntarily. If your body is dehydrated, this solution will taste quite good. If not, it will have a slightly unpleasant salty taste. This recipe can be used for both children and adults.

Same thing happened with my son. He had a 105.2 fever for 2 days and then it stayed at 103.5 for a whole 7 days. His white count was high too. My son was admitted into the hospital because he was also having a stiff neck and was acting very sick. They did a lumbar puncture to rule out meningitis and started him on antibiotics. They also did all kinds of tests and everything came back normal/negative. My son only has one functioning kidney, so they did an ultrasound and that came back normal too. He was finally released after 5 days in the hospital and the doctors never did figure out what he had, and his doctors are awesome and extremely intelligent. They told me it probably was viral since everything else came back normal. My son's fever went away and his energy started coming back, although it took a full 3 weeks until he was back to 100%. They did another blood test about a month after he left the hospital and everything came back completely normal.
Have you let the doctors know about his loose stools? Maybe they can send a stool sample to the lab to do some stool studies on it. Hang in there!

The white blood cell count says that there was an infection he was fighting off. You would *expect* a high white bloodcell count with a fever. When he came back negative for other signs of infection, the WBC let them know that there was indeed some form of infection going on. A low count is more indicative of a neurological problem with those high fevers... aka the high count was pretty good news.

CAVEAT: There are a bazillion reasons for a high or low count. MOST basically your count raises when you're sick and fighting an infection.

if i were you...i would INSIST on him being admitted... adult people go brain dead at that high of a temperature...your brain literally cooks at that temperature... kids tend to run higher fevers, but a fever that high can be LETHAL. give him a cool bath immediately.... not cold, because he could go into shock...please let us know what happened...i am very concerned....if somebody even attempted to discharge my child with a 106 temp i would basically cause a riot....that's malpractice....seriously....i am SHOCKED they let you take him home...RIDICULOUS...if they try to discharge him ask to speak to the administrator.

go through this checklist...
Has he been around anyone else that has been sick?
Has he traveled out of the country recently? (Malaria)
Has he been around any farm animals or wild animals? (Brucellosis, Tularemia)
Do you have any pets? (reptiles - Salmonella infections, Birds - Psittacosis)
Has he been bitten by a tick? (Lyme Disease, Q Fever, Rocky Mountain Spotted Fever)
Has he been scratched by a kitten? (cat-scratch disease)
Has he eaten any raw or undercooked foods or drink unpasteurized milk or juice?
Does he have a heart murmur? (bacterial endocarditis)
Has he been taking any medications? (drug fever)
Does anything like this run in the family? (familial Mediterranean fever)
In addition to the fever, has he had other symptoms, like night sweats and weight loss? (lymphoma)
Again, keep in mind that

My three month old nephew had almost identical symptoms last week. High fever, even a seizure, diarrhea, high white blood cell count. They thought he had meningitis but it turned out to be e.coli! Please have them test for that ASAP..

Well, my son is 4 years old.
A couple of months ago... pretty suddenly, he got diarrhea and throwing up.
Then that subsided in like 1-2 days.
Then, about a few days later... he got a high fever. For about 1-2 days.
I mean like 103-104 degree fever. Just a fever. High.
Took him to the Doctor.
Viral based.
No meds.
Then my son was fine.
Just fine.

Keep in mind also, a baby does not have a fully developed immune system yet... and illnesses in babies or kids, often present different symptoms, than it would in an Adult.
Your baby is only 10 months old.
They may take longer to fight off an illness, because, their immune system is not yet fully developed.
I'm not a Doctor, but that is my understanding.

KEEP your baby hydrated.
Especially with a fever, fevers are dehydrating.
Nurse on-demand or Formula, whichever you are using.

Does he have any cuts/scrapes or anything like that???
As a child, I once got VERY VERY ill... and it turned out, that I had a Staph infection, in me, which entered via a SMALL cut I had on my leg. It was a systemic infection. I had high fever, couldn't even walk because my fever was so high... and my Doc told my Dad that the infection in my cut almost reached my bone.
I had to be put on Antibiotics and almost ended up in the Hospital. My Doc wanted to admit me, but I didn't want to.

Now, ALSO.... DID the Doctors, do any "Strep" tests on your baby????
If not... then they SHOULD DO SO.
Strep infections... can affect, NOT only the Throat, but other parts of the body.
I would highly recommend, they do a Strep test on your baby.
You said that your baby did not have Strep Throat... so is this because they did a Strep Test, or because they just said so?

Or, he could be having a lingering illness/secondary infection since that time he had the diarrhea.

Your baby is only 10 months old.
You GOTTA keep him hydrated...
106 is a very high fever... and it could affect his brain or cause seizure.

Do you know what his white blood cell count is? It could just mean that he's fighting something off. With a fever that high, it would seem likely that is the case. But a prolonged super high wbc could mean something a bit more severe. Do you know what his ANC is?

Okay, I'm reading more closely. It sounds like whatever he had either ran its course or the antibiotics killed it off. This is good because it likely means it was an illness. If he white blood cell count stays elevated (way above normal) for a long time, it could mean something more serious. But it sounds like he was fighting something off. I'm so glad he's feeling better!

Sounds similar to when my kids had gastroenteritis. (stomach flu) The loose stools (and in our case this was combined with vomit in one child) is the body's way of flushing out the intruder it has detected that is making you sick. Our bout ended up dehydrating one of my toddlers and the poor guy had to get an IV. The high and sudden persistant fever and the prompt response to antibiotics suggests a bacterial infection and a huge chunk of the immune system is in the gut. That said I'd simply watch him for further signs of illness and of course his stools and if they return call the doc again for further testing.

Hello Mama,

If I was you, I would have the Dr. to continue doing blood work through out the month of August to keep an eye on his white blood cells.

Take care and God Bless You and your son.

It Could be that the tests were wrong and showed no infection when really there was something. It happens ALL the time. Follow your instincts. Mommies know their babies better than anyone else in the entire world!

my dd had the same thing happen about a month ago. high fever then loose bm really bad, every test came back negitive until they did the stool sample she had c-diff and samonella. it was bad she was hospitalized for 3 days to control the pain. they had to put her on an anti fungal not an antibiotic that would have made things even worse. get a stool sample one that has not happened in the disposable diaper they will contaminate the sample. gl

sounds like maybe a parasite.

I do not know when in the course of this disease you started going to doctor every day. High fever is usually a sign of flu not a bacterial infection. It can take a few days to cure itself or to turn into a bacterial infection, which I guess what happened to your baby. When it turns to bacterial you will eventually see some symptoms, and the blood count will go up (because the body is releasing white blood cells to fight something somewhere) but the doctors were not waiting for symptoms to show because your child is young and you were there every day... so they took a preemptive strike -put your baby on ABX and he did get better. There is no way to know now what it was.
I usually wait with my kids if they have high fever for full 5 days to see the doctor, if the temp becomes low grade fever than I go right away. I think you went too soon. With high fever you should do meds for temperature control, fluids, other soothing things until it goes away or other symptoms come in. If you have a history of ear infections go on the second day. It is not wise to rush to the doctor the minute your child gets fever. When you have high fever you give your Tylenol or Motrin and if the temp drops down a bit, like to 102 - you are successful. Also try cold packs, cool baths - those are better than pills without the liver damage.

My daughter had a low grade fever for several weeks. We were in and out of the drs office several times. Finally she told us to go to Children's hospital because she had no idea what was wrong. After many hours in the ER and two MRIs they discovered an infection deep inside her throat. The infection tried to contain itself and developed into a lump. Antibiotics cured it! If your daughter's illness has gone away with antibiotics then you know there was an infection which accounts for elevated white blood cells. I am surprised however that they didn't admit your child into a hospital especially if the fever got as high as 106. Glad your kiddo is feeling better. There is nothing as stressful as a sick child.

I'm sorry I don't have an answer for you but I am praying for you and your son. Having a sick child can be terrifying under usual circumstances, but I feel for you for all you have gone through.

I hope so deeply that your son will be just fine. You are absolutely doing the right thing in looking everywhere you can for answers. You never know what doctor or mom has seen this before.

Take care,

- E.