Our 3¾ year old came down with something just before New Year.
The rest of the family had all had a tummy bug in the preceding week so we thought little of it.
he deteriorated over the next few days untill on the Friday he could not stand up. His ankles and knees were swollen and hot. His eyes were red. His skin was sallow. His fever was spiking every night until he was too hot to touch. He had eaten on just 1 day that entire week. (Thursday).
When I came home from work on Friday I insisted on calling for advice. the 111 service told us to take him straight to A & E.
The A&E Doctor hadn't a clue what was wrong, and he was admitted to the Peads ward.
The admitting doctor said it looked like Systemic Onset JIA, and found indicative rashes.
The next day the Consultant said he thought it didn't look like Rheumatoid Arthritis because he didn't have a Heart Murmur. It was probably a reaction to a virus or bacterial infection...
He had no fever at the time and his joints had calmed down considerably.
that night his fever spiked again, but to a lower peak.
He was discharged on the Sunday, and the discharge notes said 3 possible diagnoses:
Post Viral Reactive Arthritis
Post Strep. Reactive Arthritis.
no variant on JIA was identified. He is to see the consultant paediatrician next Tuesday... and has been seen by the opthamologist on the monday but his eyes had calmed down completely before that appointment.
I'm confused and worried. Post Streptococcal ReA is closely related to Rheumatic Fever, and that's a real worry. He was tested positive for a throat infection, but the swab was only taken on the sunday after he'd been playing all day with another child with Strep. Pneumonia who was in the next bed the whole time - so he definately came in contact with that bug in the hospital so we can't know if he had it already. (why didn't they take that swab on admission????)
In terms of JIA the Opthamologist had been told it was suspected Poly Articular JIA
What can we do to make sure we get the RIGHT diagnosis not just "A" diagnosis. Obviously we're worried about his long term prognosis... but we need a diagnosis before we can understand the prognosis.
After discharge from the hospital on Sunday, the arthritis migrated to his wrists and then to his Fingers, but has now calmed down. He's still stiff and sore, but with no visible inflammation or swelling. He's been on Antibiotics for almost week now to treat the throat infection (The GP called and told my wife to come in and pick up a prescription) but they didn't say whether it's Strep or something else.
How forceful should we be in asking for a referral to see a Rheumatologist?
Other than keeping a diary of his symptoms, is there anything else we should be doing?