Q: Last night,  at 3 in the morning,  my daughter woke up with a very rapidly  peaking fever and shivering. We couldn't bring down the  temp and took her to emergency. The doctor there told us she had Adeno Virus and would peak a couple of times like this and even start coughing. She did indeed start coughing. She  is also with temperature, never less than 99.8, and sometimes rapidly peaking to 102.6 . I am treating  the temperature and keeping her happy as much as I can. Her eyes have improved very much. What should we do? How would we know? How long should this last? Please help...

A: Most viral infections tend to last about 3-5 days, or perhaps a little longer depending on the type of virus.  The best course of management would be to keep her well hydrated and continue to give either Acetaminophen (Tylenol) or Ibuprofen (Motrin/Advil) in adequate doses.  Acetaminophen is 15mg per kilo or roughly 7 mg per pound.  Ibuprofen is 10 mg per kilo or roughly 4.5 mg per pound (this is a high temp dose - greater than 102).  Also supportive care: decongestant for runny nose, comfort foods, rest.

Signs of pneumonia include: very high fever (especially if it does not respond to fever meds), rapid/labored breathing, lethargy, and chest pain.  Often the person will have persistent cough or shortness of breath. The risk for pneumonia due to adenovirus in a relatively healthy person is pretty low.

Fevers lasting more than a week warrant a re-check to make sure that any secondary problems have not developed.  Also if new symptoms appear, we sure know about it.