<s>[INST] Hi My daughter is six, has been running between 101 and 104.4 for the past two days. Medicine drops it for two hours and it goes right back up. She s complaining of abd pain and has developed a cough today. Pulse between 150-200. Blood work was okay, dip ua had some ketones. Er or wait it out? [/INST] Hi...what you say is suggesting a probability of VIRAL ILLNESS. But only one question is how is the activity of the kid when the fever touches the baseline after a dose of paracetamol. If the kid is active when there is no fever - you need not worry - its only a viral illness and no need to go to ER. High heart rate could be due to fever and as is the case with ketones.regards - Dr. Sumanth </s>