<s>[INST] Hi, my little neice, who I have been watching has had a fever, & chills, and not drinking enough flulids, constipated, etc for 2 days. She is 22 months old, & was went with a cream for premarin vaginal cream 30 g. No instructions on label so I looked online. The side effects are all everthing she is dealing with. So far have been controlling with Tylenol, but after it wears off, cycle starts all over again. Because have been re-applying @ diaper change. Was looking for how many times a day to apply for a 22 month old. My question since I just found this out & will stop usage. What will be the point to go to E.R.? Was informed that this is the 2nd time she has been this sick since starting the cream. Very disappointed in her homecare before I received her!!! [/INST] Hello, thank you for your query here are some side effects of remain vaginal cream-mild nausea, vomiting, bloating, stomach cramps breast pain, tenderness, or swelling freckles or darkening of skin change in weight or appetite;vaginal itching or discharge;if these problems appear, stop the cream use. So I think your children fever chills are not due to cream use.it's because of viral or bacterial infection.I shall advise you to consult a pediatrician and give proper medication to your child for that. </s>