Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2026-08-05 Encounter: Spruce text message CC: High fever the day after MMR vaccine, with concern about contagiousness and poor response to Tylenol. HPI: Daisy, approximately 12 months old, developed a high fever (estimated 102–103°F by mother, thermometer broken) the day after receiving her measles vaccine approximately one week prior (vaccine given the Monday before). She also had a mild runny nose and was cutting her two front teeth, which the mother noted typically causes mild cold-like symptoms. Energy level was significantly reduced, with Daisy sleeping most of the morning. She had normal wet and soiled diapers. Tylenol had been given overnight but provided limited fever relief; Motrin had been given at approximately 4:45 AM. Assessment: Dr. Hobbs assessed the fever as very likely a post-vaccination response to the measles vaccine, noting it is not contagious when fever is vaccine-related. Advised close monitoring given low energy and poor Tylenol response. Plan: Monitor energy level, hydration, and breathing. Tylenol already administered with limited effect; Dr. Hobbs recommended giving Motrin. Parent asked about timing of next Motrin dose given prior dose at 4:45 AM — conversation ended without a documented final response on dosing interval. Medications: - Acetaminophen (Tylenol) Dose not specified — already administered at home with limited effect (new) - Ibuprofen (Motrin) Dose not specified — recommended by Dr. Hobbs given inadequate Tylenol response (new) Key clinical quotes: "very likely yes, any other symptoms? not contagious if it's from the vaccine" "Yeah, I bet that's from the vaccine, but lets keep a close eye on her today in terms of energy level, drinking, breathing" "I'd give her motrin now then" Source: Spruce conversation t_2MBH50I4LS000