Foster kitten will not groom himself

Hi!   I am so happy to have found this site!   I feel myself spending many hours here in the future, learning & sharing!    My question is about a tiny kitten I am fostering - well, I'm pretty sure we'll wind up keeping him - we've gotten attached.   Fred.   Anyway, he's had SO many issues from day one - he was sprung from our high kill shelter and had to be isolated because he was sick.  We took him in and kept him away from our other cats.  He's fought ringworm, numerous bouts of diarrhea, coccidia, URI's....it's been pretty frustrating.  I was not at all happy with the vet that our rescue used so I took him to the vet that I use for my own cats and finally started getting relief.....but he's had so many setbacks.  We thought at first he could not see because his eyes would not follow objects.   He did not seem to know what to do with toys - didn't know how to play.  He tested negative for feline leukemia and AIDs, thank goodness.  Took two doses of metronidazole which cleared his diarrhea, but he could not tolerate more than that....such a strong med.   Oddly enough after that point his vision began to improve, he began to play, to act like a normal kitten....almost.   But he's just never been quite "right".   His appetite has always been good but in the last couple of weeks he is just famished.  Wants to eat all the time - acts like he's starving.  Little potbelly.  Yeah, worms I'm guessing.  Took him to vet today and he was given Panacur and an injection of antibiotic because he's starting to develop another URI.   Hoping the Panacur will rid him of the worms once and for all.  This might help explain his inconsistency with litterbox use to poop.   He's consistent with urinating in the box but it's hit or miss with making it to the box to poop.   Also troubling is that he does not groom himself like normal kittens do.   His face/chin is always dirty from eating and his bottom is always dirty.  Fred has had more baths than I think I've ever given any kittens, all total.   I've never dealt with this before.   I'm wondering about neurological deficits of some sort.  Vet also detected a low grade heart murmur and an abnormality at the base of his tongue - possibly a tumor.  He may be aspirating some of his food when he eats which would explain the strange noises he makes when he eats.  But he had only gained 2 ounces in over a month!   Failure to thrive.  I'm sure once we rid him of the worms that will help that, but he still faces a long road ahead of him.  Vet said most kittens in his condition would not have lived this long, and that was a testament to the care we gave him.   And we don't intend to stop - he's the sweetest little thing and I feel we owe it to him to give him the best chance possible - all we can do is wait and see how he progresses.  Sorry to make this such a long backstory for the question about the grooming issue -- but that's probably relevant to try to understand what he's been through - has anyone else ever dealt with this sort of thing before?  I'm wondering if the tumor on his tongue is preventing him from grooming himself, but it's sure not stopping him from eating.  At some point in the future, if he makes it and becomes strong, surgery is always an option, but the vet said he was too small & frail for that right now.  My husband and I are so perplexed by all this.....and feel so bad for poor Fred....just wondering if anyone had any input?  We're totally stumped.  We know nothing of his background prior to being dumped at the pound....he came in with no littermates.  This little guy has been through the ringer and it aint over!   Thank you so much in advance!!!

How old is Fred? I am asking because I think we need to know this to make judgments on a lot of this.

Thank you so so much for helping this kitty!!

Not entirely sure. Vet says maybe 3 months. Very small for his age if so. Sorry - out of my long winded post - that was a detail I left out. Lol. Thanks so much.

Poor little guy. He might not feel well enough or have enough energy to try grooming himself. Or he might just not know how. When I had a very young kitten, I used to groom him after meals with a damp paper towel, trying to mimic the way his mother would lick him. He loved it and would just purr away while I did it. After a little while he started grooming himself too, though it took a few weeks before he got good at it and didn't need my help.

My Patches needed help with grooming at first as well.  His mother, neighbors of a coworker who didn't take care of their animals, had her first litter outside and moved her litter.  She lost Patches and then wouldn't take him back.  It took a while for Patches to learn how to do it for himself.   He had the same issues with vision as well I think because he was so young.  My coworker took care of him for a couple of weeks before giving him to me.  She got a little overzealous with the cleaning once and rubbed some of the fur off of his nose.  He still has a little thin spot on his nose.

Thanks so much for your responses!   We had a small break-through last night - I looked over & just happened to see Fred trying his best to lick his bottom.  I got so excited and yelled for my husband & I posted it on Facebook (I know those who read my post who might not have been following Fred's story would have thought I was crazy  haha) but he has a lot of followers on Facebook so a lot of folks got very excited!   It was encouraging to me because that tells me maybe the instinct is there after all, just, for whatever reason, maybe like you said, he didn't have the energy to do it.  Maybe he HAS finally started emulating my other cats.   Bless him.....he had so much working against him from the time I got him and just couldn't seem to catch a break.  I'm trying to feed him the highest quality protein food possible to help build his immune system, and once he gets rid of those nasty worms, maybe his luck will change. He's definitely getting the TLC.    We're so attached to him now, I don't think we will be considered fosters anymore.    

Thanks again!!!!!