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This question was answered on Sun 19, Sep 2010 01:02am by bobby s, md

My daughter Melody is 26 months old. For around a year now she's had enlargedlymph nodes. One is huge about 2 cm. It's her right jugulodigastric to be exact.The other lymph nodes that are enlarged are under her jaw, along her neck and inher occipital area


    
Asked by jadenn (Female; Fevers, ear infections possible mono?; Relevant drugs:None ) on Mon 13, Sep 2010 10:27pm

My daughter Melody is 26 months old. For around a year now she's had enlarged lymph nodes. One is huge about 2 cm. It's her right jugulodigastric to be exact. The other lymph nodes that are enlarged are under her jaw, along her neck and in her occipital area but it started out with just the one (jug). About Feb. she got really sick with a high fever, ear infection the works. They did a round of Amox. and she got better. But the lymph nodes have stayed enlarged. And they said give it a couple of months for them to go away. I would check them from time to time without any changes. Still enlarged, some shotty and some just bigger. About June I finally decided to get in touch with her doctor. She ordered blood tests and checked for all kinds of viruses and bacterias and concluded that she had mono at one point but they didn't know when. I'm guessing it was back in Feb. She said we should give it a little while longer to see if they go down. When it was time to go in for her 2 year well check up in July I noticed that her jug. node has fixed to the underlying surface. They ordered an xray that came back normal and a CBC and metabolic panel that came back normal and a referall to an ENT that wasn't for over another month. So halfway through August she gets a high fever for a weekend then on that Monday we took her in. Plus one of her cervical lymph nodes on the other side has become fixed but at the time that was beside the point, but they still noted it. Anyway, they said she had a virus and to give her fever 5 days. That didn't make sense to me since she already had it for 3. Well on that Wednesday (2 days later) we took her back again because her tonsils enlarged to the point where she wouldn't eat and she was choking everytime she would take a drink. They were very close to touching. She would sleep all day, wouldn't do anything... very restless. They then took her blood and swabbed her throat(neg for strep) and determined it was a bacteria and they put her on a 10 day course of amox. The tonsils went down about 25% during the course and on the last day with the Iast dose I checked her throat (I checked it everytime I gave her a dose to notice any changes) the right one was bigger than the left. They were red with no white patches. But it was noticably bigger and I didn't want her throat to close while she was sleeping so I took her to the ER (It was a Sunday). All they could talk about was mono and I said no she already had it and they just ignored me. I stormed out of there and went to her normal ped the next day which was the day before her ENT appoint. I just couldn't wait it was scaring me. They said there wasn't anything they could do anymore at this point and just wait for the appt. the next day. She said it def. wasn't a bacteria since it didn't respond to the antibiotics she prescribed. He was such a quack. The appt. was initially for the fixed lymph node and all he could talk about was how the lymph node WASN'T fixed (when I had 3 dr's tell me that they are) and that they are enlarged because of the tonsillitis. I'm so mad that I took her to a specialist and he didn't even know what was going on. He wanted to put her on another antibiotic and some steriods. I looked up her prescriptions and there was no way I was going to the that to her little body not without a good reason, and he didn't know her whole story. There was no way he looked at my dr's notes. This was about 2 weeks ago. We have gotten in touch with a great ENT up in Portland at OHSU. Our ped. has faxed up Melody's case and we are waiting for Portland to get back in touch with us. I don't feel like I can wait another month for an appointment. Her right tonsil is still bigger than the other and they are red. She has 2 fixed lymph nodes and a bunch of other enlarged nodes. The ENT called her "lumpy" She used to be my July firecracker baby. She tires out easily from playing. She needs lots of sleep. She's ALWAYS drinking fluids. She complains her legs hurt. 2 days ago she rode in the stroller all day but she kept saying her knee hurt. She's itchy. On her head and her feet but mostly her head on her right side but nothing's there. She says her belly hurts and it sticks out. At one of her appts. for the tonsillitis her ped said her liver was slightly enlarged and ran blood tests on it that came back normal. Above her belly button she is getting an indentation... her ped said it could be a hernia. I asked for her CBC and WBC w/diff #'s when they said she had a bacteria infection with her tonsils and her numbers were: white 14.5 red 4.1 platelets 3.45 43 neutro 29 leuk 18 mono and 6 bands and that was all the info they gave me and they said it was a bacterial infection and they her numbers were normal. To me, it looks like there is some info. missing and there are a couple red flags (bands and mono's and whites). Should I just take her to the Children's hospital? Do I just wait to hear from them in Portland and then wait some more for the appt? I've been driving myself crazy with this for a very long time...

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Answer by bobby s, md  on Sun 19, Sep 2010 01:02am:

Hello,
First of all, there is no specific reason to suspect lymphoma or any other cancer in your daughter. Secondly, lymph nodes may take several months to return to normal after an episode of mono.
Please seek a second opinion by an experienced pediatrician.
All the best, and God Bless!

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