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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Recurrent Swollen Lymph Nodes In The Neck And Fever In Children?

12 almost 13 yr old boy. C/o feeling weak beginning on 8/26. No other symptoms until 1 week ago - woke up with extremely large lymph nodes in neck & intermittent increase in temp 99.7-100.7. Took to ped. Ordered US bi neck. Showed nodes largest on R measuring 2.8x1.8x1.3cm; largest on L measuring 2.5x2.3x1.5cm. Labs wnl except wbc 3.8; seg neutrophils 19%; lymphocytes 67%; granulocytes 0.73 TH/uL. Diff reviewed by pathologist showed normochromic rbc-decreased leukocytes & absolute neutropenia w/reactive changes in occasional forms..occasional lg granular lymphocytes admixed w/atypical lg reactive appearing lymphocytes. Platelets adequate in no & unremarkable morphology. Began taking Augmentin bid 8/30. Lymph nodes & c/o weakness, intermittent increase in temp continued. This morning woke up with red, swollen lips & a red, raised rash covering trunk & arms, neck & face, & c/o sore throat. Back to ped. Strep & mono neg. Advised to wait & see & d/c abx. Feeling a bit anxious as he is feeling very poorly, appetite decreased (lost 4 lbs in 1 week) & can t get a definitive answer.
Fri, 7 Jun 2019
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Radiation Oncologist,  's  Response
Hi,

Lymph nodes enlargement in a young boy could mean anything - ranging from infection to a lymphoma (a type of cancer involving the lymph nodes). However, to be very certain about diagnosis, I would like to do certain tests and also would like to know some details.

With the antibiotics (Augmentin), have you noticed any change in the size of lymph nodes - have they reduced, if so, then its more likely an infection.

Are there lymph nodes anywhere else in the body, other than the neck? Lastly, I would like to do a PETCT scan and a biopsy from the lymph node to be certain. However, first I would like to see how he responds to antibiotics, before doing the tests mentioned.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Jatin Bhatia, Radiation Oncologist
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What Causes Recurrent Swollen Lymph Nodes In The Neck And Fever In Children?

Hi, Lymph nodes enlargement in a young boy could mean anything - ranging from infection to a lymphoma (a type of cancer involving the lymph nodes). However, to be very certain about diagnosis, I would like to do certain tests and also would like to know some details. With the antibiotics (Augmentin), have you noticed any change in the size of lymph nodes - have they reduced, if so, then its more likely an infection. Are there lymph nodes anywhere else in the body, other than the neck? Lastly, I would like to do a PETCT scan and a biopsy from the lymph node to be certain. However, first I would like to see how he responds to antibiotics, before doing the tests mentioned. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jatin Bhatia, Radiation Oncologist