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Forum Name: Hematology Topics

Question: 15 month old son with fever and swollen glands


 Dr. Chan Lowe - Wed Aug 29, 2007 5:27 pm

User avatar
My son is 15 months old, 3 months ago he had a Fever and I took him to the doctors. She noticed he had "lots and lots" of swollen glands and said it was just a virus and sent us home. He also had what she called a "rash" on his leg. We came back a month later and he still had had swollen glands and the"rash" which she took a closer look at and it was ringworm and is still currently being treated with cream. Anyway she once again told me that it was a virus and his glands would go back to normal. (He also got pink eye, that was gone before the first CBC was done but after the glands were swollen.)I came back a week later because his glands didn't go down at all and it had been 2 months. She did a CBC everything was normal except for his wbc which was 19, 000. She put him on augmentin and said it must be a bacterial infection. A week later we did an ultrasound on his glands which some were almost 2 cm, there are quite a few on both sides also did another CBC w/ diff this time. Once again everything but his WBC was normal it was 15, 000 (I don't know what white blood count was high). She sent us to children's hospital to see a hematologist 2 days later and they did another white blood count and a blood smear. His WBC was 16, 700 and the blood smear showed some type of virus. The hematologist didn't find any swelling of the belly and no swollen glands by the collar bone but he did find them under the armpit. It's almost been a month since the last appointment and 3 months since this all started and his glands are still swollen, they haven't found what virus it was. He was neg for Mono and CMV. This whole time my son hasn't acted like anything was wrong except when he was getting that Fever 3 months ago and another small Fever on and off 2 months ago each only last 2-3 days. He has no symptoms what so ever except for bags under his eyes he has no weight lose, he eats well, no night sweats or fevers. What else could it be? I'm soo afriad that it is cancer since it runs sooo strong in my family. My cousin died of cancer when he was 21, my sister had cervical cancer at 16 my uncle had a brain tumor and lots of aunts, uncles and 2nd and 3rd cousins also have some type of cancers. My doc. said she was worried because this high white blood cell that was high is the one that is usually high in cancer, my hematologist said it is also the one that is high in viral infections(once again I do not know what one it is) and he says there is no reason to suspect cancer yet... but what could be making his glands swollen and his wbc so high for this long??? A week before this all started he got his 12 months vaccinations (Hib), Hep B, measles mumps, and rubella, chicken pox and pneumoccal conjugate.

 Dr. Chan Lowe - Wed Aug 29, 2007 5:36 pm

User avatar Hi Smule1985,

I hope you are able to see this post. There was a computer error while I was trying to remove the duplicate post from our system and it erased both your posts.

There are a few conditions that may be causing the persistent lymph nodes. If a diagnosis is not able to be made it may be helpful to biopsy one of the nodes. This will allow the pathologist to examine the tissue under the microscope and be sure there are no cancer cells (putting everyone's mind at ease), do some cultures for specific bacteria/viruses and look for any other clues.

An infection from a bug called bartonella (cat scratch disease) can cause persistent lymph node swelling (although it usually is not all over the body). Also, when mono was tested for, if the "monospot" test was used this test is not reliable in a child your son's age. Instead EBV titers must be done. Ebstein Barr Virus (the cause of mono) can cause these symptoms.

It may also be worth testing for infections such as coccidiomycosis (valley fever) or histoblastosis depending on where you live. These are fungal infections that can cause persistent lymph node swelling.

If no cause can be found, seeing an infectious disease doctor and possibly an immunologist may be helpful in guiding further work up.

Best wishes. Sorry again about the computer problem.
 smule1985 - Thu Aug 30, 2007 7:55 pm

Thank you so much for your reply! I was worried there that no one would answer me. We had an appointment today with our hematologist at Detroit Children's Hospital. He believes that the lymph nodes have gone down a little which i'm not so sure, they seem the same to me but im not a doctor! They don't want to do a biopsy on his lymph nodes, its to much for a little guy and he still thinks that it is just a virus since he is not acting sick. They did another CBC today and his wbc went down to 10,300 thank god! i am sooo relieved, he said that in the blood smear all the cells were normal and there were alot of active lymphocyte cells?? i think im not exactly sure but i think thats what he said, and i have no idea what that means. All the other tests were in the normal range also. They never did find out what virus it was and i believe they are not going to keep trying to test it. He told me he must have had a viral infection and now its gone and he is getting better. We still have to go back in a month and retest him.

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