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Bloody nose, swollen glands, chronic cough
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Bloody nose, swollen glands, chronic cough

My husband and I are at a total loss.  Our son is now 3.  At 10 months old he started with an unexplained cough that comes and goes every two weeks or so and recurring swollen lymph nodes (they don't stay swollen in between but return frequently).  He was on asthma meds for a while but they seemed to make things worse, and as he showed no airway problems (no low blood oxygen levels) even during his more severe coughing episodes he was taken off those.  He also has bloody noses at completely random intervals.  He's had the following based on his ped's suggestions:

Ear tubes (twice)
CF test (negative)
Allergy testing (nothing showed)
Celiac's test (negative)
scheduled for CT scan of sinuses at the end of the month

He's had blood tests done and the only abnormality was that his prevnar and hib vaccine levels were low so he's since gotten a prevnar booster (Hib shortage right now so he can't get that one yet).  His pulmonoligst said his levels for his immune system were great, so no serious immune system problems, correct?

An important note is that he had pyloric stenosis at 5 weeks old.  He was in the hospital for 10 days before diagnosed and had 3 lower GI series and various other x-rays.  He's tried Prevacid in case this is reflux but it had no effect.  He's seen an allergist, his pediatrician, a pediatric pulmonoligist and an ENT.  He is currently getting Zyrtec and Nasonex once a day.

My concerns stem from the fact that along with these coughing episodes, it is one particular lymph node that swells up every time, and is very hard, the one right behind his left ear.  The nodes in his neck swell as well but they stay soft and generally decrease in size after a couple days.  The one behind his ear stays sometimes for months.  He complains frequently of pain in his stomach and pain in his teeth (which I just assumed was sensitivity but now am not sure).  He also sweats like crazy when he sleeps.  He can play just like any kid would for a day or so but then is run down for at least 2 to 3 afterwards.  Where do we go from here?  How do we help him?  

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Avatar_dr_m_tn
Hello,
Swollen lymph nodes are usually caused by a viral or bacterial infection. Other causes include allergic reactions, arthritis, cancer, metabolic diseases, and an overactive thyroid (hyperthyroidism).Since he is having other symptoms of frequent cough,night sweats and epistaxis,I would watch out for chronic respiratory infections esp TB, liver disorders,sinus and nasopharyngeal abnormalities or serious causes like bleeding disorders and leukmias.

I would suggest that you get FNAC lymph node,complete bleeding and clotting profile,liver function tests and CT nose and paranasal sinuses doen to rule out these conditions.

Hope it helps.Take care and regards.


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