Nearly three weeks ago now, I noticed swollen nodes on my 19mo old son. I wasn't too concerned, as I have three older children and always check their glands when I think they are getting sick. Swollen nodes in themselves don't concern me. The time they had stayed swollen, however, sent up some red flags. As he was sitting on my lap, watching TV I was just rubbing his shoulder and noticed a swollen node. Then I found a few in his neck, and one on the back of his head, about an inch from the bottom of his hairline. The one on the back of his head is about 1cm and hard as a rock, unmovable. My nurse friends suggested I just get them checked, and at the time, I didn't realize the one in the collarbone area was any reason for alarm.
Over the last month, he has developed symptoms of lymphoma (or cat scratch since they are so similar in symptoms), including a 2lb weight loss in a month's time (he was 27 to begin with, dropped to 25), loss of appetite, an odd type of rash on his body, headaches, itchiness, and began digging at his belly button area saying "Belly hurt, belly hurt". The doctor did an exam, checked his nodes, and of course was alarmed at the L supraclavicular node and immediately checked his spleen, which she said was not swollen. She prescribed Augmentin, and sent him for a CBC and blood smear. I had mentioned a concern of lymphoma, and she said yes, the symptoms present, and it's a legitimate concern, then asked about cat scratch and said he would also be tested for that. Said if the nodes had not gone down at least by the end of the 10 day antibiotic run to bring him back.
She did call to tell me his blood work showed no cancer (though I am aware it is unlikely, especially in our small town, known for it's horrible medical history, that they would find the abnormal cells through a CBC). She did tell me his white count was high, showing infection, and the antibiotic should take care of that. Well, it is now 10 days later, his nodes have had no change, and rash is still present, mostly over his abdominal area, nothing like I've ever seen before.
We, of course, are still waiting on the bartonella results, and it is a possibility I think... (and HOPE)... but with these symptoms, should I be waiting it out, or should I be heading in for a second opinion? We don't have a cat, but back around Dec 22, we took in a stray for a few days. He spent about an hour with it, and the next morning, his eyes were half swelled shut, so we learned he was allergic... He did not get scratched that I'm aware of, however, I do know it can be transmitted through rubbing of eyes, which he did a lot of for a few days there. Now, symptoms didn't present until late in the second week in January, three weeks after the cat. From what the dr told us, it is a 1-2 week time frame for symptoms to show up. I definitely think the cat thing is possible, but should I be concerned about lymphoma? Should I be going for a second opinion, jumping the gun on the bartonella results? And if Bartonella comes back positive, should I take that for an answer, or could there be more to the story?
Just wanted to update, the cat scratch fever (bartonella) results came back negative. Based on his symptoms present and the length of time his nodes have been swollen, we chose to drive the two hours to University of Michigans Motts Children's Hospital to have him tested.
They were concerned with presented symptoms, ran extensive testing including blood, urine, and x rays.
The most concerning node, the left supraclavicular node is indeed swollen, but is currently soft and not fixed or matted, which is a good sign.
All of his tests came back in the normal range, only a slight abnormality in iron levels. Motts ruled out cancer 100% ., which is a huge relief, considering they were quite concerned about that node when we first arrived.
There was no explanation for the enlarged nodes. The dr said he may just have abnormally large nodes that are easily felt throughout most of his childhood.
I'm still a bit uneasy because they did not do an ultrasound, but I feel better knowing his nodes are soft and mobile. (Hard to distinguish myself not being a medical professional). In the end, I trust U of M and their expertise. I am glad we drove the two hours for the peace of mind. I would strongly encourage anyone who has symptoms to play safe over sorry, because you just never know.
This is a very similar story to what happen to my nephew who is now 6. When he was 4 he became pale and I found swollen nodes on him as well. His spleen didn't appear to be swollen at first being check by a doctor and then latter became swollen. His iron levels were low, and he had a reaction to their pet cat. My sister got rid of the cat and he now takes iron treatment and shots for allergies. It might be worth to have an allergy test, because sometimes you never know what kids may be allergic to. He is doing much better now.
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