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Having multiple swollen lymph nodes. Looks movable and painless. Report shows cervical lymph node show reactive and mature lymphocytes. Help?

Feb 2013
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Practicing since : 2002
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Hello Sir,
My baby boy is of 1 year and 10 months of age. He is having multiple swollen lymph nodes. four on back of his head and one on both sides very small on just above his caller bone and below his in total around 6-7 lymph nodes in which two of them looks bigger in size one on neck and one on back of his head.both of them looks movable and painless(because baby do not give any reaction when we touch them). one lymph node on back of his head looks hard and small in size.FNAC is done day before yesterday. According to the report it shows "Fine needle aspiration smears from cervical lymph node show reactive and mature lymphocytes, foamy macrophages and few plasma cells.There is no evidence of any granulomatous pathology in the material examined. However , biopsy confirmation may be advised if clinically indicated."
My baby's weight is just 9.5 kg. and he is having allergy on his head and itching problem on his head and legs.ulcer tongue ,constipation problem and few weeks back he was having measels. Kindly suggest I am so worried and scared.
Posted Tue, 22 Oct 2013 in Child Health
Answered by Dr. E Venkata Ramana 7 hours later
Brief Answer:
Regular follow up to monitor the size of nodes.

Detailed Answer:

Thank you for your query on Healthcare Magic.

Multiple swollen lymph nodes on back of his head, around neck or due to hypertrophy of lymph nodes as an inflammatory reaction to present or past infection on their draining area.

And the FNAC report of lymph nodes is suggestive of reactive lymph nodes and it ruled out other pathology.

As you told there is some allergy on his head, this could be a source of secondary infection.

So this infection has to be treated with antibiotics. Usually the size of lymph nodes should decreases over time once the infection is cured.

But if the lymph nodes size is increasing or persisting, other investigations like complete blood picture, ESR, mantoux test, chest X XXXXXXX and biopsy of lymph node for histopathological examination can be done with the advise of your pediatrician.

Biopsy is the confirmatory one and it should be done if the lymph nodes are increasing in size even after the completion of antibiotic course.

The child is underweight as per CDC growth charts. Try to improve his nutrition intake by giving diet consisting of more calories, proteins, and fats.

You can add ghee or edible oil to his regular diet to make more calorie dense.

Ulcer on tongue mostly due to an aphthous ulcer or due to deficiency of vitamins such as B complex vitamins. Give him vegetables, leafy vegetables, fruits, and whole grains to compensate the vitamin deficiencies and to add dietary fiber to his diet which helps to treat his constipation.

Measles interferes with child weight gain and health because of its complications like pneumonia, diarrhea, and reactivation of underlying infections such as tuberculosis.

Supplement the child with multivitamins syrup and a dose of oral vitamin A administration with the advise of his pediatrician. Vitamin A administration will fasten the recovery from measles, improves immunity, and lessen the complications of measles.

Give him a well balanced nutritious diet and try to provide an extra meal to compensate the nutritive deficiency occurred during the measles illness few weeks back.

Therefore I suggest you the following:

1. Evaluate further with investigations if the lymph nodes persisting in spite of
Augmentin course.

2. Vitamin A oral administration and multivitamin supplementation with
pediatrician advise.

3. Increase his dietary intake and add ghee or oil to his regular diet.

4. Dietary fiber XXXXXXX foods such as vegetables, leafy vegetables, fruits, and whole
grains to deal the problem of constipation.

5. Follow up with pediatrician to look for any increase in the size or number of
lymph nodes and to plan for biopsy if required.

Hope I have answered your query, if you have any clarification please let me know.

Above answer was peer-reviewed by
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