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on 24th Sep 17 My kid 3 years 6 month

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Pediatrician, Cardiology
Practicing since : 2006
Answered : 1752 Questions
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on 24th Sep 17
My kid 3 years 6 month old , weight 14 kgs.
he had skin allergies and red rashes on body and we have ATAREX SHO and it got settled down.

on 25th sep 17
My kid had cold with running nose green colour heavily along with small swelling in both side neck under ear.
We went local clinic and prescribed as follow.
Syp Cetrizine & Syp Zedocef

on 9th October 17
We went clinic again and prescribed as follow.
Syp Slox & Syp Combiflam & Syp Prugo

after above all medicines , cold and running nose with green colour controlled 100%.

But swelling got reduced but not disappear completely. so we went again clinic on 16th October 17 and prescribed medicines as follow.
Syp Cepodem & Syp Combiflam.

now swelling got reduced but not completely disappear.
hence , we have been advised to blood test which you please attached herewith.

shall arrange send Chest X-ray & Throat Swaft report by day after tomorrow.

Self herewith attached my kid neck photo for your reference.
Self could not see any swelling when I look at him.
But when he can lift head upperside , I can see swell on both side neck under ear.
Posted Wed, 22 Nov 2017 in Child Health
 
 
Answered by Dr. Pradeep Kumar 23 minutes later
Brief Answer:
Observe, no need to worry

Detailed Answer:
Hello

Thanks for asking on this platform

I have gone through the details and have seen the reports.
The report shows mild anemia, most likely iron deficiency anemia as it is microcytic, hypochromic type.
The swelling of neck lymph nodes are common with upper respiratory infection and it improves as the infection subsides.
If there is no signs of inflammation like redness or pain in the swelling or if it is not increasing rapidly, no specific treatment is needed.
As already you have completed the course of antibiotic, the cough/cold has subsided and there is no sign of inflammation, no specific treatm not is needed.
Here I would like to observe the child and I hope with time it will improve.
I would like to get iron studies done to see the level of iron and if it is low iron supplementation will be needed.

I hope this helps.
Please let me know if you have any more questions.
Regards
Above answer was peer-reviewed by
 
Follow-up: on 24th Sep 17 My kid 3 years 6 month 2 days later
Kid - 3 ½ years , 14 kg
Dear Doctor
thank you very much for your detailed answer.

Along with Blood Report , self herewith attached Throat Swab Report , Chest X-Ray Picture & CXR Report [PA View] for your further reference.

It is Mild anemia as per blood report, if so please suggest food to be taken for my 3 ½ years old Kid to get over come it..

as informed in previous mail , there is no any red rashes or pain in the swelling and it is not increasing also...

we can see swelling on his left side neck under ear when he lift his head upward.. another one right side neck under ear which is very small...
and we can feel one small swelling on back neck right side which we can only feel when we touch it.

swelling on the back right side neck is only first one which we noticed 1 year back and it is in same level..

as per yesterday physical examination by Doctor , we came to know it is getting reduced.

looking forward to your suggestion.
 
 
Answered by Dr. Pradeep Kumar 6 hours later
Brief Answer:
No need to worry as the reports appear normal

Detailed Answer:
Hi,
Thanks for following up,

I have checked the reports and it appears to be normal.

The throat swabs showing few organisms that are normally present in most of the individuals.
Similarly, chest X-ray also appears to be normal for me although it has mentioned increased vascular markings and impression of allergic bronchitis.

The diagnosis of allergic bronchitis is mainly based on clinical symptoms and this does not correlate with the finding of your child.

Also, the lymph node swelling is common in respiratory infection as mentioned earlier. So you need not be worried for all these.

Regarding low hemoglobin, I would like to get an iron profile done and better to add an iron supplement if the serum iron is low. Babies in this age are very choosy regarding the food items and most of them don't like the iron-containing food items like jiggery-pokery, green leafy vegetables, meats etc.

Give home based high-calorie food with milk and fruits.

I shall be glad to assist you further.
Regards

Above answer was peer-reviewed by
 
Follow-up: on 24th Sep 17 My kid 3 years 6 month 43 hours later
Kid - 3 ½ years , 14 kg
Doctor
thank you once again for your detailed information..
after submit all attached reports to Doctor , we have been prescribed for the following medicines for one moth TABLET R-CINEX [1½ morning Before Breakfast] & Syrup AtoZ [5ml Morning after Breakfast]

we have been informed to take above medicines for 4 week and come after for review. please find attached prescription sheet for your ready reference.

as per blood report , Lymphocyte show 63.80% . it is normal or anything problem.

is it any other test to be taken further for this investigating this or we will continue this medicine as prescribed above.

let us have your valuable guidelines.
 
 
Answered by Dr. Pradeep Kumar 3 hours later
Brief Answer:
Opinion from a different doctor suggested

Detailed Answer:
Hi

Rcinex is Rifampicin and is mainly used in treatment of tuberculosis. Rifampicin can be used as an synergistic treatment with some other antibiotic for staphylococcal infection also.
I am not able to understand why your doctor has started this Rifampicin as there is no evidence of staphylococcal infection. If he has prescribed this as a treatm not of tuberculosis which is also a very common but wrong practice, it should be stopped. ; as there is no evidence of tuberculosis also.
I would suggest you to consult another pediatrician for better evaluation.

Regards
Above answer was peer-reviewed by
 
Follow-up: on 24th Sep 17 My kid 3 years 6 month 4 days later
Kid - 3 ½ years , 14 kg
Doctor
thank you very much for your information.

we are trying to get an appointment with other pediatrician but couldn't due heavy flood in XXXXXXX right now. we will get it soon and consult.

meantime, please confirm that this swelling will get reduce after we finish this 1 month medicines {TABLET R-CINEX KID[1½ morning Before Breakfast] & Syrup AtoZ [5ml Morning after Breakfast]}

self have attached recent photos took today [01/11/17] of this swelling. we feel it got reduced somehow but not sure about it.

concern to my kid , he is very normal and active and taking food and playing without any difficult.

we always need your guidelines and advice in order to take care of kids in better way...

is there any problem to continue this course for one month since we already finished one week course.
{TABLET R-CINEX KID[1½ morning Before Breakfast] & Syrup AtoZ [5ml Morning after Breakfast]}
 
 
Answered by Dr. Pradeep Kumar 11 hours later
Brief Answer:
You may continue same till you get appointment of some other doctor

Detailed Answer:
Hi

Frankly speaking, for me it's very difficult to comment whether the improvement in swelling is due to Rcinex or it is improving itself.
I don't start antitubercular medicine without getting any clue for tuberculosis which is not there in your child's case.
As you have seen the improvement after giving medication and personally I have not examined the case I would suggest you to continue medication till you get appointment for some other pediatrician.
In most of the cases when given in appropriate dosage no significant side effect is seen. You may find the change in color of urine that is harmless and improves once medicine is stopped. Other side effect can be flu like symptoms like headache, cough, cold, Nausea etc.

I hope this helps.
Please let me know if you have any more questions.
Regards
Above answer was peer-reviewed by
 
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