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Child diagnosed with mono. Was taking steroids. Puffy, swollen neck and jawline, Lump feeling in throat. Normal? Return to doctor?

My 12 year old daughter was diagnosed with mono last week. She has finally returned to school, because she no longer has fever. Her steroid pack was finished yesterday. Today she woke up with a very puffy, swollen neck and jawline, and she is complaining of a lump feeling in the base of her throat, making it feel as if she is choking on something. She is also extremely nauseous...more so than last week, has continual pain in her spleen area, and a constant headache. Is this all normal? Should she return to the doctor?
Asked On : Fri, 12 Apr 2013
Answers:  2 Views:  45
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Pediatrician 's  Response
Feb 2013

Thank you for your query on Healthcare Magic.

This spectrum of puffy swollen neck and jawline and complaining of lump in the base of throat are due to enlargement of lymph nodes and lymphoid tissue which is classically seen in mono in the second week after 1 to 2 weeks of a prodrome of fever.

This swelling is not normal and because of this swelling there may be obstruction to breathing if it increases further.

The pain in splenic area is due to enlargement of spleen.

Avoid contact sports and play as to prevent injuries which may cause injury to enlarged spleen.
Therefore I advise you to consult ER or your Pediatrician as early as possible to assess the throat and to look for any impending respiratory obstruction.

Hope I have answered your query.

Answered: Sat, 13 Apr 2013
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Pediatrician Dr. Sanjay Sharma's  Response
Hi Deanna,
Thanks for placing your query through HCM.
I can appreciate your concerns.
Swelling in the neck & swallowing difficuly is due to enlarged lymph nodes of tonsils & nearby area.
Continual pain in spleen area is also worrisome as in mono the spleen gets enlarged & is very fragile & has a tendency to rupture even with a trivial insult.
you should imediately take her to ER.
Hope I have answered your query.
Wish her a speedy recovery.
Answered: Fri, 12 Apr 2013
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