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Ear infection with anemia in children - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Average Posted in: Child Health
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3631 Questions
User :   My daughter is 21/2 and have been fairly ill for a few months now. She continually runs a fever about every 3-4 weeks for 3-4 days. She has had ear infections and strep throat multiple times. She now has tubes in her ears because of the infections, which they thought was the cause of her sickness. However, since her tubes she has had 3 episodes of fever. She is pale, very tired, complains of leg pain and is irritable. I finally convinced her P.A. to do blood work and here are are results. She did test positive for Mono, but I am worried there is more there and she should probably see another Doctor.Thank you for you help!
WBC- 7.0
RBC- 4.3
HGB- 10.6
Hematocrit- 33
MCV- 77.8
MCH- 24.6
MCHC- 31.7
RDW- 14.7
PLT CT- 172
MPV 6.7
NEUT%- 45.7
MONO%- 20.7
BASO%- 2.6
NEUT AB- 3.2
MONO AB- 1.4
BASO AB- 0.2
Carbon Dioxide- 19.0
Creatinine- 0.4
AST- 41
Doctor :   I am Dr.
User :   Hello Dr.
Doctor :   Hi
User :   Were you able to read the labs?
Doctor :   Due to technical difficulties, we have extended your time and offered you 24 hrs package.
Doctor :   please be patient
User :   Does that mean you are unable to answer right now?
Doctor :   I will answer your questions now
Doctor :   How is old is your duaghter?
User :   Ok here are her lab tests again. WBC- 7.0RBC- 4.3HGB- 10.6Hematocrit- 33MCV- 77.8MCH- 24.6 MCHC- 31.7 RDW- 14.7 PLT CT- 172 MPV 6.7NEUT%- 45.7 LYMPH%-30.0MONO%- 20.7EOSIN%-1.0 BASO%- 2.6 NEUT AB- 3.2 LYMPH AB- 2.1 MONO AB- 1.4 EOSIN AB- 0.1 BASO AB- 0.2 SED RATE- 28Carbon Dioxide- 19.0Creatinine- 0.4AST- 41
User :   She is 2 1/2
Doctor :   ok
Doctor :   she is anemic
Doctor :   WBC count is normal
Doctor :   She has chronic era infection
User :   We had tubes put in her ears and now she no longer has them but she is still very sick. She complains of leg pain, is very tired, pale and complains of headaches.
Doctor :   The ear infections , some chronic are very common in children due to short Esustachian tubes
Doctor :   But your child is already on the artificial tubes to ventilatre the middle ear
User :   yes
Doctor :   Insppite of that, kid is getting frequent infections
User :   Yes
User :   She is not getting ear infections any longer, but she is still getting sick.
User :   Often fever without any other signs.
Doctor :   So you do not notice any discharge fromnise or ear?
User :   Her PA said she tested positive for mono, but my concerned it could be Leukemia with her low MPV, Lymphocytes and Esosins. Also she has high Monocytes
User :   No her ears seem perfect. The ENT said they look great.
User :   She also had elevated liver enzymes and her stomach is very distended.
Doctor :   Mono test for 2-.5 years kids make so sense
Doctor :   Get EBV anbibodies
User :   She did a mono spot test.
Doctor :   Do you have liver enzymes
User :   Would that be the AST? If so it is 41.
Doctor :   ASt ALT, Bilirubin
User :   Alt is 19
User :   Bilirubin is 0.3
Doctor :   They are with in normal range except ASt whci is slighly high
User :   Is that a concern?
Doctor :   so whatPA want to do with the Mono spot test?
User :   She said her liver enzymes were elevated due to damage possibly caused by mono.
User :   She used it as a confirming diagnosis
Doctor :   Please do not worry. Mono is not speficid test. in children of 2.5 years doing monospot test is not really useful
User :   The part that worries me is that she show all the physical symptoms of Leukemia. Along with a few abnormal results on her blood test.
Doctor :   The differential count is normal
User :   I am not sure what that mean. Sorry.
Doctor :   Your PA is fooling you
Doctor :   Neutrophils, esiphils, monscyes are with in nomrql range
User :   On her labs it says her Neut are 45.7 and normal is 25-35
User :   eosin is 1.0 normal is 2.0
Doctor :   eosin is 1.0 normal is 2.0 >>>>>>>>sligh allergy cause it
Doctor :   Neut are 45.7 and normal is 25-35 >>>>>>chornicinfections elevate neutrophils
User :   and monocytes are 20.7 and normal is 2.0-8.0
Doctor :   monocytes are 20.7 and normal is 2.0-8.0>>>>>>>>>>Mono cytes are levated in chornic infections
User :   So do you think leukemia should not be a worry?
Doctor :   what u told me neutrophils, moniscyes eso is called differential count
User :   So do you think leukemia should not be a worry?
Doctor :   Abnormal differential count is very common in chornic infections
Doctor :   But if u look at the couts are also they are not that huge
Doctor :   And look at the total WBC count
Doctor :   it is normal
User :   So by the chronic infection do you mean the ear infections? If so how long does it take the counts to return to normal after that is resolved?
User :   Also as far as her anemia, does it seem to be concerning?
Doctor :   Yes
Doctor :   Times is unpredictatable
Doctor :   Some kids willbe be getting infections upto 5 years
Doctor :   it is totally individualised
Doctor :   But having tubes is good
User :   Also as far as her anemia, does it seem to be concerning?
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