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16 month baby having swollen lymph node in groin area. Having fever and cold. Is this due to vaccination?

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My 16 month old daughter has a swollen lymph node in her right groin area. It is about the size of a marble and very painful. She had a fever and upper respitory symptoms (a cold) about a week ago but was better. Maybe a lingering runny nose but other than that, playing and eating as usual. We discovered the gland about 3 nights ago whene she would not put pressure on her right leg. Everytime she tried, she would cry and fall to the floor in pain. After finding the painful gland I gave her ibuprofen and she went to sleep. By the morning she seemed fine. She seemed to only have a bit of a cough and stuffiness left over from last week. No fever or pain in her groin. She was running and playing as usual. The last two days have been normal, lots of play and eating and fun. All of the sudden tonight she stood up and once again fell to the ground crying.She limped and she looked like she was really in pain. I looked and discovered the marble size lump had returned. It is hard, only on her right side, located in the crease where her leg meets her genital area. It's only 1 gland that's affected and it's very painful to the touch. I don't understand why it would come and go like that. What could it be? She did recieve her routine vaccinations about a month ago, could it be a result of that? She has never had a reaction before.
Posted Mon, 27 Aug 2012 in Child Health
Answered by Dr. Taher Kagalwala 1 hour later

Thank you very much for posing a query on XXXXXXX It appears to me that this is, as you rightly surmised, a lymph gland. A groin gland usually occurs when an infective or inflammatory process develops in the leg below the gland, for example, on the foot, from playing bare-footed in the garden. This process may be a small injury, or an infection ... e.g.. of the bed of a toe-nail. I recommend that you check her carefully for any evidence of these; if found, they will need to be seen by a doctor, who may want to treat it with specific medication.

Vaccines are usually given on the outer aspect of the mid-thigh in children, and would NOT cause glands to appear in the groin. In addition, if a gland were to appear, the site where the injection was given would also be red, painful and swollen. This does not seem to be the case with her.

If you are unable to discover any injury or infection on the foot/toes/heel, you might want to take her to the A & E for an examination.

The other, more worrying possibility is that this might be an outpouching of a hernia from within her abdomen - with a bowel loop emerging out from an enlarged abdominal muscle gap - and getting stuck. This is called an irreducible hernia - and usually will produce not just local pain, but digestive symptoms like vomiting and failure to open bowels. I have seen sometimes that when the baby sleeps, the intestine may shrink sometimes and go back "inside" so that the pain disappears completely, and the swelling too. Then, when the baby is upright, the bowel may re-emerge, and if she eats food or has gaseous content, the bowel may get stuck again.

If there is any doubt in your mind of this second, more problematic possibility, please go urgently to her pediatrician when the pain and the swelling are present.

Do revert to me when you have further clarifications to seek.

Best wishes for your little one, and warm personal regards to you and her father.

-Dr. Taher
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