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    Suggest treatment for swollen lymph nodes and fever in a child

Posted on Mon, 17 Jul 2017 in Ear, Nose and Throat Problems
Question: Hi, My son is 17 and a swimmer. 2 weeks ago he started feeling like he was getting a cold. By Tuesday night he had a fever of over 103 and his tonsils were swelling. I took him to the ER because the temp when up quickly, They said his lymph nodes were very swollen and verified his high temp at 102.7. Said his ears looked fine and decided to check him for Mono, but that came back negative. They put him on Zithro and sent him home. He took the Zithro, the fever went down but his tonsils got more painful and developed a big white spot on the right side. He said his throat hurt a lot. I took him back to Dr on Friday after he had a fever Thursday night and the white spot got bigger on the right and spread to the left. She did a strep test and that came back negative. She put him on 400 mg Amoxicillin. 5 days later his tonsils were almost completely white and more swollen then before. Took him to urgent care yesterday. Dr took another Mono test came back Negative. She said he was on too low of a dose of antibiotics. She put him on 500 mg Amoxicillin. Today he's in more pain than ever his tonsils are more swollen and his fever is up again. I'm not sure what to do next. Suggestions would be appreciated
Answered by Dr. Michelle Gibson James 1 hour later
Brief Answer:
may need to switch amoxicillin, see ENT

Detailed Answer:
HI, thanks for using healthcare magic

I agree that the dose of the amoxicillin was too low, at 17 he would be at adult doses which would be 500mg.

There is a lot of resistance to amoxicillin (bacteria do not respond to it) which causes it not be effective for some persons, this is the reason that augmentin is sometimes used instead.
Augmentin is amoxicillin plus another agent to help overcome the antibiotic resistance.

High dose augmentin should be considered.

He may want to gargle/spray with an antiseptic/pain killer combination such as chloroseptic gargle/spray or covonia throat spray.

In addition, he may need to see an ENT specialist since symptoms are not improving but are actually worsening for him.
His doctor can refer him to ENT to be seen

I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 16811 Questions


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