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Suggest treatment for swollen lymph nodes in neck and boils on scalp

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Posted on Sat, 22 Aug 2015
Question: hi my 2 year old son is not keeping well since past 20 days. He has 2 swollen lymph nodes in his neck, he is having boils on his scalp, he has 10.80 haemoglobin, 5-7 WBC/hpf pus cells in urine and his urine culture shows 12000 colonies/ml proteus mirabilis . pls tell which disease does this indicate to.. I am extremely worried. His Paed. is giving Topcef for treatment
doctor
Answered by Dr. Diptanshu Das (41 minutes later)
Brief Answer:
It could be a soft tissue infection or an urinary tract infection.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through the details provided. However, I would like to know how long the boils on the scalp have been there. An image of the same would be helpful. You can upload the same using the facility on the upper right of this page.

I would also need to ask you to specify what exactly do you mean when you say that he is not keeping well. I mean to ask if there is lethargy or reduced amount of feed intake or reduced amount of urinary output. 5-7 WBCs is not very significant and the colony count is not very high (higher than 1,00,000 colonies per cu.mm indicates urinary tract infection). But if in doubt, it might be wise to treat it with antibiotics like Topcef.

Based on the possibilities, your child could either be suffering from a soft tissue infection of the scalp or a UTI. The scalp infection could explain the cause of the lymph node swellings.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Diptanshu Das (13 hours later)
OK, thank you Sir for the reply. Though I do not have a pic of the boil, but I would describe the boil as a pus filled boil occuring one at a time on an interval of 5-6 days. And the lymph nodes are swollen abt the same time from the onset of the 1st boil. By not being well i meant to say , he sleeps a lot, say about 13-15 hrs a day and is taking almost half of the food what he was taking last month. The weight he has lost is worrisome. He also gets tired very quickly and complains of pain in legs. Dont know if this is due to the infection or any other underlying disease. His blood report has the following parameters...pls see if these indicate towards any other issue..also what can be done to improve his health and immunity. Pls inform if his weight and height are ok as per his age.

Thanks a lot Sir,
XXXX
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Follow up: Dr. Diptanshu Das (1 minute later)
Blood report main parameters:

Hemoglobin 10.80
packed cell vol 34.10
RBC count 5.03
Leukocyte count 5.03
platelet count 225


the report says that the RBC's are mildly hypochromic and microcytic. No parasites, premature cells seen. Platelets are adequate.
doctor
Answered by Dr. Diptanshu Das (8 hours later)
Brief Answer:
Visit a pediatrician and get the child evaluated

Detailed Answer:
Thanks for writing back. Sorry for not being able to respond earlier.
The description of the boil worries me and so does the reduced food intake along with weight loss. You need to visit a pediatrician and get him thoroughly evaluated. A blood CRP (C reactive protein) quantification would be helpful. The mentioned blood report has shows nothing abnormal except for slightly low hemoglobin which correlates with iron deficiency anemia but I would also like to know the differential count.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Diptanshu Das

Pediatric Neurologist

Practicing since :2005

Answered : 3871 Questions

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Suggest treatment for swollen lymph nodes in neck and boils on scalp

Brief Answer: It could be a soft tissue infection or an urinary tract infection. Detailed Answer: Thanks for asking on HealthcareMagic. I have gone carefully through the details provided. However, I would like to know how long the boils on the scalp have been there. An image of the same would be helpful. You can upload the same using the facility on the upper right of this page. I would also need to ask you to specify what exactly do you mean when you say that he is not keeping well. I mean to ask if there is lethargy or reduced amount of feed intake or reduced amount of urinary output. 5-7 WBCs is not very significant and the colony count is not very high (higher than 1,00,000 colonies per cu.mm indicates urinary tract infection). But if in doubt, it might be wise to treat it with antibiotics like Topcef. Based on the possibilities, your child could either be suffering from a soft tissue infection of the scalp or a UTI. The scalp infection could explain the cause of the lymph node swellings. Regards