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What causes enlarged occipital nodes on scalp in an infant?

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Posted on Tue, 24 Nov 2015
Question: My 14month old son has 3 enlarged occipital nodes on the back of his head. I took him to his ped a week ago who checked them. She noted that they are soft & move, yet not tender or warm. They seem quite firm to me, though. She wasn't worried & said they are probably due to an old bug bite. I don't remember any bites as my son is bald & he has absolutely no scalp condition of any kind. No treatment was given.

She would like to check him again in about 6 weeks. In the past week the nodes are noticeably larger, but do seem to have leveled off. He has a quite noticeable mass sticking off of his head-close but not quite kidney bean sized. My son is healthy and energetic, yet has always been in the 10th percentile in h/w & now is a bit smaller. 21 lbs at 14 1/2 months. He does not have a good appetite and still nurses.

I'm concerned about the lumps & am not sure about waiting 6 weeks for a re check. I'm thinking of waiting another 2 weeks & getting checked again if they have not started to shrink. Am I being too much of an alarmist?
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
You are not allarmist?

Detailed Answer:
Hi.
Thanks for your query and an elucidate history related to your son who is 14 month old.
Also read that he has 3 enlarged occipital nodes on the scalp, taken to the Pediatrician - She has said that the nodes are still XXXXXXX non-tender and has normal temperature and hence not given any treatment.

I can understand the apprehension you must be going through and need an active treatment just to make this sure that there is nothing to prove or rule out.

I would advise you the following:
Take a second opinion of another Pediatrician or Pediatric Surgeon if available for clinical evaluation, examination and investigations.
FNAC under the guidance of Ultrasonography.

I hope this answer helps you to get a proper diagnosis, and get a proper further treatment. Please feel free to ask for more if you need to or if you feel that there is a gap of communication.
...
I hope this answer helps you to get a proper diagnosis, and get a proper further treatment. Please feel free to ask for more if you need to or if you feel that there is a gap of communication.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (2 days later)
Thank you for your response & I took my don in this morning to another ped in the same practice. My son has run a low fever for several days, anywhere from 99.5-100.8. At least one of his nodes seems much larger & lumpy, and now there are 4 enlarged instead of 3 in the same area.

The dr could also feel some shoddy nodes in his groin as well as the top if his spleen. She felt that he needed blood work (stat at hospital) just in case, but felt that it was probably viral as my son appears healthy.

Blood work was completed, dr called & said wbc was 16000, mildly anemic (11), but everything else looked normal & the blood work suggests a viral infection. Inquired if my son was exposed to mono-I have no knowledge that he has. No treatment prescribed.

She wants to see him in about 10 days to recheck his spleen. While I am grateful that the blood work does not indicate anything worse, my son does have these frightening looking lumps protruding from the back of his head and seem to be getting worse, not better.

Is it typical for a virus to continue growing in this manner? I know that there is no treatment for viruses, yet it's a bit unnerving that it's already been 9 days since the nodes were noticed & they've only gotten worse, not better.
doctor
Answered by Dr. T Chandrakant (4 hours later)
Brief Answer:
I think the baby needs antibiotic and anti-inflammatory

Detailed Answer:
Thanks for your feedback.
The combination of running fever, increase in size and numbers of the swelling and count of 16000 is an indication that there is a bacterial infection and your child needs a proper course of an antibiotic and anti-inflammatory medicines.
Viruses do not cause such lumps and in fact may reduce the WBC counts.

I think you have to consult your Doctor now or take another opinion and get started with proper treatment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (3 hours later)
Thank you. I will do so immediately!
doctor
Answered by Dr. T Chandrakant (54 minutes later)
Brief Answer:
Great,

Detailed Answer:
You are most welcome.
Please give feedback.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19254 Questions

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What causes enlarged occipital nodes on scalp in an infant?

Brief Answer: You are not allarmist? Detailed Answer: Hi. Thanks for your query and an elucidate history related to your son who is 14 month old. Also read that he has 3 enlarged occipital nodes on the scalp, taken to the Pediatrician - She has said that the nodes are still XXXXXXX non-tender and has normal temperature and hence not given any treatment. I can understand the apprehension you must be going through and need an active treatment just to make this sure that there is nothing to prove or rule out. I would advise you the following: Take a second opinion of another Pediatrician or Pediatric Surgeon if available for clinical evaluation, examination and investigations. FNAC under the guidance of Ultrasonography. I hope this answer helps you to get a proper diagnosis, and get a proper further treatment. Please feel free to ask for more if you need to or if you feel that there is a gap of communication. ... I hope this answer helps you to get a proper diagnosis, and get a proper further treatment. Please feel free to ask for more if you need to or if you feel that there is a gap of communication.