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enlarged spleen on a 11 year old boy. hospitalized for

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Posted on Tue, 26 Feb 2019
Question: enlarged spleen on a 11 year old boy. hospitalized for 5 weeks earlier in the year- for EBV
His spleen is measuring 14 right now (per an ultrasound done in December 2018)

He is getting random spleen pains, and also on the right side - same area as the spleen pain just on the opposite side.

His inflammatory markers have been normally high.

His last blood tests done )- XXXXXXX 19, 2019 showed the following:
Mean Platelet- HIGH
C Reactive - HIGH
Sed Rate- HIGH
White Count- down
hemoglobin -down
doctor
Answered by Dr. Diptanshu Das (3 hours later)
Brief Answer:
Needs medical attention

Detailed Answer:
Thanks for using the Ask a Doctor service.

I have gone carefully through your query. Your child has suffered from a viral infection and EBV is one among the many viruses that can give rise to such a presentation. EBV infections are associated with splenic enlargement and it may take some time for this enlargement to subside. The pain on both sides could also be due to costochondritis or inflammation of the cartilage of the ribs and can involve the same region as you have described. It could be a likely sequel of such a viral infection. Since the WBC count is low and the CRP is high, he would best be given an antibiotic coverage.

Wait and watch. Give paracetamol. Talk to your doctor if you need to give ibuprofen. The child also needs to be examined clinically.

Let me know if I could help further.

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Diptanshu Das (17 hours later)
This morning we woke up, started our day- and he ended up with a nose bleed- for about 20 minutes. not gushing, just a continuous small flow. Should this be a concern? I did not send him to school, his energy level is still minimal.
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Follow up: Dr. Diptanshu Das (49 minutes later)
Also is it normal to have an oral temperature reading of 97.1 - 97.3? highest it's been in 2 weeks has been 98.0 and that was 2 hours ago and it went right back down to 97.1
doctor
Answered by Dr. Diptanshu Das (3 hours later)
Brief Answer:
Possibly normal, but get an ENT evaluation done

Detailed Answer:
Thanks for writing back. The nose bleed could be normal but nevertheless calls for an ENT evaluation (unless that has been done already) to rule out nasal pathology like polyps. A coagulation panel also needs to be sent for. Other things that I had said earlier remain valid.

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Diptanshu Das

Pediatrician

Practicing since :2005

Answered : 3828 Questions

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enlarged spleen on a 11 year old boy. hospitalized for

Brief Answer: Needs medical attention Detailed Answer: Thanks for using the Ask a Doctor service. I have gone carefully through your query. Your child has suffered from a viral infection and EBV is one among the many viruses that can give rise to such a presentation. EBV infections are associated with splenic enlargement and it may take some time for this enlargement to subside. The pain on both sides could also be due to costochondritis or inflammation of the cartilage of the ribs and can involve the same region as you have described. It could be a likely sequel of such a viral infection. Since the WBC count is low and the CRP is high, he would best be given an antibiotic coverage. Wait and watch. Give paracetamol. Talk to your doctor if you need to give ibuprofen. The child also needs to be examined clinically. Let me know if I could help further. Regards