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Is it leukemia or other infection?

my 2 year old son had a low grade fever that would spike to 103-104 at least twice a week for the past month. After his WBC read 19 his pediatrician gave him a shot of rocephin, two days later his wbc was the same and he got another then had a chest x-ray that came back clear. That still didn t help so he was put on oral anibiotics of 1000mg per day. Now it has been 1 month and his lymphnodes on both sides of his neck and his groin are swollen, this started at the end of the antibiotics. They have been swollen for 2 weeks with no signs of going down. Through all of this he had extensive blood work tested and I am starting to doubt the competence of the pediatricians results. Here is the result of the metabolic panel: Protein 6.8 Albumin 3.6 (L) Calcium 9.8 Sodium 138 (L) Potassium 4.4 Chloride 103 COZ 22 BUN 5 (L) Creatine .4 Glucose Nonfast 85 ALK Phosphatse 230 AST 45 (H) ALT 23 Total Bilirubin .1 (L) Here is the CBC W/Manual Diff: WBC 19.7 (H) Red Blood Cell 4.60 Hemoglobin 12.2 Hematocrit 36.7 MCV 79.8 MCH 26.5 MCHC 33.2 Platelet Count 359 MPV 6.1 (L) RDW 14.1 NEUT 66.3 EO .2 BASO .3 LYMPH 23 MONO 10.2 LYMPH Count 4.5 Mono Count 2.0 (H) Neut Count 13 (H) EO Count 0.0 BASO Count .1 DIFF TCTCH Test: RBC Morphology - Normal Platelet Estimate - Adeq Segmented NEUT 58 Lymphocytes 20 Band Neut 13 (H) Monocytes 7 Reactive Lymphs 2 SED Rate 17(H) This blood work was performed after the 2 shots of rocephin. We just had another in office CBC 2 days ago and his WBC is still 12.2, MCH 26.3, MCMH 32.4, LY% 63.7, LY# 7.8. Are we missing anything or should we pursue this further and get a second opinion?
Asked On : Thu, 7 Apr 2011
Answers:  2 Views:  428
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Lab Tests
  User's Response
I would encourage you to get a second opinion. I am not a doctor, just a grandma who's 5 year old grandson was diagnosed with ALL 5 months ago. If not for an "on the ball" pediatrician it would not have been caught until he was a very sick little boy. His pediatric oncology/hemotoligist has told us several times that we caught this very early. His only symptom? A cough that wouldn't go away. The PA ordered a white count, put him on iron drops and after 30 days his white count did not go up refered us to UNMC in Omaha. Within 24 hours of our first appointment tests had been done and a diagnosis reached. I am praying that this will not be your son's diagnosis as it is a very bumpy road to travel. God bless you both.
Answered: Sat, 16 Apr 2011
Hematologist Dr. Anthony Oyekunle's  Response
Its good that you gave details of the CBC. The 1st one shows elevated counts, with differentials that do not support a diagnosis of a leukemia, and the 2nd one shows a reducing count, which is a good sign.
However, I'm not totally happy with the absolute increase in the lymphocyte population, and the appearance and persistence of lymph nodes. As you may know, diseases may sometimes be in evolution, so it is important to keep track of these 2 parameters (say weekly). I'm sure most doctors can tell when they refuse to return to normal.
Answered: Sat, 23 Jul 2011
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