QuestionMy daughter is 12. She has had swollen lymph nodes/glands for about a week now. I took her to the pedi about a week ago because her node on the right side was swollen and painful, also because she complained of a sore throat. Her strep test was negative, and we were sent home. Since then, the nodes further back on her neck, and at the top of her collar bone area are enlarging, and the lymph node that was originally swollen is twice the size it was a week ago. What could be causing this?
AnswerDear Tina,
I would recommend taking your daughter back to your pediatrician for a complete re-evaluation of your daughter. Lymph node enlargements, referred to as lymphadenopathy, may be caused by various diseases - from viral infections to cancer growth. In a 12-year-old female, pediatricians usually try to rule out infectious causes - such as bacterial and viral infections. For streptococcal infections causing strep throat, a throat is usually not effective as it may not be a source to conclude a strep infection. A rapid strep test may be more accurate for immediate diagnosis of strep throat. However, if your daughter has no fever and white spots intraorally (you can check by examining inside her mouth. take a look at her tonsils with a flashlight. The tonsils are located in the back of the throat. If you see white spots with a large swollen tonsil, then, it may well be a bacterial infection. To determine if it is swollen is to observe a difference in color. Swollen objects, like the tonsil is usually darker reddish pigment versus the color of the inside cheek).
In 12-year-olds, pediatrician have to rule out mononucleosis. Mononucleosis is a viral infection that is self-limited and needs of treatment. However, the infection may sustain for up to 12 weeks duration. This may be a social problem for your daughter. Mononucleosis is contracted through kissing or saliva/fluid exchange with another infected individual.
The last thing that I am particularly worried about is a malignancy. Childhood malignancy - lymphomas (non-Hogkin lymphoma)- presents itself with enlarged lymph nodes that may mimic a strep throat with fever, sore throat, and pain. Since you've stated there are lymph node enlargements on her collar bone, it may suggest her body's immune system's reaction. Your pediatrician may have performed various blood tests to rule out any malignancies.
Again, it is in your best interest to have your daughter re-evaluated by her pediatrian. Write down your questions prior to coming to see her pediatrician. Address your concerns appropriately and ask specific questions. It is also your right to seek a second opinion from another pediatrician with the assistance of your insurance company.
Regards,
John
