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Splenomegaly and mesenteric lymphadenopathy in kid with abdominal pain

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my nephew 9 years old having abdominal stomach pain since last 30 days all tests done and are in normal range The USG sonography done twice after medication and both time same findings are MILD SPLENOMEGALY AND MULTIPLE MESENTRIC NODES. WHAT IS THIS PROBLEM. Here all doctors says its infection and antibiotec does not effects.

Category: Family Physician-GP

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Category: Family Physician-GP
 32 Doctors Online

Hi,
Thank you for your consult at DoctorSpring.com.

Does he has fever/ diarrhea/ constipation/ bleeding per rectum/ vomiting and nausea?

With the available described details, there appears to be high chances of infectious etiology.

Splenomegaly with enlarged lymph nodes could be associated with viral and bacterial infections. Epstein Barr virus, CMV, Yersinia enterocolitis, Campylobacter jejuni infection could be associated with defined pathology.

You should consult with Pediatrician and hematologist simultaneously and should go for thorough check up.

He should go for complete blood count, erythrocyte sedimentation rate, peripheral blood film, Quantiferon TB gold analysis, serology analysis of EB virus, and CMV virus.

As the disease remains undiagnosed after so many investigations, exploratory laparotomy with excision biopsy of mesenteric lymph nodes appears to be necessary.

Culture sensitivity of excised tissue also appears to be mandatory.

Treatment depends on exact diagnosis.
Meanwhile, he should take broad spectrum antibiotics i.e. quinolones, azithromycin, and ESBL sensitive antibiotics under guidance of treating doctor.

Take care,
Let me know your other associated query.
Wishing a speedy recovery.
Dr. Mayank Bhargava


Dr. Mayank Bhargava
Category: Family Physician-GP
Experience: 
Fellowship: Gastroenterology, Chotiram Hospital & Research centre, Indore, 2009
Residency: General Medicine, Rajasthan University Jaipur, 2008
Medical School:  MBBS, Rajasthan University Jaipur, 2004
Dr. Mayank Bhargava and 4 other Medical Specialists are ready to help you

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