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Asked by kristastlouis - 6 years ago
My one year old son has had swollen lymph nodes on one side of his neck since he started getting teeth, they are still swollen. Is this normal or should I take him to a different doctor?
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smohpal Level 22 / ENGINEER
Answered 6 years ago
1
Tiny vessels called lymph vessels carry germs, foreign particles, and unhealthy or malignant cells to the lymph nodes, where they are trapped. Active lymph nodes enlarge as they attempt to destroy the unwelcome material.

The lymph nodes also function as schools. Lymphocytes, a type of white blood cell, study the foreign material so that they can produce antibodies, killer cells, and other substances to protect the body from the threat.

Sometimes the lymph nodes are overwhelmed in the process. Our defenders can be taken over by a cancer or an infection. These enlarged nodes can become a refuge where the invaders can hide and proliferate.


In a newborn infant, the lymph nodes are often small enough and soft enough not to be felt. But by the time a baby is several months old, healthy, growing, learning lymph nodes are frequently obvious enough to be noticed by parents -- to their alarm.

When evaluating enlarged lymph nodes the first consideration is whether these nodes are localized (in one or two adjacent regions of the body) or generalized (spread throughout the body, often including the spleen -- the largest lymph node -- which is found just under the rib cage in the left upper part of the abdomen). Generalized enlarged lymph nodes suggest that the body is responding to a whole-body problem, such as an infection (bacterial, viral, or fungal), an autoimmune disease (arthritis or lupus), a drug reaction, or a malignancy such as leukemia. The infection might be very mild, or might be as serious as HIV.

Localized enlarged lymph nodes are responding to events in the part of the body filtered by those nodes. A scratch on the finger can produce swollen nodes at the elbow and /or the armpit. Minor trauma to the foot is filtered by nodes behind the knee and in the groin.

The localized nodes most often noticed by parents are those around the head and neck. They frequently grow in response either to the mouth organisms that enter the body during teething, or to the tiny particles that get into the scalp from a baby's lying down most of the day, or to respiratory infections of all kinds (ear infections, colds, sinus infections, etc.) -- or, to some combination of these.

Much less commonly, head and neck nodes can grow from cat-scratch-fever, tuberculosis, drinking unpasteurized milk (mycobacterial infections), or eating undercooked meat (toxoplasmosis). They can also grow from an isolated malignancy, such as a lymphoma.

Many people have a sunny attitude toward "swollen glands," not believing they will really be serious. Others believe these lumps to be harbingers of doom. The truth is somewhere in between. Most of these situations turn out to be fine, but enlarged lymph nodes should be respected.

When should you be concerned?

When examining your child, your physician will pay attention to several important signs:


Location -- enlarged lymph nodes just above the collar bone often indicate serious disease.
Character -- nodes that are hard, non-tender, and irregular are very suspicious. Normal nodes are mobile beneath the skin. Fixed nodes, those that are firmly attached either to the skin or to deeper tissues, are often malignant. Nodes that are tender, inflamed, or rubbery in consistency usually represent an infection.
Growth -- enlarged nodes that continue to enlarge rapidly should be evaluated rapidly.
Associated symptoms -- fever, night sweats, or weight loss accompanying enlarged lymph nodes should be investigated thoroughly.
Size -- size does matter! The definition of an enlarged lymph node is size larger than one centimeter (0.4 inch) in diameter. Pea-size lymph nodes are not enlarged, even if you didn't feel them there before. Any node that is larger than 1cm in diameter should be followed closely by a physician. It should shrink noticeably within 4-6 weeks, and should be less than one centimeter within 8-12 weeks. High-risk enlarged nodes are those larger than 3cm (more than an inch) in diameter.

If lymph nodes remain truly enlarged for more than 2 weeks, or if other worrisome signs are present, then the next steps of evaluation include a complete blood count (CBC). Isolated anemia is not usually a problem, but anemia with unusual white blood cell count or platelet number is worrisome. An abnormal CBC can be diagnostic of leukemia and lymphoma, but it is important to note that most children with neck malignancies have normal CBC's.

Other simple tests include a sedimentation rate (a general blood test that indicates whether something significant might be going on in the body as a whole), blood chemistries (LDH is often elevated in malignancies, AST and ALT are often elevated in infections that cause enlarged lymph nodes), and a tuberculosis skin test. Depending on the results, other studies might include tests for specific illnesses (mono or HIV), and an x-ray or an ultrasound to get a better picture of what is going on.

If the node remains enlarged (greater than 1cm) for 2 to 3 months, or continues to grow after 2 weeks, then a biopsy of the lymph node is indicated, unless the physical exam and lab tests are convincingly reassuring. At least half of the time, a biopsy does not reveal a definite cause for the enlargement, but the biopsy can rule out cancer and other serious problems.
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Jess Level 9
Answered 6 years ago
1
From http://www.drgreene.org/body.cfm?id=21&a...

"In a newborn infant, the lymph nodes are often small enough and soft enough not to be felt. But by the time a baby is several months old, healthy, growing, learning lymph nodes are frequently obvious enough to be noticed by parents -- to their alarm.

When evaluating enlarged lymph nodes the first consideration is whether these nodes are localized (in one or two adjacent regions of the body) or generalized (spread throughout the body, often including the spleen -- the largest lymph node -- which is found just under the rib cage in the left upper part of the abdomen). Generalized enlarged lymph nodes suggest that the body is responding to a whole-body problem, such as an infection (bacterial, viral, or fungal), an autoimmune disease (arthritis or lupus), a drug reaction, or a malignancy such as leukemia. The infection might be very mild, or might be as serious as HIV.

Localized enlarged lymph nodes are responding to events in the part of the body filtered by those nodes. A scratch on the finger can produce swollen nodes at the elbow and /or the armpit. Minor trauma to the foot is filtered by nodes behind the knee and in the groin.

The localized nodes most often noticed by parents are those around the head and neck. They frequently grow in response either to the mouth organisms that enter the body during teething, or to the tiny particles that get into the scalp from a baby's lying down most of the day, or to respiratory infections of all kinds (ear infections, colds, sinus infections, etc.) -- or, to some combination of these."

From http://www.associatedcontent.com/article...

"In teething infants or those with ear infections, the lymph nodes around the head and neck will become noticeably swollen."

It is normal that infants do get swollen lymph nodes during teething. Glands that are swollen and are not red or tender are usually not anything to worry about, and they will usually return to normal one to two weeks after the infection resolves, but it may take months, especially in preschool or school age children. Talk to your doctor if your child has swollen glands all over his body, if he has swollen glands and is having nightly fever or is loosing weight, or if he has a swollen gland that is continuing to enlarge or is not going away after a few weeks.
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Richard Level 73 / Retired Dentist
Answered 6 years ago
-
I think we can assume from your question that the nodes are larger than 1 centimeter and that they have persisted for more that a few weeks. If both these conditions are true, then this is not normal and your son has a chronic infection and should be treated. (A tumor is also a possibility, anything else is extremely rare.)
While It is true that these are the nodes that would be swollen from an infection involving the teeth and surrounding gingiva, The infection could be from other areas also.
worriedsick Level 37 / R.T.(R)(M), BS
Answered 4 years ago
1
Teething can cause an inflammatory response in the body. The gums are inflamed and irritated, and this can trigger a response throughout the lymphatic system. Sometimes an underlying infection can coincide with the teething and can be written off as part of the teething process. A slight fever can sometimes be associated with teething, which can be treated with children's tylenol.

Sometimes other issues can be easily attributed to teething, but are in fact, not part of it at all. Please copy and paste the site below and read about this. After doing so, see your pediatrician and ask some specific questions about the swollen glands, the chance of an underlying infection or the presence of some other process. Do no leave until you are satisfied with your answers. If you still aren't happy, see a different docter for a second opinion.

http://www.parenttime.com/babyarticles/t...
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