Resolved question:
Our 5 week year old baby has a swelling on he ear lobe and the swelling continues down to her jawline on her face. She has a temperature of 98.8 You can feel a bump the size of a finger tip right under her ear lobe
Submitted:
4 Days
Category:
Pediatrician
Hello,
Thank you for your query at DoctorSpring.com
This seems to be of significant concern in a 5 week old baby. This swelling appears to be a lymphadenitis (lymph node swelling). Lymph node swellings are due to infections of a draining area, which in your child's case include ears, throat, etc. The fact that she is running low grade temperature (not qualified as fever). She needs to be taken to a pediatrician, where the following needs to be done urgently:
1. Ear examination using an otoscope
2. Throat & tonsil examination
3. Ultrasound examination of the local region for any pus collection/abscess formation.
4. C-reactive protein, total leucocyte counts, absolute neutrophil counts, etc for any evidence of systemic infection
Child may require IV antibiotics if any evidence of infection is identified. May even require surgery/ abscess drainage if there is a collection of pus.
There is a small chance that this could be due to a MUMPS-like illness, but mumps-like illnesses are unlikely in a 5 week old as the maternal antibodies protect the baby from such infections. Unless the mother or baby is immunocompromised, it is highly unlikely.
Feel free to discuss further,
Regards
Dr. Saptharishi L G
thanks for your response. Is this something that can wait until Monday morning since its late Saturday evening here? Or do we need to go to the emergency room tonight? ALso are there any other symptons to look our for that may further indicate there may be an infection or lyph node swelling? She seems to be eating as normal still. ALso she has acne right now, is that related to the lymp node swelling?
Thanks
Hello,
I need to emphasize that sitting across thousands of miles, there is no way, one can make an absolute judgement regarding the level of sickness of a 5-week-old. Anyone claiming to do is grossly under-estimating how quickly a baby of this age can deteriorate.
Having said that, any signs of poor feeding/ lethargy/ fever/ cool peripheries/ decreased feeding/ decreased urine output/ increased stools/ diarrhea/ change in normal pattern of behavior can be subtle signs of an underlying infection. These, when present indicate that the baby could be harboring an infection. However, their absence does not rule out an infection and definitely should not push us into complacency.
I have been dealing with such cases for many years now. In my experience, you should go to the pediatric emergency immediately. It may happen that nothing serious is detected and everything turns out to be fine. That is the best situation for the baby and the family. But the alternate situation of a parent going to the pediatrician after nearly 48 hours only to find that the infection has advanced or child's life is at risk, is something that I never would want for any of my patients.
Take care
Regards
Dr. Saptharishi