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Abstract: Lymph nodes, or swollen lymph nodes, are divided into superficial and deep lymph node enlargement. Today, this child came to the clinic with symptoms such as abdominal pain and nausea, and was diagnosed with deep lymph node enlargement due to acute mesenteric lymphadenitis after examination. After treatment with famotidine tablets and ceftazidime for injection, the swollen lymph nodes gradually subsided, and the symptoms of nausea, abdominal pain and vomiting improved, with all indicators returning to normal.
Basic information】Female, 7 years old
Disease Type】Acute mesenteric lymphadenitis
Hospital】The First Affiliated Hospital of Kunming Medical University
Date of Consultation】July 2021
Treatment plan】Medication (Famotidine tablets, Bifidobacterium triptans, ceftazidime for injection)
Treatment Period】4 days hospitalization, 6 months follow-up
Treatment effect】Lymph node swelling subsided, nausea, abdominal pain, vomiting and other symptoms improved, and all indicators returned to normal
I. Initial consultation
The parents brought their child to the clinic, saying that the child had abdominal pain half a month ago, which was paroxysmal in nature, showing pressure and rebound pain around the umbilicus and lower abdomen, with variable pain points, accompanied by vomiting and nausea, with no obvious correlation with food intake, occurring 3-4 times a day, without symptoms such as fever and chills. After 5 days of treatment at a local hospital with no signs of improvement, he came to our clinic and was admitted with vomiting and abdominal pain for investigation and treatment. Since the onset of the disease, the child slept well, had no significant abnormalities in stool or urine, and had a poor appetite. After a physical examination, no signs of acute infection such as bilateral enlarged tonsils and congested pharynx were found, and no other obvious abnormal signs were detected. The diagnosis of acute mesenteric lymphadenitis was confirmed.
II. Treatment history
After communication with the family, the child was given oral Famotidine tablets for gastric protection and ceftazidime for injection for anti-infection treatment, and oral Bifidobacterium trituberculatum to regulate the intestinal flora to improve the gastrointestinal environment. In addition, rehydration with sodium chloride glucose injection was used to supplement the dehydration and electrolyte disturbance of the body due to diarrhea and vomiting.
III. Treatment effect
After treatment in our hospital, the child’s symptoms of nausea, abdominal pain and vomiting gradually improved, and he was in good spirits without fever. Feeding and urination and defecation were normal. The abdomen was flat and soft, and there was no longer rebound pain or pressure pain. Bowel sounds were normal, and the liver and spleen were not felt under the ribs. The lymph nodes were also swollen. After 4 days of hospitalization, the child’s body indexes had completely recovered and met the criteria for discharge, and the child was allowed to go home with medication for recuperation. The parents were instructed to follow up with the child for six months.
Notes
We are glad that the child’s condition has improved after treatment, but we still need to remind the child to pay attention to the following matters in daily life.
1, pay attention to diet, eat less spicy, greasy, cold and other stimulating food, you can drink some millet porridge, noodle soup and other light, well-digested food. Eat food must ensure clean and hygienic to prevent re-infection.
2. In daily life, you need to actively exercise and strengthen your body, and pay attention to strengthening care, maintaining indoor hygiene, ensuring that your home is always ventilated, and paying attention to personal hygiene to prevent cross-infection.
3.After discharge from the hospital, take the medication as prescribed by the doctor, and come to the follow-up clinic in time if there is any discomfort.
V. Personal insight
Acute mesenteric lymphadenitis is a disease caused by bloodstream infection with streptococci, resulting in enlargement of mesenteric lymph nodes with multiple congestions, which is common in children or adolescents. Acute mesenteric lymphadenitis often involves the lymph nodes at the end of the ileum, so the child’s abdominal pain usually occurs around the umbilicus and in the lower and middle abdomen. In this case, the child did not develop septic mesenteric lymphadenitis because he came to the hospital in time, so he only needed medication.