R.L.
Hi Gamma G,
Swollen lymph nodes are an indication that the body has mounted a substantial immune defense against an invading pathogen (so is the fever). The swelling is caused by the increased production of a variety of immune cells, especially different types of immune messaging cells and a variety of T cells. Considering that at least three members of your family have the same symptoms, it's more likely that you're all fighting a viral infection than a bacterial one. Influenza Type C is fairly prevalent at this time of year, and can cause the symptoms you're describing, as can a whole host of other upper/lower respiratory viruses.
K-flex was probably prescribed because the ER doc didn't want to miss treating a possible primary or secondary bacterial infection and was hedging his/her bets (unless there was a clear sign of bacterial infection, such as a positive rapid strep test, purulent wound, or obvious bacterial colonies in the throat). Unfortunately, this kind of poor antibiotic stewardship is a leading contributor to the rise in antibiotic resistant organisms, such as MRSA and MRSE. (Too bad the PCT test is still not approved for general diagnostics in the US yet -- it's very good at differentiating viral from bacterial infection.) If there's no bacterial infection, the K-flex will do nothing -- you're just going to have to be patient and let the virus run its course. Unfortunately, what it could do is cause side effects such as diarrhea and nausea, so I suggest you watch for these symptoms and treat prophylactically with probiotics.
There's not much you can do to treat the pain from the lymph nodes beyond Tylenol and Motrin. You can safely give both drugs interchangeably every 3 hours, but do be very careful with the Tylenol and don't exceed the recommended dose, as it can cause liver damage. Don't add in any other analgesics, as any other drugs will be the same class as either Tylenol (acetaminophen, e.g. Paracetamol, Panadol) or Motrin (ibuprofen, e.g., Advil, Caldolor, EmuProfen). Definitely do not give aspirin, as it's been linked to Reye's Syndrome when given in conjunction with a viral illness. (If anyone recommends willow bark tea or slippery elm tea as natural remedies, don't use these either -- they're both natural sources of salycilic acid -- the active chemical in aspirin.) Cold drinks, popsicles and cold packs applied to the neck can also help to reduce inflammation and relieve the pain of swollen glands, and you might try juicing some celery, as it contains a natural mild anaesthetic. You can also use cool (not cold) baths to help alleviate fever. Heat can help with congestion. The sudafed probably helped you because it's a general vasodilator and decongestant. Don't just start using a bunch of over the counter meds, though. Talk to your doctor or pharmacist about appropriate medications for your illness
One poster mentioned using steroids to treat EBV (Epstein-Barr virus). This is pretty extreme, and not likely to apply to your family. EBV rarely causes overt symptoms in children, although can cause severe symptoms in adolescents and adults. About 60 -70% of children in this country will contract EBV before the age of 10 and never know it. About another 10 - 20% will get the virus as a teen or adult in the form of infectious mononucleosis (but other viruses, such as CMV, can also cause a type of infectious mononucleosis). Since your daughter has severe symptoms, it's unlikely she has mono, but if you're really concerned, you can always request testing, especially if she has or develops a swollen and tender tummy. EBV (and a number of other viruses) can cause a type of hepatitis (liver inflammation -- swelling and tenderness will be in the upper right abdomen just beneath the ribs) as well and inflammation of the spleen (swelling and tenderness will be in the upper left abdomen, beneath the ribs and lower), both of which need to be monitored. I'm assuming the ER doc checked your daughter's throat though, and didn't see signs of EBV, which are usually pretty obvious.
What you do want to watch for is a combination of symptoms that can indicate the illness has become more severe. If your daughter (or you/your husband) has two or more of the following symptoms together, head back to the ER and tell the doctor you're concerned about SIRS and developing sepsis: fever over 101.3 deg F, rapid heart beat, rapid respiration (panting) or difficulty breathing, extremely lethargic or altered state of consciousness, inability to urinate for 24 hours or producing only scant, dark urine. It is unlikely you need to be concerned about this, but everyone should know the warning signs. Sepsis is actually caused by an over-response of the immune system to a viral, bacterial, parasitic, or fungal infection and is not something you want to mess around with.
I hope you all feel better soon. BTW, I would postpone your son's anaesthesia for fillings. If you're all sharing a virus, there's a good chance your son will come down with it too in the next 7 to 10 days. Plus, if you still have symptoms (especially fever) you are probably all contagious and I'm sure the dentist would not appreciate you infecting him/her, the staff, and other patients.
