A review of treatment for neutropenia caused by lymphadenitis at Pusan National University Hospital

One day, while taking antibiotics for sinusitis, I developed symptoms of lymphadenitis and a high fever.

The neutrophil count was significantly low, so the patient was hospitalized at Pusan National University Hospital for four days for treatment and was discharged after immune recovery.

The cause of the low neutrophil count could not be identified, but it seems that the low neutrophil count was detected in a timely manner thanks to the lymphadenitis.

Lymphadenitis is a common disease, but in my case, it was a rare instance accompanied by leukopenia, which could have been dangerous.

I am leaving this message in case it might be helpful for you to know as well.

 

 

It's already a story from four years ago.

At that time, I had been taking antibiotics for sinusitis for over two months.

One day, I started having a high fever above 39°C, and two days later, I felt a thumb-sized lump behind my neck and experienced a stiff, painful neck.

I was already taking antibiotics and thought that lymphadenitis was common, so I endured at home for about two days.

Since the high fever continued, out of concern, I visited the ENT clinic where I had been treated for sinusitis and explained my symptoms.

It's nothing special; contrary to my thoughts here.

Since the doctor is already taking strong antibiotics, the development of a new tonsillitis is not a minor situation.

He told me to go to a large hospital and have a detailed examination.

I visited the nearby general hospital's ENT department.

There, it is also possible that it is Kikuchi disease, but more precise tests are needed, so a referral letter was provided to a higher-level hospital, a university hospital.

 

 

 

 

 

 

Just a moment here!

 

Lymph nodes (lymph glands) serve as pathways for body fluids other than blood to move and connect the entire body through small channels.

Lymph nodes are the crossroads of this lymph gland.

Lymphadenitis, characterized by swollen lymph nodes, can occur when the upper respiratory tract, such as the mouth, larynx, or pharynx, is infected by bacteria or viruses.

Some cases are due to tuberculosis or malignant tumors, but most are either benign, require no special treatment, or are caused by temporary infections.

The Kikuchi disease mentioned at the general hospital is a necrotizing lymphadenitis that requires treatment, and its cause is unknown.

It is said to occur mostly in young Asian women in their 20s.

 

 

 

From this point on, I started to feel scared. I thought it was just a simple lymphadenitis...

I visited the emergency room at Pusan National University Hospital, the nearest university hospital, along that road.

Various tests such as urinalysis, blood tests, X-rays, and neck CT scans were conducted busyly.

The inflammation level in the test results is not significantly high.

A surprising result showed that the white blood cell count, especially the neutrophil level, was significantly low.

Hospitalization has been decided.

 

 

 

 

 

 

Wait a moment here!

 

Everyone knows that white blood cells are responsible for immunity.

Actually, what we commonly refer to as white blood cells specifically means neutrophils.

Neutrophils make up 50-70% of white blood cells and serve as the police force that protects our body from infections.

When a pathogen invades the human body, the immune response is triggered first.

White blood cell count x neutrophil percentage = absolute neutrophil count (ANC)

Normal individuals have an ANC of over 2000.

When ANC is below 1500, it is called leukopenia.

When below 500, severe cases require isolation in a sterile room or a single room.

Although the immune system is weakened to the point where even bacteria in the mouth that normally do not cause problems can become infected.

Before infection occurs, it is difficult to notice because there are no particular symptoms with only neutropenia.

Because localized infections can quickly progress to systemic infections.

If an infection is not detected and treated quickly, it can be life-threatening.

 

 

 

 

My white blood cell count was 1,600 and the neutrophil count was around 900.

The next day's blood test after admission showed the neutrophil count dropped to 600.

Since the immune system is very weak, raw fruits and vegetables are prohibited.

Wearing a mask even while sleeping 24 hours a day

It was said that infection can occur even from brushing, so brushing was also prohibited, and I had to rinse only for several days.

Received multiple doses of antibiotics and antipyretics.

I also received the neutrophil increase injection a day later.

Blood tests were conducted in the morning and evening, and weight was measured repeatedly.

I was informed that a biopsy of the lymph nodes or a bone marrow test can be performed.

 

 

 

 

 

 

During my hospitalization, the doctor did not provide detailed explanations, perhaps worried that I might worry unnecessarily.

They said they would explain when I was discharged later. They mentioned that they conducted various tests with blood cancer in mind.

Actually, after I was hospitalized, I found out that I was admitted to the cancer ward and that the hematology-oncology department head was providing my treatment.

I was already very scared, though.. haha

Still, I could feel the kindness of the doctor.

 

 

Fortunately, after a day or two, the neutrophil count recovered to around 3,000.

The high fever has subsided, and the lymphadenitis has also decreased. There has been no change in weight.

And on the neck CT, the lymph node swelling does not appear to be malignant, and blood tests did not detect any blood cancer.

The doctor has decided that it is okay to discharge the patient without performing a biopsy or bone marrow test.

It's a relief that it's not cancer.

It was said that the cause of the lymphadenitis and the decrease in neutrophils could not be determined.

It could be due to medication, or it could be caused by an infection from something.

Without losing weight or worsening the condition

With a single granulocyte colony-stimulating factor injection, the neutrophil count returns to normal levels.

Conducting a comprehensive examination from A to Z to identify the cause after the body's functions have returned to normal.

You said that medical efficiency decreases.

 

 

 

 

 

 

 

So, I was discharged after being prescribed antibiotics for a few days and an antipyretic to take in case of emergencies.

After confirming that the white blood cell count is well maintained through outpatient treatment in a week

Treatment has been completed.

 

 

 

 

The same symptoms have not appeared for the past four years since then.

Although the neutrophil count tends to be slightly low, around 1,000, in annual check-ups.

It is not to the extent that treatment is necessary.

However, not knowing the cause still leaves me feeling frustrated.

Because I don't know the cause, I worry that such an incident might happen again at any time.

I'm afraid to take medicine when I'm sick, and I get nervous even if I have a slight fever.

It seems that the white blood cell count is congenitally somewhat low, so efforts are being made to boost immunity.

I try to maintain regular exercise and a healthy diet.

It seems I still lack effort, haha.

 

 

If any of you feel a lump in your neck that wasn't there before someday

Please do not overlook it and make sure to go to the hospital for a check-up.

It could be lymphadenitis caused by a simple infection.

It could be a warning indicating that my body is in danger.