What began as persistent fever and swelling on the side of 2-year-old Mila’s neck led to a hospital stay over the holidays, including two admissions and one surgery at Our Lady of the Lake Children’s Hospital.
Once a familiar face in the hospital as a former nurse, Rosalind Kenny, BSN, RN, Mila’s mom, found herself in the role of a worried parent seeking answers. The family experienced exceptional care and support as they walked through this challenging medical experience.
Initial Concerns
After initial bloodwork and testing positive for strep, Mila’s pediatrician recommended Rosalind take her to our pediatric emergency room, the only one in the Greater Baton Rouge region. The week before Christmas, Mila was admitted to the hospital.
“They did more bloodwork and a computerized tomography (CT) scan, which showed little pockets of fluid along her lymph nodes,” Rosalind says. IV antibiotics were started to slow the strep infection, and Mila perked up after a dose of IV steroids.
“We stayed Tuesday to Friday, her neck was better, and we went home,” Rosalind says. “Two days later she spiked fever again, her neck was swollen and painful to turn.”
The day after Christmas, Rosalind and Mila returned to their pediatrician’s office. Mila’s c-reactive protein (CRP), a test that checks for inflammation, and white blood cell count were both very elevated even after almost a week on antibiotics. The family returned to our ER.
Emergency Surgery and Recovery
The urgency of the situation unfolded.
“They did a CT scan and found a bunch of pus pockets along her lymph nodes,” Rosalind says. Doctors weren’t comfortable with their location, close to major vessels and Mila’s heart.
“She was in the OR that night around 9 p.m.,” Rosalind says. With an incision and drainage procedure to combat the infection, doctors removed all the pus they could see and left a drain in for a few days.
Mila’s path to recovery involved a meticulous care plan, strengthened antibiotics and the unwavering dedication of the hospital team.
“She started to respond very well,” Rosalind says. “Two or three days later the drain came out and she just improved from there. She had no more fever after her admission the second go round.”
Personal Touches Amidst the Challenge
The hospital’s Child Life team, nutrition services and thoughtful gestures painted a picture of care that extended beyond the clinical realm.
“Everyone was so reassuring, and the communication was always open,” Rosalind says. “They’d take the time to sit down and talk to me and answer any and all questions. I didn’t feel like a burden, and we experienced great round-the-clock care.”
Any concerns Rosalind had were addressed and the why of things were always explained.
“The nurses were fantastic, just patient with Mila when she was fussy and didn’t want vitals or bloodwork,” Rosalind says. “The ER nurses and lab techs were great with her and all the pokes and sticks. I could not have asked for a better experience probably in the scariest time of my life with her.”
Beyond the medical procedures and exceptional patient care, Rosalind and Mila experienced a sense of community being back among former colleagues. Rosalind worked in our neonatal intensive care unit (NICU) from December 2020 through October 2021 when Mila was born.
“Some of my friends from the NICU would always come to our room and check on us,” Rosalind says. “They made sure I was OK through the whole process and also checking on Mila. We felt taken care of in the best way.”
Rosalind appreciated everyone who cared for Mila, especially nurse Supria Carline, RN. “Her personality was so caring, I knew I could leave to go home and take a shower because Mila was so well cared for. I felt that comfortable with Supria and really want to say thank you to her.”
Alana Marquies, RN, graduated high school with Rosalind and cared for Mila. Lindsey Granados, RN, house supervisor, and Kennedy Rudolph, PICU nurse tech, also provided exceptional care for which Rosalind is so grateful.
Rosalind’s mom is also a nurse and also speaks very highly of the care Mila received. “My parents, friends and family were all really pleased with the care,” Rosalind says. “I have no complaints, truly.”
Additional Challenges
Doctors suspected a combination of strep and mononucleosis as the cause of Mila’s symptoms. Although Mila didn’t test positive for mono, the team could see she’d had a fairly recent exposure.
“It was just a double whammy and her immune system took a very big hit,” Rosalind says. “It took a while to recover, her lymph nodes went crazy walling off the infection, and that’s why the first go-round of antibiotics couldn’t penetrate and couldn’t see it on the first CT.”
After being discharged in late December, Mila remained healthy for about a week, even returning to daycare. Her fever returned, and a visit with her pediatrician ruled out flu, COVID-19, strep adenovirus and enterovirus.
“We treated her with Tylenol, Motrin, rest and cuddles,” Rosalind says. The next morning Mila’s temperature was 103.6 and the family returned to our ER where Mila received bloodwork, a repeat CT scan of her neck and chest and IV fluids.
“She had been treated with two antibiotics for two weeks, so we were not suspicious of any bacterial infection,” Rosalind remembers. Her CT was negative, no abscess was seen but bloodwork indicated a possible viral infection.
Mila was admitted, and Adaora Uzodi, MD, pediatric infectious diseases specialist, met with the family to discuss a plan of care, which included additional labs that took a few days to complete. Mila’s fever kept recurring.
A Terrifying Possibility
Mila’s fevers, negative results to viral and bacterial illnesses, recent lymph node issues and abnormal blood counts were all factors that could indicate leukemia or lymphoma. “As a mother and a registered nurse my mind was flooded with the constant concern of cancer,” Rosalind says.
“Although there could be other explanations of what was causing these fevers, we could not take that possibility off the table,” she says. “I prayed and prayed so hard. I cried when she slept because I needed her to see me strong and happy.”
Jeff Deyo, MD, PhD, medical director at the St. Jude Baton Rouge Affiliate Clinic at Our Lady of the Lake Children’s Health, met with Mila’s family and ordered additional blood work that all came back normal.
“Although my heart was so happy to hear that, we still did not have answers as to why Mila was still so sick,” Rosalind says. Over one more weekend in the hospital, Mila experienced a fever on Saturday evening, but that was the last one.
“Her blood work had returned to normal as well, and we were cleared for discharge,” Rosalind says. “The doctors think it was a viral illness she caught while still fighting off the lymph node abscess.”
Return to the Joys of Toddlerhood
As Mila emerges on the other side of her ordeal, she is fever-free, lively and back to dancing and her perky self. Finally, in February the family is back to their old routine!
