Since he's your NEPHEW and therefore has no ovarian cyst causing the pain you need to have a doctor examine him ASAP.

If he's feverish and in extreme pain, get him to an emergency room.

You might want to consider looking for a new PCP, especially if this one did not even do a blood test.

Lisa's absolutely right about the high white blood cell count. If he has appendicitis, his WBC be through the roof and he will most likely need his appendix removed. I'd forgotten all about the blood test part of it. Then again, I had mine removed a LONG, LONG time ago.

Liver enzyme readings can also be derived from a simple blood test.

I've had a hysterectomy, so know it's not ovary related. I've also had my gall bladder removed, while on IV Rocephin, so that's not the culprit. We haven't been able to find a reason for it, it just happens periodically.

Hold on..

We've been through this.

First, what Breathwork says is right in any case when she says:
" but it can present with or without these symptoms as well. The list of symptoms for appendicitis are not iron clad, just more likely than not."

But even MORESO when on abx.

Two MAJOR points (talk to LLMD) are..
IF the child is on antibiotics, symptoms of appendicitus will be dampened, across the board.

So...the WBC count would not go through the roof, but may rise some from baseline. (if you have a baseline WBC count taken over time)

If the child has had routine bloods done ..you maybe, maybe cound tell from the blood count.

(ie: my son was getting weekly blood draws for a year, and his WBC was normally around 3, running low..
the ER Doc followed "routine" screening "rules"..and came back and said he didn't have "elevated" WBC's.
Pesky me said "What was the count"..she said "6.9"...but despite my assertions that that was high for my son..and he had NEVER had a count that high for over a year, though not abnormal for a child not on abx..she still sent him home after performind a scan, which was "equivocal".

We were darn lucky it didn't rupture, I left announcing my concern and that I was really uncomfortable, and (get this)..they said to give him anti-inflammatories (which would only serve to further dampen the symptom of pain) I called in the AM and a surgeoun called back and when I explained I was concerned about the pain in the lower right quadrant and the fact abx could effect test results, he urged us to rush back to the hospital right away. Had him in surgery from ER in fifteen minutes flat. He then explained that noone told him that night before at 1AM when we were in the ER that my son was ON abx, as he knew that being on them changes the whole scene)

Doctors can be, and often are WRONG, not only in Lyme. When there is something this serious as a possibility, you can't be too careful.

Point being..if he is on abx, they cannot use the typical screening tools in the same way..
WBC count, and even a scan..which they do next..can be equivocal, as it was in my son's very infected appendix.

ABX dampens the signs, but in no way will address the seriousness or prevent rupture.
I guess it just can keep some inflammation down and fight some of the sirculating infection.

The signs that were clear in my son were these:
he had bad abdominal pain, first centered in the center..then it all moved over to the lower right side.

He had the classic "rebound pain"..they check for, when you press down right on the appendix, and pull off it fast, it really hurts upon pulling pressure off. Rebound pain.

Mom ought to be very careful to find an evaluator who understands and respects the efects of abx on this, and will screen carefully with that in mind.

The first ER Doc treated him like he was on no abx, and further ignored our LLMD's concerns..
The second Doc (the surgeon) Knew better, and got it out just in time.

I don't know if the cause was TBD's or the usual, which is some sort of bowel obstruction at the valve that allows the appendix to become blocked.

We are going to have the tisue tested for DNA.

Mo

I got home and the pain came trampling back, I was doubled over and screaming.. I got back to the ER..by this time I had elevated WBC...ALthough they still did not know if it was appendicts but decided to go in anyway... Thank GOD they did! My Appendicts was ready to burst at any minute!

My suggestion would be take every precaution...I did nto present with typical Appendicitis pain in the beginning. Just pain in middle of abdomin that later spread but nt until the end. As well as nausea..No elevated WBC either until right up until time of sugery. I was on Bicillan the whole time..probably what caused WBC to stay normal for so long, and could be what saved me.