Question: I went to Panama City Panama on 11/14/12. I returned on 11/18/12. I had oral sex/kissed a women while I was there. I also visited new construction condo sites where there was excessive airbourne debris. The Next day I had slight acidic feeling in my throat. It only bothered me for a few days mainly right before i went to bed. Other than that I felt fine. When I returned on 11/19 around 1AM, I started feeling like the flu was coming on and had some sinus pressure behind my cheeks. My nasal passages seemed clear and had no signs of a stuffy nose/nasal drip. Doc gave me 3 day antibiotics. After a week I didn't feel any better and started getting some night sweats/fatigue. The doctor then put me on a 10 day/AMOXIC 875mg. On 11/22, I started getting swollen bilateral sub-mandibular lymph nodes (SBSLN).. They were varied in swelling swollen and varied in pain/aching all the time. I was also getting some random itching all over at times mainly at bedtime. Most of itching was occurring from the waist up, mainly head/face/chest/arms but also on legs at times. After the 10 day antibiotics, still had/have all the symptoms (minor Fatigue, swollen lymph nodes, periodic night sweats and random itching). Took STD test on 12/11/ for HIV1/HIV2, Chlam, Gonn, Hep A/B/C and all were neg. HSV1/2 were positive. I did have a cold sore above my lip before I went to Panama but it cleared up before I left. I had no signs of HSV2. I went to another clinic and got HSV1/2 test and both were neg. I went to see a doc on 1/9/13 he tested for HIV/MONO. Both were negative. No visible signs of infection or sores in mouth. I get a minor sore throat feeling at times but it felt more like it was only sore near where the nasal passages open into back of throat/mouth. Doc said I may have some kind of viral infection and should go away over time. I am now taking vitamin C/D. Most noticeable symptom is still (SBSLN) with random itching and sinus pressure (NO congestion). Always somewhat painful all the times but always some level of pain and swolleness. The pain was only specific to those Lymph nodes. I recently started to notice the small lymph nodes under start to randomly swell with some pain. I also sometimes get sharp minor pinpoint pains at random part of my body but mostly on the inside of the thighs, quadriceps and outer armpit area/shoulder blades but sometimes in other random places. These mild shooting pains are random and infrequent. Did blood test(CMP12+8AC+CBC/D/Plt+UA;LP;Cholest). All Ok but slightly high Glucose serum&cholesterol. Also took acyclovir/400mg for 7 days. No help. My jaw hinge area up to temples and upper and lower molar areas is now starting to feel mild pressure/pain on both sides. I have mild pressure aching behind eyes, nose/cheek area and sometimes in forehead area. The symptoms seek to be getting worse as time goes on. I have had my tonsils out at a very young age and i have had all my wisdom teeth taken out a long time ago. My nasal cavity just inside the opening of my nose it always dry and itchy. Recently been sneezing more at times. I have had regular seasonal allergies but nothing major. No asthma either. Any suggestions on what kind of infection I may be dealing with and would would you recommend I do?

Thanks for the response. Is it possible to have chronic sinusitis with sinus blockage while still being able to breathe fine through your nose? Ever since I started feeling bad I never had any noticeable congestion at least in my nasal passageway that runs from my nose to the back of my throat. The only mucus i have had in my nasal passage has only been a slight drip now and then in the back of my throat. Other than that my nasal passage way fro breathing has been fine. Is it possible to have congested sinus cavities but no nasal passage congestion? My airway has been so open it sometime hurts when i take a XXXXXXX breath of air through my nose as it feels very dry and tender when the air goes from my nose to the throat area. It feels like the sinus cavity above the roof of my mouth is very tender and is very sensitive when I try to inhale and exhale only through my nose. Is it common for this to be going on for over 2 months? I have a steam inhaler and was wondering if just regular water is ok or should I use a eucalyptus solution? How long should I do the inhaler and saline for if it doesn't improve?

Hi Doc,

I have been doing the steam and saline nasal spray now since we talked. I have been doing steam for 15-20 min 4 times per day. This has caused some activity in my sinus areas. I have been getting some drip down in my throat from my sinus cavities. I have tried to cough it up but 50% I end up swallowing. I still have the pressure in my face area and swollen bilateral lymph nodes. The pressure has not gone down but is about the same maybe a little more with the steam affecting it. I was wondering if you think I should get an MRI with contrast to see if there is anything else going on. It cheaper for me to get an MRI than a CAT scan if an MRI would still work. My lymph nodes feel more swollen now since the steam and saline treatment mat be even a little bigger and swollen. I have noticed a little pain in my lower right abdomen area coming from whatever organ is there. It started this morning. Not sure if its cause from the infected sinus stuff I am ingesting. Is there anyway I can keep communicating with you until I have resolved this issue. I don't mind paying again on the website that got me to you but I don't know if I can request you or if you can send a request for me to pay so we can continue with my treatment and analysis. Also, if you tell me it would be good to get an MRI, let me know the best way to get it to you assuming you read MRI's. If not who would you recommend that is good at reading MRI's. Would I need contrast XXXXXXX or no contrast dye? Any suggestions would be greatly appreciated as I have been dealing with this for over 2 months and it is very aggrevating, depressing and demotivating to deal with. I will give you my email just in case. YYYY@YYYY . Anything you can do would be greatly appreciated!

Signed
Very desperate to get rid of this

Hi Doc,

I called to found a place to get a low cost full body ct scan from brain to abdomen. FYI..I have also had some bad lower back pains mainly in the middle and right side of my lower back. I typically get some lower back lower pains at times but this one lasted for 4 weeks and was more on the right side than in the middle where it usually is. I have also had some recent pain under my rib cage on the right side front and back. The pain I mentioned in my lower abdomen yesterday was not actually in my abdomen. It felt like it was more in whatever organ is next to the abdomen on the right side of my body. its not a constant pain but more of a random pain at times. Pain is mild but noticible. I have not been getting good sleep lately as I have this tingling in my lower legs (calf and ankle area) and both my hands feel like they are going to sleep or tingling as well but "don't" get numb to the touch. The sensation I am getting in my hands at night is very strange. I thought it may be because i was sleeping on my side and cutting off circulation but it also does it when I sleep on my back. If for some reason the ct scan doesn't help find and later come to resolve my illness, is there another type of test like a biopsy of one of the lymph nodes in my neck to see what kind of infection my body is fighting? I feel like the infection is more isolated to my throat/neck area and sinus cavity but appears to be affecting other parts of my body. I don't really have a sore throat (more like and aching inside the throat) and it only feels sore if some at times from drippage coming from my sinus cavity. I have never really had headaches ever in my life but they have been on and off during the course of this illness. Anyway, I am getting the ct scan on Wednesday 830AM pacific standard time. Once I get the the results I will contact you. The wont be able to produce a cd of the ct scan images same day but they said they will give me some kind of report that day. CD takes a few days to mail to me. I will up load it once I get home. Thanks again for all your help.

I did the full body CT scan and I will upload it for you to review. I am waiting for the actual cd of all the images. Once i get those i will upload them. The doc said i looked good overall. A little slug near my gull bladder. He saw a small sign of something in my sinus cavity but he said I did not have acute or chronic sinusitus. Not sure if that small area in my sinuses is the cause of anything. The pain and swelling in my submandibular lymph nodes are still there and have slightly diminished since we last talked but it is still noticeably swollen and slightly painful at times. Other than that I don't feel that bad. I am not sure if this issue will go away over time. I called around for fine needle aspiration and its pretty expensive. I was wondering if it would be worth doing that and is that procedure guaranteed to find out what issue is causing the swollen/painful lymph nodes in my neck. How long should I wait before I take the next step and what would you recommend i do?

Thanks for the response. Can I have my dentist prescribe me the oral clindamycin or do I need a doctor? I feel like the infection is somewhere in my throat area but i dont really have sore throat but its does have some minor soreness at times. Would a bacterial or viral infection be more apt to live in the throat area and affect the lymph nodes? Can a USG tell what kind of infection may cause lymph nodes swelling? Which is safer, taking the medicine or getting the USG of the neck? I read the side effect of oral clindamycin and it seemed to be long lasting after stopping. How long would i take that medicine for if I did decide to go that route? Can you call in a prescription or does it have to be a US doctor or dentist?

Thanks for the informative answer. I am thinking i need a throat swab culture as my throat has a mild soreness but doesn't not appear red or distressed to the naked eye. It feels like its a little deeper near where the back of the tongue meets the throat. I have a feeling ti was caused when I either kissed or had oral sex with the girl i XXXXXXX in Panama. Since I have tested clean from all STD's, i believe i have some kind of viral, bacterial or maybe even fungal infection somewhere in my throat causing my lymph nodes to swell and be painful. I have taken antibiotics (Z pack and amoxicillan as well as generic valtrex, etc) and these did not help. Is it possible the infection I may have could resist these medicines? Will the throat swab determine "exactly" what kind of infection it may be? I don't think its acid reflux as I am familiar with that feeling.