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Found lump under jaw line. Strep and mono test negative. What could it be?

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ENT Specialist
Practicing since : 2001
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14 yr old health male with a 1 week history of right sided lump under jaw line. No fever, sore throat, throat slighly red. Had a T & A in 2009. Strep and mono tests negative. Throat culture sent out last Friday showed positive for Serratia marcescens growth. Patient was on Z-pack and now switched to Bactrim. Now complains of mild right ear pain as well. Should I wait it out and take him to primary for 2nd opinion? He was previously seen in urgent care since he was sent home from school.
Posted Wed, 21 Nov 2012 in Dental Health
Answered by Dr. Naveen Kumar 30 minutes later

Thanks for posting the query

The lump noticed under the jaw line could be an inflammatory lymph node which has appeared secondary to the infection in the throat or neck.

Antibiotics are usually not required unless there are signs and symptoms of active infection in the throat/neck (such as sore throat, fever, difficulty in swallowing, congested pharyngeal wall, etc). The mild ear pain could be secondary to pharyngitis with referred pain into the ear. A complete examination of the ear, nose and the throat will help in identifying the problems. Try to consult an ENT specialist for an early diagnosis and appropriate management.

My advice is:
1. To continue with the present antibiotic
2. To drink plenty of warm water
3. Take mild pain relievers such as ibuprofen or paracetamol.

Hope I have answered your query; I will be available for the follow-up queries.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
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