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Took antibiotic for cold, fever, night sweats and acute sinusitis. Noticed enlargement of submandibular gland. Normal?

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General & Family Physician
Practicing since : 2010
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About 3 months ago, I had quite a bad cold with fever, night sweats and acute sinusitis. The cold went away however the sinusitis persisted for a following 2 months until I was prescribed a course of antibiotics. At the time of the cold, I noticed symmetrical enlargement of my submandibular glands. They were painless and quite hard, and just under 1cm in diameter, clearly spherical and very mobile.

Now, the sinusitis has cleared up but sometimes I still produce a sputum which is very thick and clear/translucent (before the antibiotics it was yellow). It seems like it has accumulated over a couple of days. I do not have any pain or otherwise difficulty breathing etc. I have noticed the submandibular gland on the left has not gone down much, the one on the right has reduced a little bit in size but I can also feel 2 other 'shotty' lymph nodes (just under 0.5cm) in the submandible, so 4 in total.

Can you please advise if it is abnormal for the glands to remain that size, hard, painless (note, they were never painful) considering the length of time? Is it possible for them to remain permanently enlarged? Is it recommended to get them checked out further?

Posted Sun, 28 Apr 2013 in Infections
Answered by Dr. Muhammad Ishfaq Habib 2 hours later
Welcome to XXXXXXX

As you have stated you suffered from sinusitis and now you are having sputum which is very obvious that your are suffering from actually sub-mandibular lymphnodes which are not normally palpable and enlarges during infection. These lymphnodes returns to their normal size once the infection have resolved. It is recommended to send your sputum for culture and sensitivity to identify the causative organism and effective antibiotic against it.

Despite of treatment, if the lymph nodes still remains enlarged then biopsy is required for diagnosing the problem

If you still have some query, feel free to ask

Above answer was peer-reviewed by
Follow-up: Took antibiotic for cold, fever, night sweats and acute sinusitis. Noticed enlargement of submandibular gland. Normal? 9 minutes later

Thanks for the clear answer. I am slightly worried because I have never felt my lymph nodes before, not even when I've had quite bad flu infection. This is the first time.

Also, I am more worried as they were not painful at all, and still are not. They are very firm, but small in size (never larger than 1cm, even during infection). When I went to the doctor to get antibiotics, he palpated for lymph nodes but didnt feel any. I can feel them in a specific manner and they are well defined and round and can be moved quite far, even to outside the jawbone.

I am also concerned as now the sputum is gone (only very rare days). How long is it possible for these nodes to remain enlarged following subsidence of a chronic infection.

Is there any other underlying cause that may result in these painless, persistent and shotty feeling nodes?

Thanks again.
Answered by Dr. Muhammad Ishfaq Habib 13 minutes later
Thanks for the reply

There are number of causes for painless enlarged lymphnodes. On the top of the list is infections which can be bacterial or viral. which you are already having bacterial infections. The infections also involves TB. Inflammatory conditions like autoimmune diseases also enlarges the lymphnodes. Cancers is also one of the most common cause.

Usually we don't tell patients such major disease because they are irrelevant to patients because they get panic and its psychological that they think they are suffering from such conditions. Therefore do not think about any serious disease, your enlarged lymph nodes are because of the infection you are already having and once the infection subsides they will resolve within a week.

If you still have some query, feel free to ask

Above answer was peer-reviewed by
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