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What causes enlarged lymph nodes?

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Internal Medicine Specialist
Practicing since : 1980
Answered : 1357 Questions
I just answered the symptoms part of this - wondering what's going on. Went to dr. twice and they did an ultrasound on my lymph nodes twice, bloodwork has been fine, lymph nodes are visible on one side. this has been going on for a week. general muscle achiness.
Posted Tue, 11 Mar 2014 in Cancer
Answered by Dr. Rakesh Karanwal 26 minutes later
Brief Answer: Furnish more detailed information Detailed Answer: Hi Young Lady, Thanks for your query. The details provided by you are too sketchy/vague to offer an opinion. There are numerous conditions in which the lymph nodes get enlarged in a particular site of the body. We can narrow down to the most likely causative condition by studying the history, problems and test reports, if available. Therefore, give me a more detailed information about the duration and nature of your problems, such as, having off-and-on low fever/feverish feeling, loss of weight, tiredness, fatigue, loss of appetite, cough with phlegm or blood, chest pain, nature of bowel movements, urine or menstrual problems if any..... Also tell me - the SITE, number and size of enlarged lymph nodes; are they painful; are they soft, firm or hard; are they attached to each other.... It would indeed be wonderful if you scan all test reports, including ultrasound report, and upload them on this website, for my perusal. I will be keenly awaiting the required information and the test reports. Take care, Col (Dr.) Rakesh Karanwal
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Follow-up: What causes enlarged lymph nodes? 28 minutes later
unfortunately I can not seem to get the results of the ultrasound(s) - I have called several times, get put on hold, then the machine hangs up. Anyway, I was constipated for a couple of days - but that was remedied by a couple of beers. nodes are large on both sides of the neck and firm (but tender) (especially the top ones) - but the left ones are visible to the naked eye. Very uncomfortable to swallow. I am on the pill so periods are regular. Low grade temp. This has been going on over a week, I'm not deathly ill but one day hot flashes, the next day, headache, next day sore throat etc. Hope this helps
Answered by Dr. Rakesh Karanwal 24 minutes later
Brief Answer: It is most likely Glandular Fever Detailed Answer: OK. Bilateral, tender lymph nodes enlargement in the neck region is usually due to either, viral conditions (particularly Infectious Mononucleosis- also called Glandular fever); or, bilateral sinus infection or throat infection. They can also occur in bilateral chest infection. Tuberculosis is another common cause of bilateral lymph nodes enlargement. Get yourself tested for Infectious mononucleosis (IM). If the test excludes IM, it would be a bacterial infection, in which case, 5-7 days' course of a suitable antibiotic, such as, Ciprofloxacin; anti-inflammatory pain-killers, such as, ibuprofen; carry out saline gargles and steam inhalation through the nose, will cure the disease, though lymph nodes will take a bit longer (2-3 weeks) to regress and disappear. Take care, young lady. Col (Dr.) Rakesh Karanwal
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Follow-up: What causes enlarged lymph nodes? 56 minutes later
The bloodwork came back negative for mono - and I neglected to mention (I so apologize as I know this is an important piece of the puzzle) that I was given a three day course of Azithromycin; which I finished Sunday. Still feeling lousy. Could it be that the bloodwork was negative and could be positive now? (I know you're throwing up your hands in frustration about the antibiotics...I REALLY apologize)
Answered by Dr. Rakesh Karanwal 8 hours later
Brief Answer: Take treatment as advised by me Detailed Answer: Excellent! The test for Mono (depending on the sensitivity of the test) may be negative, if done within 1-2 days of the onset of problems. So, it should be repeated. Azithromycin should have been taken for 5-7 days, instead of 3. So, continue with it for another 3 days. Also take anti-inflammatory pain-killers, such as, ibuprofen; do saline gargles (with 6 teaspoons of salt in a glass of lukewarm water) thrice daily and, steam inhalation through the nose. These measures will relieve all your symptoms. If the lymph nodes do not start reducing in size in a week's time from now, request your doctor to order Fine Needle Aspiration Biopsy of one of the lymph nodes (which will diagnose the EXACT cause of their enlargement). And dear, don't worry! You will be OK, provided you take the advised medication/follow other measures given above.
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