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Swollen lymph nodes in neck - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Infections
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
User :   Hi, I am a 57 year old retired female college professor; my smptoms are
- onset of an apparent cold 2 weeks ago with typical URI symptoms cough, sneezing, sore throate
- one week ago developed a grapefruit sized swelling in my left supraclavicular/lower cervical region which currently remains
-developed a fever of 103 degrees which has currently decreased to
1 degree or less
- severe headaches 7/10
-sudden onset of muscle weakness coming and going
Have been to my Dr. twice since onset of swollen lymph nodes in neck; he is unable to diagnose my condition; suggests taking Tylenol every 4 hours; he did order a differential CBC; but no antibody test for mononucleosis (which seems like a likely diagnosis to me.)
1. Dr. is not responding to my phone calls for up to 48 hrs.; should I go to ER.
2. Is this size of lymph node enlargement common in mono?
3. Dr. took a culture for STREP; negative; how are other bacterial/viral infections ruled out?
THANKS for your help.
Doctor :   Hi
Doctor :   Hi
User :   HI
Doctor :   Let me read your query
User :   do not know if I need to respond each time?/fine
Doctor :   Pleae wait
Doctor :   The bacterial culture is negative
User :   OK- so strep test checks for all bacteria..
Doctor :   it test only Strept
Doctor :   that is the common organism
Doctor :   negative rules out infections
Doctor :   But still cultures are needed
Doctor :   The next step is testing viral
Doctor :   Are you there?
User :   yes
Doctor :   Some people do monospot test
Doctor :   if monospot is positive treatment is conservative
Doctor :   but ateast we can can confrom the disease
Doctor :   *confirm
User :   yes
Doctor :   But real conventional approach is
Doctor :   Just start antibitics
Doctor :   after all the tests done
Doctor :   Only mono positive does not need antibitcs
Doctor :   If negative still it could be other viral or bacterial
Doctor :   Do you follow
User :   yes
Doctor :   So if your doctor is not responding , go to ER and get antibitics
User :   OK; do you know about the size of the lymph node and any correlation with a specific disease?
Doctor :   The lymph node is from inflammation
User :   yes, I understand; I taugh human anatomy and physiology
Doctor :   Please .
Doctor :   Is the query cleared?
Doctor :   clinical approach is very different
Doctor :   1. Sterptococi >>>>>>>>> do do culture and rapid strp test
Doctor :   2. Mono spot
Doctor :   Take positive only for consideration
Doctor :   Negative is not acuare
Doctor :   rapid step neg , waiting for culture takes time
Doctor :   negative mon indicates bacterial or viral
Doctor :   so the tests only find the cause
Doctor :   but many doctor still treat with antibitics
Doctor :   Did i answer the question?
User :   so are you saying that my Dr. may now be doing further culture on Strept culture?
Doctor :   i do not know
User :   And yes you have substantially answered my questions;; THANKS SO MUCH
Doctor :   usually if rapid stre is negative they send it for culture
Doctor :   if rapid only positive the bug is identified
Doctor :   Right
Doctor :   Thank you for consulting
Doctor :   Bye'
User :   Bye!
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