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Feeling exhausted. Ultrasound showed painful lymph nodes in neck and armpit. Blood work showed epstein barr. Suggest?

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I had six weeks of feeling super exhausted and weak. Went to the doc and I routine exam he found a very large lymph node ...2 cm. in my neck. He ordered ultrasound and blood work. Ultrasound showed several enlarge lymph nodes in neck saying largest was 1.6 cm ( they are. It painful). Blood work showed a slightly elevated white count and positive epstein barr ( was tested for ebv 6 months ago and it was negative). My tiredness and weakness are totally gone but today I found another large, painless lymph node in my armpit. The doctor wanted to re check the neck one in a month but doesn't know about this new one. Is waiting a month a reasonable thing to do at this point? Or should I ask for more investigation? Actually the armpit node is hurting more and more now that I have been prodding it,
Posted Thu, 16 May 2013 in General Health
Answered by Dr. Satyadeo Choubey 1 hour later

Thanks for your query.

Your symptoms of easy fatiguability with multiple enlarged cervical lymph node along with raised white cell count and positive report for EBV points to the diagnosis of infectious mononucleosis. Usually EBV is a common infection in united states and by adulthood almost 90% of population gets infected. Infectious mononucleosis mainly occurs in age group of 10-30 years but a small percentage of adult population can have it like you.

Usually there is increased lymphocyte count with >10% of atypical lymphocytes, monospot test is positive and viral specific IgM is positive in initial days.

The disease is self-limiting and need only supportive measures like rest and pain relief. In complicated cases steroids are given. Exertion should be avoided in first month of illness.

Your doctor is following the similar protocol and are waiting to get the disease resolved by its natural process and then to look for the nodes whether they have decreased in size or not. Your enlarged axillary node seems to be the part of disease process and don't panic if you get your liver or spleen enlarged. You must wait for your axillary node to decrease in size as you are waiting for your neck nodes.

Best wishes,
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