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Painless Swollen Lymph Nodes Behind Ears. Had Unprotected Sex. Pain Below Rib, Sore Throat. Negative HIV Test. Additional Tests?

Posted on Fri, 12 Apr 2013

Question: Hi there
Thanks for helping me.I live in the Netherlands and since july 2012 I have had painless swollen lymph nodes behind my ears and on october i had unprotected sex and 2 weeks after that i experienced painful burning sensation under my left rib i also had sore throat for 3 months and after several anti-biotics and azitromaycine it went away,on january 2013 i did Hiv test and all sexual diseases and they all came back negative however since then i have swollen painful lymph nodes on my face,my neck,shoulders,armpit,groin,back of my head and burning sensation and pain on the area of my left rib which comes and goes,two weeks ago i went to dubai and there and there i had sinusitis like symptoms i had pain around my head around my eyes sometime i couldnt see very well,and i also have noticed that before my monthly periods i have a bumpy tissue under my right breast and after periods it goes away,I have never had it before what kind of additional test do you recommend? what kind of disease could it be?i am really under stress plz help me

Answered by Dr. Mayank Bhargava (3 hours later)

Hi XXXXXXX
Welcome to XXXXXXX forum.

With the available described symptoms, there appears to be possibility that you are suffering from generalized lymphadenopathy.
Presence of enlarged painful lymph nodes suggests the diagnosis.

Generalized lymphadenopathy could be infectious (bacterial/ viral/ fungal/ parasitic) or non infectious in origin.
Infectious causes could be tuberculosis, brucellosis, histoplasmosis, infectious mononeuclesis, and toxoplasmosis.
Non infectious causes could be leukemia, lymphoma, amyloidosis, sarcoidosis.

Generalized lymphadenopathy due to infectious causes may cause recurrent infection (as you are getting sinusitis).
Non infectious causes may lower immunity and may cause recurrent infections.

You should consult with XXXXXXX medicine specialist and ophthalmologist and should go for thorough check up.
You should go for complete blood count, peripheral blood film to rule out leukemia/ lymphoma/ brucellosis, excision biopsy of enlarged lymph nodes.
You should also go for sputum examination for tubercular and histoplasmosis.
You should also go for XXXXXXX Anti ds-DNA, Anti XXXXXXX antibodies, angiotensin converting enzyme.

Treatment depends on the diagnosed disease.

Hope that helps.
Let me know your other query.
Take care,
Dr. Mayank Bhargava

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mayank Bhargava (3 hours later)

Hi Dr Bhargava,

thanks alot for your help i have appointment next tuesday with my general doctor I am diffinitely gonna do those test you recommended ,my another question is that as in some cases hiv will be shown after 6 months or even one year in blood test ,couldnt it possibly be because of HIV?I am gonna repeat hiv test as well in the end of april all am worried about is hiv.

thanks alot,

XXXXXXX

Answered by Dr. Mayank Bhargava (1 hour later)

Hi,
There could be possibility of HIV and you should go for repeat HIV testing.
You should also go for XXXXXXX (nucleic acid testing) for HIV, if available.
Best regards,
Dr. Mayank Bhargava

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mayank Bhargava (13 hours later)

thank you, I forgot to mention that i adopted a persian cat almost 1 year ago, first when i touched him i got rashes in my skin and my hands was itching alot then i used antihistamine pills for a while and i stopped,there were no symptoms but swollen lymph nodes under my ears,only sometimes that i kissed his lips i had to wash my mouth immediately otherwise it would be swollen and itchy. regardless of hiv and other viral or bacterial reasons could i get all these symptoms just because i live with a cat and i am close to him?another symptom that i have experienced since i came back from dubai is small red rashes on my forehead and 1 or two on my nose and cheek, could any type of cancer or blood disorder or generalized lymphadenopathy etc... except hiv cause skin rashes ? and what about that bumpy lump in my right breast just before each monthly periods? I really appreciate your guidence and help

Answered by Dr. Mayank Bhargava (4 hours later)

Hi,
There could be possibility of cat scratch disease or brucellosis.
Exact diagnosis can be made by excision biopsy and complete blood count.
Whatever skin lesions have been defined by you, there appears to be least correlation with cancer but you must rule out presence of blood disorders.
You should also undergo mammography of right breast to rule out any pathology.
There could be possibility of menstrual period induced hormonal changes in breast.
Get well soon.
Dr. Mayank Bhargava

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mayank Bhargava (19 hours later)

Hi,
After doing all these test that you recomended how can I let you know the result for further questions because this discussion will be closed after 2 days and I am not familiar with this website rules.thanks alot

Answered by Dr. Mayank Bhargava (5 hours later)

Hi,
Most welcome.
You can ask further question if you have.
Get well soon.
Dr. Mayank Bhargava

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mayank Bhargava (19 hours later)

Hi,
At the moment I don't have any specific question as I need to do those tests you recommended
But it takes a while to get the tests results and this discussion will be closed after 2 days automatically,so how can I let you know and ask for your guidence after I get the result which might be in 10 days? By the way I brought my cat back to the former owner maybe it helps to reduce the symptoms thanks a lot good night

Answered by Dr. Mayank Bhargava (3 hours later)

Hi,
You can recharge the query with defined amount or ask direct query to me on this URL:
http://bit.ly/Dr-Mayank-Bhargava

Removing suspected culprit agent may help you.
Get well soon.
Dr. MAaank Bhargava

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mayank Bhargava (21 hours later)

Very well thank you,I am very satisfied with your extensive,detailed answers .
Actually i have another question ,does leukemia has the term window period like hiv ? like maybe in the early stage of disease?what about other cancers?is the term window period only used for hiv?

Answered by Dr. Mayank Bhargava (2 hours later)

Hi,
Window period term is mostly used in case of infection such as HIV, Hepatitis B & C, bacterial infection.
Window period is not used in leukemia.
Take care,
Dr. Mayank Bhargava

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mayank Bhargava (2 days later)

Hi, I did abdominal ecography and im waiting for the result and i did also cbc and hiv as well.Is echo helpful regarding my symptoms? One bad thing about the Netherlands is that patients cant visit a specialist without general doctor's request and iam afraid he cant detect my disease therefore it gets worse,by the way i have recently noticed that i have pain in my breast cage could it be a sign of cancer?however i know without blood test no one can say what it is.thank you

Answered by Dr. Mayank Bhargava (13 hours later)

Hi,
Abdominal Echography/ ultrasound imaging may help by detecting intraabdominal lymphadenopathy.
Is there any visible swelling in rib cage?
Pain in breast cage may be suggestive of rib bone cancer (Osteoclastoma/ osteoblastoma).
Take care,
Dr. Mayank Bhargava

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar