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Suggest treatment for fever and swollen lymph node

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Posted on Mon, 18 Jul 2016
Question: Hi,
I have a swollen cervical Lymph Node ( left side ) for last one month. I am getting low grade fever at night. Additionally I experience Joint and feet pain sometimes. I completed two antibiotic courses as per doctor advice ( Zithrocin 500, Augmentin duo 625 ) but it had no effect. My ESR (95), TC counts are high. All the reports are attached herewith. The problem is still not diagnosed. Please tell me what disease I May have ?.
doctor
Answered by Dr. Shailja Puri (19 minutes later)
Brief Answer:
Clinical features and lab results suggestive of rheumatoid arthritis

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.

After going through all your reports, the abnormality is that of high total leukocyte count with normal differential count, low hemoglobin and high ESR.
The aspiration cytology of the cervical lymph nodes shows reactive lymphoid hyperplasia, which is an inflammatory condition.
All biochemistry parameters are also normal.
These laboratory findings coupled with joint and feet pain are pointing towards an inflammatory condition which is affecting the joint and causing secondary hematological effects.
I am of the opinion that rheumatoid arthritis should be ruled out.
Rheumatoid arthritis is an autoimmune disorder affecting joints. more common in young females.
I suggest you to get following investigations:
Rheumatoid factor and anti nuclear antigen assay after discussing with your referring doctor.

Thanks and take care
Dr Shailja Puri



Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Shailja Puri (20 hours later)
Hi,
I have already consulted two experienced docs.They all suspected TB.Doc adviced me to go for repeat FNAC which is also not suggestive. They advised for excision biopsy. What should be tge correct step at the moment ?
doctor
Answered by Dr. Shailja Puri (1 hour later)
Brief Answer:
Investigations not suggestive of tuberculosis, excision biopsy may be done.

Detailed Answer:
Hello and welcome again,
The FNAC report is not suggestive of tuberculosis.
Mantoux test is also negative, thus possibility of tuberculosis is less.
However, you may go for excision biopsy to histopathological examination which is more definitive.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Shailja Puri

Pathologist and Microbiologist

Practicing since :2006

Answered : 8672 Questions

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Suggest treatment for fever and swollen lymph node

Brief Answer: Clinical features and lab results suggestive of rheumatoid arthritis Detailed Answer: Hello, Thanks for posting your query on HealthcareMagic. After going through all your reports, the abnormality is that of high total leukocyte count with normal differential count, low hemoglobin and high ESR. The aspiration cytology of the cervical lymph nodes shows reactive lymphoid hyperplasia, which is an inflammatory condition. All biochemistry parameters are also normal. These laboratory findings coupled with joint and feet pain are pointing towards an inflammatory condition which is affecting the joint and causing secondary hematological effects. I am of the opinion that rheumatoid arthritis should be ruled out. Rheumatoid arthritis is an autoimmune disorder affecting joints. more common in young females. I suggest you to get following investigations: Rheumatoid factor and anti nuclear antigen assay after discussing with your referring doctor. Thanks and take care Dr Shailja Puri