Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Lymph Node Swelling?
Question: hi my daughter 21 yrs, has lymph node swelling back of neck right side and under chin. It is fairly big and hard. Blood test shows esr 66. X ray says plueral tag on left dome. FNAC test results awaited. She has taken augmentin. But today the swelling seems to have increased. What should i do? ANother doc said it could be a skin infection.. what is the proper medicine to take? How serious is this?
Brief Answer:
Let us wait for FNAC report.
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
Lymph nodes as you have explained with a ESR of 66 in a patent of just 21 years and pleural tag on X-ray Chest is more indicative of Tuberculosis.
Well, FNAC may be confirmatory.
I would advise to undergo Gold Quantiferon test for TB id FNAC is not conclusive.
The swelling can increase due to bleeding at FNAC or due to cold abscess formation or secondary infection which Augmentin will take care of.
Seriousness will depend upon the report of FNAC hence there is no point discussing this at this hour, as you will be getting the report soon.
Wait till FNAC report, continue Augmentin.
Please keep posted the report and post other reports if you have got them. You may please attach the scanned copies attached to this question.
Let us wait for FNAC report.
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
Lymph nodes as you have explained with a ESR of 66 in a patent of just 21 years and pleural tag on X-ray Chest is more indicative of Tuberculosis.
Well, FNAC may be confirmatory.
I would advise to undergo Gold Quantiferon test for TB id FNAC is not conclusive.
The swelling can increase due to bleeding at FNAC or due to cold abscess formation or secondary infection which Augmentin will take care of.
Seriousness will depend upon the report of FNAC hence there is no point discussing this at this hour, as you will be getting the report soon.
Wait till FNAC report, continue Augmentin.
Please keep posted the report and post other reports if you have got them. You may please attach the scanned copies attached to this question.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Doctor, Thanks for your prompt and kind response.
I have uploaded FNAC, x ray and blood report. Is the Gold quantiferon test necessary now or is TB confirmed? What precautions should we take as i have a younger daughter (14 yrs) at home?
I am taking her straightaway to hospital.
Regards,
Geeta.
I have uploaded FNAC, x ray and blood report. Is the Gold quantiferon test necessary now or is TB confirmed? What precautions should we take as i have a younger daughter (14 yrs) at home?
I am taking her straightaway to hospital.
Regards,
Geeta.
Brief Answer:
Go for Gold Quantiferon for TB test.
Detailed Answer:
Thanks for your feedback.
Seen all the three reports.
There is no definite report saying this to be tuberculosis although all the evidence goes in favour of TB. But one needs a definitive diagnosis.
Now - we should go for Gold Quantiferon test for TB. If this is positive one can go ahead with ATT- (Anti Tuberculosis Treatment).
Another option is a 1 to 3 weeks course of treatment with antibiotic and anti-inflammatory medicines- see the response and then only take a decision.
Next option is to go for formal Lymph node biopsy to get a definite diagnosis.
Or to repeat the FNAC at different center.
After 3 weeks - In doubtful cases : if the corroborative evidence of TB is thought of positive along with clinical examination and suspicion - ATT can be given on an empirical basis if the routine treatment fails.
Since the X-ray chest of your elder daughter is negative for any TB- you and your family members have to take NO precautions at all.
Please let me also know what was decided by your Doctor.
Go for Gold Quantiferon for TB test.
Detailed Answer:
Thanks for your feedback.
Seen all the three reports.
There is no definite report saying this to be tuberculosis although all the evidence goes in favour of TB. But one needs a definitive diagnosis.
Now - we should go for Gold Quantiferon test for TB. If this is positive one can go ahead with ATT- (Anti Tuberculosis Treatment).
Another option is a 1 to 3 weeks course of treatment with antibiotic and anti-inflammatory medicines- see the response and then only take a decision.
Next option is to go for formal Lymph node biopsy to get a definite diagnosis.
Or to repeat the FNAC at different center.
After 3 weeks - In doubtful cases : if the corroborative evidence of TB is thought of positive along with clinical examination and suspicion - ATT can be given on an empirical basis if the routine treatment fails.
Since the X-ray chest of your elder daughter is negative for any TB- you and your family members have to take NO precautions at all.
Please let me also know what was decided by your Doctor.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Thank You, Doctor.
We were asked to continue with augmentin. Also the swelling has reduced since starting on that treatment.
Also, she had severe acne for which we had taken treatment from Oct 2013 to may 2014 (mainly isotroin and azithromycin tablets) . The doctor said they have seen something similar before, in skin acne cases . So no change in treatment or further tests have been advised as of now.
We were asked to continue with augmentin. Also the swelling has reduced since starting on that treatment.
Also, she had severe acne for which we had taken treatment from Oct 2013 to may 2014 (mainly isotroin and azithromycin tablets) . The doctor said they have seen something similar before, in skin acne cases . So no change in treatment or further tests have been advised as of now.
Brief Answer:
Get 3 week course- Care of acne
Detailed Answer:
Oh ! I too got relaxed !
The lymph nodes to me too looks positive due to infection in acne transmitted to the lymph nodes.
The treatment will help resolve the lymph nodes also.
I hope your daughter is also on anti-inflammatory medicines.
Give her plenty of oral fluids. Face cleaning with plain water 4 times a day. ( Besan-peeth- I hope you understand this- is the best cleansing agent for face than any proprietary face-washes ). Ask to take a therapeutic Dose of Vitamin A and D and continue as multivitamins ( Without Ginseng).
Ask her to take a sound sleep of at least 8 hours and avoid hot and humid places, exposure to direct sunlight.
I hope your daughter is not introvert- these personalities get more of pimples.
Review after 3 weeks.
I would be happy to assist more. Please feel free to ask for more if you need to.
Get 3 week course- Care of acne
Detailed Answer:
Oh ! I too got relaxed !
The lymph nodes to me too looks positive due to infection in acne transmitted to the lymph nodes.
The treatment will help resolve the lymph nodes also.
I hope your daughter is also on anti-inflammatory medicines.
Give her plenty of oral fluids. Face cleaning with plain water 4 times a day. ( Besan-peeth- I hope you understand this- is the best cleansing agent for face than any proprietary face-washes ). Ask to take a therapeutic Dose of Vitamin A and D and continue as multivitamins ( Without Ginseng).
Ask her to take a sound sleep of at least 8 hours and avoid hot and humid places, exposure to direct sunlight.
I hope your daughter is not introvert- these personalities get more of pimples.
Review after 3 weeks.
I would be happy to assist more. Please feel free to ask for more if you need to.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
She had stopped all medication for acne in May 2014- about 4-5 months now. So we met a dermatologist who has prescribed doxycycline 1-0-1 and B-active once a day. She has started taking it from today. And we have started her on Ensure as well.
Any other medicine she should take? What is anti-inflammatory medicine? Also any other tablet she should take containing vitamin A and D ?
Any other medicine she should take? What is anti-inflammatory medicine? Also any other tablet she should take containing vitamin A and D ?
Brief Answer:
Ibuprofen or Diclofenac
Detailed Answer:
Thanks for your feedback.
Please continue as advised.
Anti-inflammatory medicines means the ones which reduce swelling- the known are Ibuprofen or Diclofenac.
You can get Vitamin A capsules and Vitamin D is available as Calcirol XXXXXXX if not given by the Medical store you may need a proper prescription.
Multivitamins are easily available, she can take one capsule a day.
See the results in one week.
If there is no response you can certainly ask for another FNAC test.
Ibuprofen or Diclofenac
Detailed Answer:
Thanks for your feedback.
Please continue as advised.
Anti-inflammatory medicines means the ones which reduce swelling- the known are Ibuprofen or Diclofenac.
You can get Vitamin A capsules and Vitamin D is available as Calcirol XXXXXXX if not given by the Medical store you may need a proper prescription.
Multivitamins are easily available, she can take one capsule a day.
See the results in one week.
If there is no response you can certainly ask for another FNAC test.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
