What causes painful lymph nodes despite taking medications?

Posted on Mon, 15 Jun 2015 in Medicines and Side Effects
Question: Hi.A month back i notices the lymph nodes on the left side of my neck (between the collar bone and shoulder) are swollen. That was on the day i had taken a nasal swine flu vaccine. I am not aware if the lymph node swelling had existed prior to that day. In a couple of days they turned painful. I went to a doctor and took some blood tests, chest xray and FNAC. The FNAC result was reactive hyperplasia. I took a course of antibiotics, the size reduced although it did not go down completely. After the course of antibiotics was over, the nodes turned painful again and the skin over the largest one became itchy. I went to another doctor who again put me on a course of different antibiotics. I have not seen any improvement since then.
Answered by Dr. Kaushal Bhavsar 1 hour later
Brief Answer:
Collect FNAC report first.

Detailed Answer:
Thanks for your question on HCM.
I can understand your concern.
Infection is the most common cause for cervical lymphadenopathy.
Since you are not improving with antibiotics since 25 days, possibility of tuberculosis infection of lymphnodes is high.
So at present, wait for FNAC report.
If this is negative or stating only hyperplasia then get done excision biopsy of the nodes and get done histopathological examination.
FNAC material is not representative of whole node. It represents local (needle insertion) site only.
So this can be false negative.
In biopsy, whole lymphnode is taken out and send for histopathological examination, so this will give you more correct results.
So at present, wait for FNAC report.
Also discuss about possibility of tuberculosis with your doctor and need for excision biopsy.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
Above answer was peer-reviewed by : Dr. Yogesh D
Follow up: Dr. Kaushal Bhavsar 2 days later
Thank you for the answer Dr. XXXXXXX
I had a query, i do not have cough, cold or fever. Or any other symptom either. But tuberculosis is still a possibility? I mean have you come across any cases where tuberculosis has been detected without those other symptoms?
Also one more thing i wanted to point out it is about 4 or 5 nodes in the left side of my neck are swollen. Although their sizes change, as in one appears smaller but another larger, from the initial days.
Answered by Dr. Kaushal Bhavsar 17 minutes later
Brief Answer:
Yes, EPTB can present without cough, fever.

Detailed Answer:
Thanks for your follow up question on HCM.
Lymphnode tuberculosis is known as extra Pulmonary tuberculosis (EPTB).
Cough is seen only in Pulmonary tuberculosis.
Cough is absent in EPTB.
So patients with enlarged lymphnode can have TB lymphadenopathy without classical symptoms of tuberculosis like cough, fever etc.
And in my daily OPD, I see daily 1-2 patients with tb lymphadenopathy without fever or coughing.
And 4-5 lymphnode together is known as matted lymphnodes.
This is characteristic feature of tb lymphadenopathy.
So discuss all these with your treating doctor and rule out tuberculosis in your case.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Kaushal Bhavsar


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