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What causes swollen lymph node in neck with low WBC when HIV test are negative?

Answered by
Dr. Shailja Puri

Pathologist and Microbiologist

Practicing since :2006

Answered : 7494 Questions

Posted on Wed, 4 Dec 2013 in Medicines and Side Effects
Question: I went to the ER this morning because of swollen lymph node's in my neck on the right side...I had a HIV RNA PCR test done last week which was negative and the ER performed two rapid HIV tests both lymphs are swollen WBC count is low, lymph absolute count was normal (1.5 I believe), two other things were high Mono and something else...The Dr in the ER stated that he believes it's bacterial due to the fact I have no fever, chills or anything else. What could it possible be any ideas? I was given antibiotics which I will pick up today on my lunch break and start
Answered by Dr. Shailja Puri 1 hour later
Brief Answer: Suggestive of reactive lymph node enlargement Detailed Answer: Hello, Thanks for posting your query on XXXXXXX Enlargement of lymph nodes in neck can occur in number of conditions. The neck lymph node commonly enlarge in infections of the oral cavity and pharynx. The lymph nodes are store house of lymphocytes which provide immunity to the body. Infections and inflammations in the region drained by particular lymph nodes cause their enlargement. A course of antibiotics may resolve the enlargement of the lymph nodes. The other possibility of enlargement is lymphoma (malignant enlargement of the lymph nodes). However, absence of fever, weight loss, normal blood counts rule out this possibility. Take the course of antibiotics as suggested by your doctor and wait for the results. You may visit your doctor if the enlargement does not clear away after few days after completion of the course of antibiotics for more investigations. If you have more queries, I will be glad to answer. Dr Shailja P Wahal
Above answer was peer-reviewed by : Dr. Yogesh D
Follow up: Dr. Shailja Puri 1 hour later
Thanks Dr, Should I be considered about a possible HIV infection? I ask because one of the signs is swollen lymph nodes in the neck...I have had 3 negative tests so far one being a HIV RNA PCR test which is supposed to show an infection as early as 9 days?
Answered by Dr. Shailja Puri 13 hours later
Brief Answer: Supporting history & positive tests also required. Detailed Answer: Hello and welcome again, Lymph node enlargement is one of the features of HIV infection. Besides weight loss of more than 10% of body weight and diarrhea for more than one month should be present in the history for the suspicion of HIV. High risk behaviour - multiple sexual partners, drug abuse, sharing of needles, transfusion of infected blood can all cause HIV infection. Is there any history of any of these risk factors? The rapid tests and HIV RNA tests are negative so the possibility of HIV infection is negligible. RNA PCR is a very sensitive test and it detectes the viral RNA even if present in very small amounts. If you have more queries, I will be glad to answer. Thanks and take care Dr Shailja P Wahal
Above answer was peer-reviewed by : Dr. Shanthi.E

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