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Lupus

Swollen gland - tight neck

08/19/2002

Question:

I have had several tests done in the past few weeks concerning fatigue, hormone imbalances and general feeling of malaise. The last 3 or 4 weeks I have felt horrible. I have had 3 blood work ups done by three different doctors - all normal. I went to the ER on Friday because I felt so bad and they found that I had an enlarged lymph node below my chin area on the left side. THe wanted to do a CT scan with the dye - and also a chest xray - all came back normal. They sent me home with Keflex for an infection. I have taken 5 days of it. Felt better for the first time the next day, but now I feel bad again and my neck is tight. On the side of the swollen node, I did have a re-piercing of my ear about 5 weeks ago and woke up one morning with it super swollen and bloody and infected. Could that have drained down and stayed? I have had no fever, no sweating, no loss of appetite, no loss of weight. I do take thyroid -small dosage and cenestin - hormone - but the doctors haven`t mentioned changing them. Thanks so much.

Answer:

1. Regarding the fatigue, malaise - this is very nonspecific; one cannot diagnose a certain disease from these symptoms. They can appear with infectious conditions (acute, subacute, and chronic), with connective tissue diseases and autoimmune diseases, glandular malfunction (hypothyroidism, adrenal insufficiency, at certain ages also lack of estrogen), with cancers, with depression, etc. You do not mention your age and what tests were done. It is reassuring if 3 physicians (what specialty?) found nothing wrong with you. It is better though to `stick` with one who knows you the best and whom you trust. 2. Regarding lymph nodes - as you suspected they can enlarge and be tender when people have a local infection in the drainage area of the lymph node (e.g. your ear infection). Lymph nodes enlarge in blood diseases, viral and bacterial and fungal infections, in inflammatory and autoimmune diseases, in cancers (head and neck for example). Again it is very reassuring that all the tests and CT scan and Chest X-rays came back normal. It is also reassuring that you have no fever, chills, sweating, loss of appetite, loss of weight which all mean a more serious condition. If the lymph node is increasing in size, a biopsy can be done and the node examined under microscope. 

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Response by:

Yolanda   Farhey, MD Yolanda Farhey, MD
Associate Professor
College of Medicine
University of Cincinnati