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Forum Name: Lymphoma

Question: Posterior cervical lymph node enlargement, night sweats,


 ZoomJag3 - Wed Jan 24, 2007 5:58 pm

Hi, I am 25yo M in good health. Have always been the type of person with the "strong immune system" until just before this XMas.

12/24 Admitted to ER, with swollen face and fever of 104. Dx was Systemic Infection of unknown origin. Only symptoms before and during at that time were fever, malaise, and the severe swelling of my face..

1/2 Mild ear ache. Dx was Middle Ear Infection.

1/5 Flu like symptoms lasting less than 24 hours, no Dx, nor Rx

1/9 Fever of 101-102, malaise, and very slight swelling around my nose. No other symptoms or pain, Dx Sinusitis.

Since that date I have malaise and low grade fever on occasion (temp of about 100).

Starting about a month before XMas I began and am continuing an unusual pattern of very excessive night sweats. I will have 3-4 nights a week of sweating every OTHER week. Typically these drenching sweats occur from my head only and will drench thru two thick pillows. Occasionally the sweating extends to about the waistline. This has not been previously mentioned to a Dr as I kept expecting the pattern to cease. For the last month as well I have had a very hard node(s?) in my left posterior cervical node. The node seems to slightly change firmess from very firm to rock hard. Occasionally there is some swelling around it that is visible. There isn't pain when it is pressed on, but I do notice that when I "play" with it it will not move, but the skin above moves freely.

Other background info, is TB negative, HIV negative, tobacco smoker, mild/moderate drinker (2 drinks with dinner on occasion, maybe 3, night sweating pattern does not follow alcohol consumption), no regular Rx, or OTC meds, Rx in last 30 days has been Levaquin, Erytho, and Cipro. 6'1, 153, which is down from 159 two months ago, but I always maintain a very strong appetite.

I know these symptoms warrant a visit to my Dr, however I am changing health insurance companies, and am perhaps seeking advice as to the criticallity of going now or being able to wait a month.

Thank you kindly,
 Dr. Safaa Mahmoud - Thu Jan 25, 2007 6:19 pm

User avatar Hello,

There is a probability that the lymph nodes you have noticed are reactionary to infection in the area drained by this lymph node group but this has to be confirmed by your physician.

Sometimes, following infection, Lymph nodes remain permanently enlarged, though they should be non-tender, small (less the 1 cm), have a rubbery consistency and none of the characteristics described for malignancy or for infection (hard, fixed, increasing progressively in size).

Of significance, an increase in nodal size on serial examinations. Hence nodes that continue to grow in size are important and those that regress in size after infection control tend to be more reassuring.

The consistency is also very important in differential diagnosis.
Abnormal Lymph node enlargement commonly results from infection / immune response, cancer.

The night sweating is of consideration and can occur in many systemic diseases including infections (although TB, HIV were negative), cancer, certain drugs and some endocrine disorders.

It is also helpful if you can inform us about the investigations done and their results.

Follow up with your doctor is essential.
Best regards.

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