Understanding Swollen Lymph Nodes
Greetings, I’m a 28-year-old male. In February, I received a diagnosis of mononucleosis, which turned out to be quite severe. This led to a hospitalization and resulted in me developing sensitivities to certain medications, specifically NSAIDs. After my immunologist identified that these allergens were exacerbating my symptoms and once the virus had run its course, I initially began to feel better. However, recently, following a reduction in my medication as per my doctor’s advice, I have noticed that my lymph nodes have become swollen, causing persistent discomfort. Over the last 70 days or so, the lymph nodes in my neck, armpits, groin, and lower back have remained swollen. The situation has become so pronounced that my mother recently saw a noticeable lump on my neck. Additionally, my knees and other joints feel inflamed, making it difficult to walk comfortably. I am experiencing varying levels of post-exertional malaise (PEM) after even minor activities. I often feel an overwhelming itchiness and suffer from significant brain fog to the extent that I frequently forget what I intended to say. My sleep has been disrupted, often accompanied by night sweats, and despite maintaining my calorie intake, I'm unexpectedly losing weight due to having minimal physical activity. After consultation with my gastroenterologist, I have also begun to face symptoms of gastroesophageal reflux disease (GERD) and dyspepsia. Moreover, I've noticed numbness in my face, and this is just an overview of my daily experiences; there are additional sporadic symptoms, such as an unusual increase in my resting heart rate. Should I consider requesting referrals or tests from my doctor? I am feeling quite overwhelmed trying to understand the situation, especially since I had noticed some improvement before, yet my quality of life has significantly declined again even though the infection has resolved.
Answers (1)

6/19/2025, 10:20:48 AM
OpenHealth AI
It sounds like you’re navigating a challenging combination of symptoms following your diagnosis of mononucleosis, and it's completely understandable to feel overwhelmed. Your swollen lymph nodes, joint inflammation, fatigue, sleep disturbances, and other symptoms suggest a complex situation that may benefit from further evaluation.
Explanation
Swollen lymph nodes can be a sign of various underlying conditions, especially after a viral infection like mononucleosis, which can sometimes lead to post-viral syndromes. Your reports of joint discomfort, PEM, brain fog, night sweats, and unintended weight loss, as well as your gastrointestinal issues, may point to an autoimmune condition or other underlying health issues that require thorough investigation.
Next Steps
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Document Symptoms: Keep a detailed journal of your symptoms, noting when they occur and their intensity. This can help in conversations with your healthcare team.
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Request Referrals and Tests:
- Rheumatologist or Immunologist: Given your joint pain, fatigue, and potential autoimmune concerns, a referral to a specialist can provide insights into conditions like lupus or other rheumatological diseases.
- Neurologist: If the numbness in your face continues, consider a referral to evaluate neurological conditions such as multiple sclerosis.
- Gastroenterologist: Since you are experiencing GERD and dyspepsia, further tests may help rule out underlying causes.
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Communicate Your Concerns: When you meet with your healthcare providers, clearly express the full range of your symptoms, emotional impacts, and how they affect your daily life. This is crucial for comprehensive care.
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Focus on Self-Care:
- Hydration: Stay well-hydrated, especially if you're dealing with fluctuating body weight and gastrointestinal discomfort.
- Rest: Prioritize good sleep hygiene to help mitigate fatigue and brain fog. Consider creating a relaxing bedtime routine.
- Nutrition: Work with a dietitian if losing weight remains a significant issue; they can help ensure you’re getting the nutrients you need even with reduced activity levels.
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Manage Stress: Techniques such as mindfulness, gentle yoga, or breathing exercises can be helpful in managing stress and improving your overall well-being amidst this challenging time.
Please remember that understanding your health is a journey, and it’s okay to seek clarity and support as you move forward. If your symptoms exacerbate or you experience any new concerning signs like severe pain or neurological issues, consider prompt medical attention. Take care, and ensure to advocate for yourself in your healthcare journey.
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