Is My Lymph Node Issue Related to TB?
**Profile**: - **Age**: 19 years - **Height**: 5'8" - **Weight**: 97 lbs - **Nationality**: Indian NRI Hello everyone, I'm a 19-year-old male. About a month ago, I noticed a lump beneath my ear. Initially, it felt similar to a small pimple, but within a few days, it enlarged significantly and became very painful. I underwent an MRI which revealed multiple lymph nodes that were matted together and showing signs of necrosis. Subsequently, I had a Fine Needle Aspiration Cytology (FNAC), which indicated reactive hyperplasia. However, the FNAC was inconclusive, leading to a biopsy that reported necrotizing granulomas in my lymph nodes. This prompted doctors to suspect tuberculosis (TB). A series of TB tests ensued, including a Mono test, GENE Xpert, acid-fast bacillus (AFB) smear, culture analysis, a chest X-ray, and a TB Gold test, all of which returned negative results. When I mentioned that I own a cat, the doctor suggested the possibility of Cat Scratch Disease. Following that, I was prescribed Azithromycin for five days, which provided substantial relief; the major lymph node reduced in size, and I experienced less pain. Unfortunately, after a short period, the discomfort in the node returned, prompting me to visit my doctor again. This time, he prescribed doxycycline and painkillers. Yesterday, I experienced a fever and pain in the lymph nodes, which seems to be either radiating from my throat or affecting it somehow, along with night sweats. Strangely, I still have a strong appetite and have not lost any weight. This recent escalation began just yesterday. I'm curious if anyone has insights on what might be happening. Could this potentially be an undiagnosed TB infection? If that were the case, why did Azithromycin alleviate the swelling of the largest node?
Answers (1)
9/2/2025, 7:30:53 AM
OpenHealth AI
Main Points: Your symptoms and medical history suggest a complex situation with lymph nodes, but extensive testing has ruled out TB. The relief you experienced with Azithromycin indicates a bacterial component that may not necessarily be TB. Let's explore your symptoms and consider the next steps.
Explanation: Lymph nodes can react to various infections, and their swelling can be due to viral, bacterial, or even non-infectious causes like autoimmune conditions. The presence of “necrotizing granulomas” in your biopsy often suggests some chronic infection or inflammatory condition, and while TB is a primary concern, your extensive testing has returned negative for TB specifically.
Azithromycin, an antibiotic, is effective against certain bacteria and may have relieved your symptoms because it targeted a bacterial infection (which could have been something other than TB) or reduced inflammation. The recent return of pain and fever might indicate an ongoing infection or inflammation that hasn't fully resolved.
Next Steps:
-
Monitor Symptoms: Keep a close eye on your symptoms, particularly any changes in fever, pain levels, or new symptoms. Tracking how your body responds to medications may provide useful information.
-
Medication Adherence: Continue taking the doxycycline as prescribed, and let your doctor know about any side effects or changes in your condition.
-
Follow-Up Appointment: Schedule a follow-up visit with your healthcare provider to discuss your recurring symptoms. This can help reassess your condition and possibly lead to additional tests or referrals if needed.
-
Hydration and Rest: Ensure you’re staying well-hydrated and getting enough rest, as these are crucial for your immune system to function optimally.
-
Consider Follow-Up Testing: If your symptoms do not improve or worsen, discuss with your doctor the potential for further tests or evaluations, as this may provide more answers about the underlying cause (e.g., possible infections or autoimmune issues).
Remember, responses to infections can vary, and it’s important to maintain close communication with your healthcare provider regarding any changes. Stay hopeful and proactive in managing your health.
Related Questions
Concerns About Persistent Symptoms: A 29-Year-Old's Health Dilemma
Hello, I’m a 29-year-old female, and I’m increasingly anxious about my health situation. For several months now, I have been experiencing daily rectal bleeding. Each bowel movement includes a mixture of blood and stool, with some instances featuring only bloody mucus or blood dripping. Despite undergoing an iron infusion, I continue to feel extraordinarily weak and fatigued. I often experience dizziness and can even feel faint, during which my hearing occasionally dulls, leading to near fainting episodes. Additionally, I suffer from persistent headaches that are unresponsive to medications, whether they be over-the-counter options like Panadol or stronger pain relievers. My vision seems blurred most of the time, and my cognitive function has noticeably declined; tasks that used to be simple now present challenges, and conversations feel laborious. I’ve had friends express concern about my well-being. Moreover, I notice that my legs and feet turn purple when I remain seated or still for any length of time. Despite trying to eat more to alleviate my dizziness, I'm still losing weight. I also contend with night sweats and persistent discomfort in my bowel area and lower back. In terms of medical evaluations thus far: - A CT scan of my abdomen and pelvis yielded normal results. - My stool blood test returned positive. - The faecal calprotectin level was recorded at 18, suggesting inflammatory bowel disease (IBD) is unlikely. - Blood tests indicated anemia, and after my iron infusion, my condition has not improved; instead, I feel like I'm worsening. - I’ve been referred for a colonoscopy, but I was categorized as Priority 2 by the hospital, which means I might wait up to 90 days. I feel like I am deteriorating weekly, and the fear of a potential cancer diagnosis, even at my young age, is overwhelming. I have several questions: 1. Could the presence of polyps explain all these symptoms, or is cancer a more plausible explanation? 2. Should I advocate for a more immediate colonoscopy, or is a 90-day wait acceptable under the circumstances? 3. Are there additional inquiries I should make to my healthcare provider? Thank you for any insights you can provide. I'm at a loss and genuinely wish to understand my situation better as I feel like I'm slowly declining.
Inquiry Regarding Shingles Symptoms
I am a 45-year-old female, standing 5 feet 4 inches tall and weighing 125 pounds. I reside in Pennsylvania, and my main concern is related to shingles. I first noticed the rash on Wednesday and received a diagnosis at a walk-in clinic on Saturday morning. That same afternoon, I began treatment with Valtrex, taking one gram three times daily. My rash appears to be on the verge of bursting, with fluid-filled blisters that remain intact. In addition to shingles, I deal with depression, anxiety, and hypothyroidism. Here’s a rundown of my current medications: - Effexor (300mg, once daily) - Propranolol (10mg, twice daily) - Clomipramine (50mg at bedtime) - Hydroxyzine (50mg at bedtime) - Levothyroxine (75mg on Monday, Wednesday, and Friday; 50mg on Saturday and Sunday) - Liothyronine (2.5mg, once daily) I do not smoke, consume alcohol, or use recreational drugs. I am managing shingles-related discomfort with ibuprofen. The physician assistant at the clinic suggested steroids, but I chose not to pursue that option, believing my pain to be manageable. I have a follow-up appointment with my primary care provider scheduled for in about two weeks, in case the pain persists. Currently, I am experiencing a subtle tingling sensation throughout the left side of my body. This coincides with the shingles rash located under my left breast and across my left back, extending to my spine. The tingling has also affected my left side in areas such as my head, arm, hand, torso, leg, and foot. It has become uncomfortable enough that I can no longer comfortably place a hair clip on the left side of my head, while the right side feels perfectly fine. Should I be worried about these symptoms, or is this normal for shingles? I had the impression that pain would remain localized to the area of the rash. I appreciate any guidance or insights you can provide on this matter.
Evaluating the Risks of Terbinafine: What to Expect at a Clinic or Emergency Room
At 45 years old, standing at 6 feet 3 inches tall and weighing 172 pounds, I maintain a lifestyle that avoids alcohol, smoking, and drugs while not taking any medications. For nearly ten years, I have been managing a persistent fungal infection affecting both my fingernails and toenails. It all began around a decade ago when my right middle fingernail showed severe signs of the infection. After visiting the ER, medical staff lanced that nail, which significantly improved its condition, allowing it to regrow without further issues. Despite this, I continue to struggle with the infection on two of my fingernails and several toenails. Throughout this period, I primarily received topical treatments, particularly ciclopirox. While it hasn’t eradicated the infection, it has helped to some extent in controlling its spread. The condition of my nails has deteriorated, making them fragile. To manage any active infection on a new nail, I usually resort to peeling the affected areas off. Last Fall, I consulted a new physician who prescribed terbinafine. However, after conducting some research, I found alarming information regarding its potential negative effects on the liver. Additionally, numerous users on Reddit express concerns about experiencing depression and suicidal ideation after starting the medication. These findings made me hesitant to follow through with taking the prescribed drug. Instead, I opted to try a homemade remedy suggested by a friend, which involved coconut oil and oregano oil. Unfortunately, during this time, I neglected to apply ciclopirox as well. Recently, an infection has developed under the nail of my left thumb, complicating my efforts to remove the infected area. This situation has caused the nail to lift visibly. I have a couple of questions: 1) What is your perspective on the severity of the side effects associated with terbinafine? 2) Should I visit a walk-in clinic or emergency room, what treatment methods might they employ? Would they consider lancing the fingernail again? I’ve read conflicting information online, some suggesting that lancing is only performed if pus is present, but I believe there's significant infection beneath my nail. I appreciate your time and insight on these matters!
Concern Over Deteriorating Cat Bite Infection Despite Antibiotic Treatment
Recently, I suffered an injury from a cat bite, despite the animal being up-to-date on vaccinations and not being allowed outdoors. The bite led to an infection that escalated rapidly. To address this, I was prescribed Augmentin to be taken twice daily over a span of ten days. However, after a week on this antibiotic, I’m dismayed to notice that the infection seems to be worsening rather than improving. Each day, I have been diligently cleansing the wound with soap and water before applying triple antibiotic ointment and securing it with a bandaid to prevent irritation from my clothing. Unfortunately, the area around the bite is now marked by a very itchy, bright red ring, accompanied by what appears to be a hard swelling at the center, along with a concerning amount of pus. Upon changing the bandaid, I observe a peculiar discharge that is a yellow-green hue. Due to its location in the thigh and pelvic crease, I am hesitant to share any images of the affected area for privacy reasons. My urgent care physician advised that if symptoms persist beyond the antibiotic course, I should reach out to my primary care provider (PCP). I was also informed that significant improvement should be evident within 48 hours, yet that hasn’t been the case. Should I reach out to my PCP now about this problem, or can it wait until Thursday? I’m apprehensive about getting an appointment since I can’t afford another visit to urgent care. For context, I am a 23-year-old person assigned female at birth, weighing 120 pounds and standing 5’4" tall. My current medications include 10 mg of amlodipine, a combination birth control, Maxalt, magnesium glycinate once daily, and a probiotic twice a day. I have a diagnosis of an unspecified connective tissue disorder, POTS (Postural Orthostatic Tachycardia Syndrome), and experience mild episodes of SVT (Supraventricular Tachycardia). The cause of my hypertension is unknown, but it was once severe prior to medication. My kidney function has been ruled out and I have yearly consultations with a cardiologist, with plans to see a genetic specialist in cardiology soon. Apologies for the lengthy background; I’ve been on a long journey to understand my health issues for the past 16 years!
Seeking Guidance on Dental Issues: Young Adult in Distress Over Tooth Condition
Hello, I’m a 20-year-old female, and I find myself in a distressing situation regarding my molar on the right side. After having a deep cavity diagnosed as necrosed, I underwent a root canal that required three sessions. However, two days following my fourth appointment—where my dentist took an impression for the crown and re-cleaned the canals—I began to experience severe discomfort. My dentist chastised me for failing to properly care for my temporary filling, which she claimed had hindered fluid drainage and led to my pain. I was apprehensive and didn’t manage to address it myself. Initially, she fitted a cotton temporary filling that didn’t cause pain, but it emitted a foul odor similar to pus. After four days, she replaced it with an earlier filling that had already caused me pain. Fast forward to this past Saturday, a week and four days later, I started to develop mild pain, which rapidly escalated to an intense level by today. Alongside this, I’ve noticed swelling, a fever, and a small bump resembling a pimple on my gum. Now, my dentist has observed that my tooth feels loose, attributing this to bone loss and suggesting that extraction might be necessary. While I suspect the looseness could merely be related to the gum inflammation, the fear of losing my tooth terrifies me. Initially, my dentist has been hesitant to prescribe antibiotics; I received a three-day course earlier, and after I pressed for more, she has now provided another three-day supply. Nevertheless, my anxiety over this situation remains. If there are any dental professionals or individuals who have faced similar challenges, I would greatly appreciate your advice. I genuinely want to save my tooth, and I believe the perceived looseness might just be linked to the swelling.