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:
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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.
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Medication Adherence: Continue taking the doxycycline as prescribed, and let your doctor know about any side effects or changes in your condition.
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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.
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Hydration and Rest: Ensure you’re staying well-hydrated and getting enough rest, as these are crucial for your immune system to function optimally.
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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.
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