What causes persistent swollen lymph nodes and fever?

Question

Hello doctor,

I have had swollen lymph nodes in my neck for the past two months, a dry cough for three months, on and off a fever in the evening, headache, vague abdominal pain, and muscle pain.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thanks for your query, and I understand your concerns.

Persistent swollen lymph node requires tissue biopsy (sampling) as it could represent serious conditions, especially if painless. Can you estimate the size? Is it painful? Is it single or multiple? The possible causes are TB (tuberculosis), chronic infection, lymphoma, and other blood diseases.

Please provide me with more details and send me the investigations to narrow the differentials. For further advice, please do not hesitate to follow up.

I hope this helps.

Please revert in case of further queries.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Thanks for your follow-up.

You have chronic cervical lymphadenopathy, which could be due to glandular fever, tuberculosis, or chronic infection like chronic tonsillitis or sinus infection, dental infection, lymphoma, or any other blood disease. Please let me know:

Do you have any pharyngitis, dental infection, or tonsillitis?
Any chronic infections?
Any lymph nodes in other parts of the body?

My advice:

Send me the CBC (complete blood count) photocopy.
Perform chest X-ray.

In case we find any reasonable cause, we will treat accordingly, or if we can not find the cause, fine needle cytology will be required. Being painless suggests other causes than infection. I am willing to do a follow-up in your case and provide consultations to reach the appropriate diagnosis.

I hope this helps.

Please revert in case of further queries.

Thank you.

Answer 3

Hello,

Welcome back to icliniq.com.

Thanks for your follow-up.

Glandular fever is a viral infection EBV (Epstein-Barr virus), causing fever, tonsillitis, cervical lymphadenopathy, enlarged liver, and spleen. Please tell me the following:

Do you have a dental infection, tonsillitis, or pharyngitis?
Do you have any enlarged lymph nodes in other parts of the body?

A chest X-ray is required to exclude tuberculosis and the presence of lymphadenopathy in the lungs.

Please revert in case of further queries.

Thank you.