Swollen Lymph Nodes in Neck

Patient

Q: The lymph nodes on the right side of my neck are very painful and swollen, along with shoulder pain. I went to a walk-in clinic because my PCP is out of town for the week. The ANP could not find any signs of infection in my ears, nose or throat, but said obviously something is wrong. I am also not running a fever. She prescribed 875mg Amox, twice a day for 10 days. I work for a Pharmacy and my RXM said it sounds like something more serious than a possible infection since the swelling is only on one side. She said I need to get checked for Lymphoma. Should I be scared? Or should I seek ER help since my PCP will not be back in town for a week? I am in pain, feel ill (nausea, headache, exhausted), or should I see it through until my PCP returns? Thank you for any assistance.

Doctor

A:   I agree with your pharmacist that it may be more serious than an infection. However, there is not a need to go to the Emergency Room unless you are feeling very ill. You can wait until your primary care physician returns. He will perform a thorough examination and take a detailed history to better determine the possible causes of the lymph node swelling. You will also need to do several blood test as well as a biopsy of one of the lymph nodes.
You should bare in mind the following possibilities for the lymph node swelling apart for acute infection and lymphoma:

Chronic infections (Eg. Tuberculois, HIV)
Leukemia
Systemic Lupus
Rheumatoid arthritis

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