[23F] With persistent neck pain and lymphadenopathy

Patient Description

A 23-year-old female presents with persistent dull neck pain and severe stiffness, primarily on the left side, which has gradually worsened over the past six months. The pain is exacerbated by turning to the left but is not significantly relieved by movement or massage. The patient reports possible swollen lymph nodes in the neck and a noticeable asymmetry in tonsil size, with the left tonsil appearing larger for about a year. She has experienced over five episodes of strep-like symptoms in the past year, though tests for strep, COVID-19, and mono were negative. Additionally, the patient experiences transient itching lasting less than 40 minutes and daily gas pains. There is no history of fever, chills, unexplained weight loss, or night sweats. The patient uses a disposable vape for nicotine and reports extremely dry, flaky palms occurring almost weekly. There is no family history of autoimmune diseases, and she has not been exposed to environmental irritants or infections recently.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential explanations:

  1. Chronic Tonsillitis or Tonsil Hypertrophy: The changes in your left tonsil's size and appearance, along with recurring sore throat symptoms, could suggest chronic tonsillitis or tonsil hypertrophy. This condition can cause discomfort and difficulty swallowing. Treatment often involves monitoring, antibiotics if bacterial infection is suspected, or in some cases, a tonsillectomy.

  2. Lymphadenopathy: The swelling in your neck and armpit could be due to lymphadenopathy, which is the enlargement of lymph nodes. This can occur due to infections, inflammation, or other conditions. A healthcare provider might recommend blood tests or imaging to determine the cause.

  3. Muscle Tension or Cervical Strain: The neck pain and stiffness, especially if it's worsened by certain movements, could be due to muscle tension or cervical strain. This is common with poor posture or stress. Physical therapy, stretching exercises, and ergonomic adjustments can help alleviate symptoms.

  4. Dermatological Condition: The dry, flaky palms could be related to a dermatological condition such as eczema or psoriasis. These conditions can cause skin changes and may require topical treatments or lifestyle modifications.

What you can do

Neck Pain and Stiffness:

  • Continue with stretching and posture exercises. Consider consulting a physical therapist for personalized exercises.
  • Apply heat or cold packs to the affected area to help reduce pain and stiffness.
  • Maintain good posture, especially when using electronic devices or working at a desk.

Swollen Lymph Nodes:

  • Monitor the size and tenderness of the swollen areas. If they continue to grow or become painful, seek medical evaluation.
  • Stay hydrated and maintain a healthy diet to support your immune system.

Tonsil Changes and Sore Throat:

  • Gargle with warm salt water to soothe your throat.
  • Avoid irritants such as smoke or strong odors that can aggravate your throat.

Dry, Flaky Palms:

  • Use a gentle, fragrance-free moisturizer regularly to keep your skin hydrated.
  • Avoid harsh soaps or detergents that can dry out your skin further.

Consider using MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

What you should look out for

  • If you experience significant changes in the size or number of swollen lymph nodes, or if they become painful, seek medical attention.
  • Watch for any new symptoms such as fever, unexplained weight loss, or persistent night sweats, as these could indicate a more serious condition.
  • If your neck pain becomes severe or is accompanied by neurological symptoms like numbness or weakness, consult a healthcare professional promptly.

Remember, while this information can be helpful, it's important to consult with a healthcare provider for a formal diagnosis and appropriate treatment.

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2 mo ago

People Also Ask


What could cause persistent neck pain and stiffness on one side?

Persistent neck pain and stiffness on one side can be caused by muscle tension, cervical strain, or poor posture. It may also be related to underlying conditions such as chronic tonsillitis or lymphadenopathy. Consulting a healthcare provider for a proper assessment is recommended.


Why might one tonsil be larger than the other, and is it a cause for concern?

One tonsil being larger than the other can be due to chronic tonsillitis, tonsil hypertrophy, or an asymmetrical response to infections. While it can be benign, persistent asymmetry should be evaluated by a healthcare provider to rule out any serious conditions.


What are the possible reasons for swollen lymph nodes in the neck?

Swollen lymph nodes in the neck can result from infections, inflammation, or other conditions like lymphadenopathy. They often enlarge in response to infections or immune responses. Persistent or painful swelling should be evaluated by a healthcare provider.


How can I manage dry, flaky skin on my palms?

Managing dry, flaky skin on the palms involves using a gentle, fragrance-free moisturizer regularly, avoiding harsh soaps, and protecting the skin from irritants. If the condition persists, consulting a dermatologist may be beneficial to rule out conditions like eczema or psoriasis.


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10 Comments


Anonymous#8743

2 mo ago

test comment

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2 mo ago

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Anonymous#8743

2 mo ago

valid reply

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2 mo ago

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Anonymous#8743

2 mo ago

test reply 1

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Anonymous#8743

2 mo ago

test

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2 mo ago

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Anonymous#8743

2 mo ago

foobar

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