[23F] With severe neck pain, swollen lymph nodes, and systemic symptoms

Patient Description

A 23-year-old female presents with severe neck pain and tightness on both sides of her neck for the past three days. The pain started suddenly and is not exacerbated by any specific activities or movements. She reports two swollen lymph nodes under her chin that are tender and hard. Additionally, the patient has experienced fever, chills, night sweats, and occasional difficulty breathing that comes and goes. She has not had any recent infections, illnesses, or injuries to her neck. The patient is not on any prescribed medications but has been taking 1000 mg of both ibuprofen and Tylenol every 4 hours since yesterday. She has a family history of cancer and autoimmune diseases. The patient also uses vape and consumes alcohol.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  • Viral or Bacterial Infection: Infections such as the flu, strep throat, or mononucleosis can cause symptoms like sore throat, swollen lymph nodes, fatigue, and fever. These infections can also lead to neck pain and tightness due to swollen lymph nodes and muscle strain.

    • Treatment: Viral infections typically resolve on their own with rest, fluids, and over-the-counter medications to manage symptoms. Bacterial infections like strep throat may require antibiotics prescribed by a doctor.
  • Tonsillitis: Inflammation of the tonsils can cause a sore throat, swollen lymph nodes, fever, and neck pain.

    • Treatment: Similar to other infections, treatment may include rest, fluids, and over-the-counter pain relievers. If bacterial, antibiotics may be necessary.
  • Lymphadenitis: This is an infection of the lymph nodes, which can cause them to become swollen, tender, and hard. It can also lead to fever and chills.

    • Treatment: Depending on the cause, treatment may involve antibiotics if bacterial, or supportive care if viral.
  • Thyroiditis: Inflammation of the thyroid gland can cause neck pain, swelling, and sometimes fever.

    • Treatment: Treatment depends on the underlying cause and may include anti-inflammatory medications or other specific treatments.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Rest and Hydration: Ensure you get plenty of rest and stay hydrated. This can help your body fight off any potential infections.
  2. Over-the-Counter Medications: Continue taking ibuprofen and Tylenol as directed to manage pain and fever. However, be cautious with the dosage and frequency to avoid potential side effects.
  3. Warm Compresses: Applying a warm compress to your neck may help alleviate some of the pain and tightness.
  4. Gargle with Salt Water: This can help soothe a sore throat and reduce inflammation.
  5. Monitor Symptoms: Keep track of your symptoms using the MDandMe journal. This can help you identify any patterns or changes and provide useful information to your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Difficulty Breathing: If your breathing issues worsen or become constant, seek immediate medical attention.
  • High Fever: If your fever persists or gets higher, it may indicate a more serious infection.
  • Severe Pain: If the pain in your neck becomes unbearable or spreads, consult a healthcare professional.
  • Persistent or Worsening Symptoms: If your symptoms do not improve or worsen over the next few days, it's important to see a doctor.

Remember, while these suggestions can help manage your symptoms, they are not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and appropriate treatment.

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6 mo ago

People Also Ask


What could cause swollen lymph nodes and neck pain without a recent infection?

Swollen lymph nodes and neck pain can be caused by various conditions, including viral or bacterial infections, tonsillitis, lymphadenitis, or thyroiditis. Even without a recent infection, these symptoms can arise due to underlying issues such as inflammation or immune responses.


How can I differentiate between a viral and bacterial infection based on symptoms?

Viral infections often present with symptoms like fatigue, body aches, and mild fever, and they typically resolve on their own. Bacterial infections may cause more severe symptoms, such as high fever, localized pain, and pus formation, and often require antibiotics for treatment. A healthcare provider can perform tests to determine the cause.


Is it safe to take both ibuprofen and Tylenol together for pain management?

Yes, it is generally safe to take ibuprofen and Tylenol (acetaminophen) together, as they work differently in the body. However, it's important to follow dosing instructions carefully to avoid potential side effects, such as liver damage from acetaminophen or stomach issues from ibuprofen.


When should I seek medical attention for neck pain and swollen lymph nodes?

You should seek medical attention if you experience difficulty breathing, a high or persistent fever, severe or spreading pain, or if your symptoms do not improve or worsen over a few days. These could indicate a more serious condition that requires professional evaluation and treatment.


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