[33F] With swollen lymph node, fatigue, and vertigo

Patient Description

A 33-year-old female presents with a swollen, soft, and tender lymph node on the right side of her neck, noticed for the past three days. She reports extreme fatigue, upper back pain radiating to the arms and ribs, and uncontrollable flatulence. The back pain, described as achy, began two days ago and is temporarily relieved by stretching. Additionally, she experiences a low-grade fever of 99.7°F, achy joints, and vertigo with a 'swimmy' head sensation rated 6/10 in severity, all starting within the last day. Her blood pressure is 109/59, lower than her usual readings. The rib pain is dull and achy, rated 4/10, with no specific triggering incident. She has no recent infections, injuries, or sick contacts and has not traveled recently. Her medical history includes stage 3 kidney disease diagnosed in early 2024 and a pituitary adenoma diagnosed in 2021. She is on Cabergoline 0.5mg twice weekly and has no known allergies. Recent tests for mononucleosis and strep throat were negative.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential explanations for what you might be experiencing:

  1. Viral Infection: Even though your tests for mono and strep were negative, other viral infections can cause symptoms like swollen lymph nodes, fatigue, low-grade fever, and body aches. These infections often resolve on their own with supportive care.

  2. Inflammatory or Autoimmune Condition: Conditions such as lupus or rheumatoid arthritis can cause joint pain, fatigue, and swollen lymph nodes. These conditions often require further evaluation by a healthcare provider for diagnosis.

  3. Pituitary Adenoma Effects: Your pituitary adenoma could potentially contribute to some of your symptoms, such as fatigue and vertigo, due to hormonal imbalances. It's important to follow up with your endocrinologist to ensure your adenoma is being managed effectively.

  4. Kidney Disease: Stage 3 kidney disease can cause fatigue and may contribute to other symptoms like changes in blood pressure. Regular monitoring and management by your healthcare provider are essential.

What you can do

For Swollen Lymph Node and Fatigue:

  • Rest as much as possible to help your body recover.
  • Stay hydrated by drinking plenty of fluids.
  • Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain and fever, but consult your doctor before taking them, especially with kidney disease.

For Upper Back Pain:

  • Continue gentle stretching exercises to relieve tension.
  • Apply heat or cold packs to the affected area to reduce pain.
  • Consider seeing a physical therapist for targeted exercises and pain management strategies.

For Vertigo and Low Blood Pressure:

  • Move slowly when changing positions to avoid dizziness.
  • Ensure you are eating regular, balanced meals to maintain energy levels.
  • Monitor your blood pressure and report significant changes to your healthcare provider.

For Overall Health:

  • Keep a symptom journal using MDandMe to track your symptoms, which can help your healthcare provider identify patterns or triggers.
  • Follow up with your healthcare provider to discuss your symptoms and any necessary tests or treatments.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening symptoms, such as high fever, persistent pain, or significant swelling.
  • New symptoms, such as difficulty breathing, chest pain, or severe headaches.
  • Any signs of infection, such as redness, warmth, or pus around the swollen lymph node.

Remember, while I can provide guidance, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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1 mo ago


People Also Ask


What could cause swollen lymph nodes and fatigue if tests for mono and strep are negative?

Swollen lymph nodes and fatigue can be caused by various viral infections other than mono and strep, such as the common cold or flu. Inflammatory or autoimmune conditions like lupus or rheumatoid arthritis can also cause these symptoms.


How can a pituitary adenoma affect symptoms like fatigue and vertigo?

A pituitary adenoma can lead to hormonal imbalances, which may cause symptoms like fatigue and vertigo. It's important to have regular follow-ups with an endocrinologist to manage these effects.


What are some common symptoms of stage 3 kidney disease?

Common symptoms of stage 3 kidney disease include fatigue, changes in blood pressure, and sometimes swelling in the legs or ankles. It's crucial to monitor kidney function regularly and follow a healthcare provider's advice.


What should I do if I experience vertigo and low blood pressure?

For vertigo and low blood pressure, move slowly when changing positions, eat regular balanced meals, and monitor your blood pressure. If symptoms persist or worsen, consult your healthcare provider.


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