[35F] With swollen painful lumps under armpits, rash, fever, fatigue, and dizziness

Patient Description

A 35-year-old female presents with swollen, painful lumps under both armpits for the past week. The lumps are described as hard, movable, hot, and have increased in size since they first appeared. The patient has not experienced any injuries, trauma, recent infections, or changes in skin care products or deodorants that could explain these lumps. Additionally, the patient has a low-grade fever of 99°F that started today, which has been managed with Tylenol. The patient also reports fatigue and moderate lightheadedness that started today, with no specific activities or situations that exacerbate these symptoms. There is a rash on both armpits, but it has not spread, changed color, or increased in itching. The patient denies night sweats, unexplained weight loss, recent changes in diet, medications, or travel history. The patient does not use tobacco, alcohol, or recreational drugs. Past medical history includes abnormal cervical cells diagnosed in 2008, which has since resolved. The patient has no known allergies or adverse reactions to medications and is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Lymphadenitis: This is an infection of the lymph nodes, which can cause them to become swollen, hard, and painful. The fever, fatigue, and dizziness you are experiencing could also be related to this infection. Treatment typically involves antibiotics to clear the infection.

  • Hidradenitis Suppurativa: This is a chronic skin condition that causes painful lumps under the skin, often in areas where skin rubs together, such as the armpits. These lumps can become infected and lead to fever and fatigue. Treatment may include antibiotics, anti-inflammatory medications, and sometimes surgical drainage of the lumps.

  • Abscess: This is a collection of pus that can form in the body due to an infection. Abscesses can cause painful, swollen lumps that are hot to the touch. Fever and fatigue are common symptoms of an abscess. Treatment usually involves draining the abscess and taking antibiotics.

  • Viral Infection: Some viral infections can cause swollen lymph nodes, fever, fatigue, and dizziness. These infections often resolve on their own, but supportive care and rest are important.

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 in the meantime:

  1. Apply Warm Compresses: Applying a warm compress to the affected areas can help reduce pain and swelling.
  2. Stay Hydrated: Drink plenty of fluids to stay hydrated, especially if you have a fever.
  3. Rest: Make sure to get plenty of rest to help your body fight off any potential infection.
  4. Over-the-Counter Pain Relief: Continue taking Tylenol (acetaminophen) to help manage your fever and pain.
  5. Avoid Irritants: Avoid using any new skin care products or deodorants that could further irritate the rash and lumps.
  6. Monitor Symptoms: Keep track of your symptoms using the MDandMe journal. This can help you and your healthcare provider understand how your symptoms are progressing and identify any potential triggers.

What you should look out for

Seek medical attention more urgently if you experience any of the following:

  • Increased Pain or Swelling: If the lumps continue to grow or become more painful.
  • High Fever: If your fever rises above 100.4°F or persists despite taking fever-reducing medications.
  • Pus or Discharge: If you notice any pus or discharge coming from the lumps.
  • Difficulty Breathing: If you experience any difficulty breathing or chest pain.
  • Severe Dizziness or Weakness: If your dizziness or weakness becomes severe or you feel faint.

Remember, while this information can help you understand your symptoms, it is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and appropriate treatment.

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4 mo ago

People Also Ask


What are the common causes of swollen, painful lumps under the armpits?

Common causes of swollen, painful lumps under the armpits include lymphadenitis (infection of the lymph nodes), hidradenitis suppurativa (a chronic skin condition), abscesses (collections of pus due to infection), and viral infections. Each condition has distinct characteristics and may require different treatments.


How can I differentiate between a viral infection and a bacterial infection causing swollen lymph nodes?

Viral infections often resolve on their own and are usually accompanied by symptoms like fatigue and fever, while bacterial infections may cause more localized pain and swelling, and often require antibiotics. A healthcare provider can perform tests to determine the cause.


What are the treatment options for hidradenitis suppurativa?

Treatment options for hidradenitis suppurativa include antibiotics to treat or prevent infection, anti-inflammatory medications to reduce swelling, and sometimes surgical procedures to drain or remove the lumps. Lifestyle changes and avoiding skin irritants can also help manage symptoms.


When should I seek medical attention for swollen lymph nodes and associated symptoms?

You should seek medical attention if the lumps continue to grow or become more painful, if your fever rises above 100.4°F or persists despite taking medication, if you notice pus or discharge from the lumps, or if you experience difficulty breathing or severe dizziness or weakness.


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