[43F] With head pressure, eye discomfort, and swollen lymph node

Patient Description

A 43-year-old female presents with head pressure, left eye discomfort, and a swollen lymph node on the left side of her neck. The lymph node is hard and tender to touch, with pain radiating to the back of her eye. She also reports muscle pain in her neck, left shoulder, left hip, spine, and left leg, described as dull and sometimes throbbing, rated 10/10 in severity. Symptoms have been present for about a month. Additionally, she experiences night sweats but no fever, and has been feeling unusually fatigued. Her medical history includes a cerebral plate removal due to metal rejection, and she has a left thrombosis stent placed in 2021 and a left cerebral shunt placed in 2023. She is currently taking Cymbalta (120mg twice a day), Elavil (25mg once at night), Seroquel (25mg once at night), Lamictal (25mg once at night), and Protonix (40mg once at night). She has allergies to Bactrim. She does not use tobacco, alcohol, or recreational drugs, has no family history of similar symptoms or conditions, is up to date with vaccinations, and has not been exposed to anyone sick or traveled recently.

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Arora's Assessment

What might be happening

Based on the symptoms and medical history you've provided, here are some possible explanations for your condition:

Swollen Lymph Node, Head Pressure, and Eye Discomfort

  • Infection or Inflammation: A swollen lymph node that is hard and tender could be due to an infection or inflammation. This could also explain the pressure in your head and discomfort in your left eye.
  • Lymphoma: Given the duration and nature of the swelling, a more serious condition like lymphoma (a type of blood cancer) could be a possibility. This would require further evaluation by a healthcare professional.
  • Thrombosis Complications: Since you have a history of thrombosis and a stent, complications related to these could also contribute to your symptoms.

Muscle Pain and Fatigue

  • Fibromyalgia: This condition can cause widespread muscle pain and fatigue. It often presents with tender points in various parts of the body.
  • Chronic Fatigue Syndrome: This condition is characterized by severe, long-lasting fatigue that is not improved by rest and may be accompanied by muscle pain.

Night Sweats

  • Hormonal Imbalances: Conditions like hyperthyroidism or menopause can cause night sweats.
  • Infections: Chronic infections, such as tuberculosis, can also cause night sweats.

Swollen Ankle and Foot

  • Venous Insufficiency: Given your history of thrombosis and a stent, venous insufficiency could be causing the swelling in your ankle and foot.
  • Lymphedema: This condition involves swelling due to lymphatic system blockages and could be related to your swollen lymph node.

What you can do

Swollen Lymph Node, Head Pressure, and Eye Discomfort

  • See a Doctor: Given the duration and severity of your symptoms, it's crucial to consult a healthcare professional as soon as possible. They may recommend imaging studies like an ultrasound or CT scan and possibly a biopsy of the lymph node.
  • Pain Management: Over-the-counter pain relievers like ibuprofen can help manage pain and inflammation. However, consult your doctor before taking any new medication.

Muscle Pain and Fatigue

  • Physical Therapy: A physical therapist can provide exercises to help manage muscle pain and improve mobility.
  • Lifestyle Changes: Gentle exercises like yoga or swimming can help alleviate muscle pain. Ensure you get adequate rest and maintain a balanced diet.
  • Medication Review: Discuss your current medications with your doctor to see if any adjustments are needed.

Night Sweats

  • Keep Cool: Use lightweight bedding and keep your bedroom cool at night.
  • Hydration: Drink plenty of water to stay hydrated.
  • Medical Consultation: Discuss your night sweats with your doctor to rule out any underlying conditions.

Swollen Ankle and Foot

  • Compression Stockings: Wearing compression stockings can help reduce swelling.
  • Elevate Your Legs: Elevate your legs when sitting or lying down to help reduce swelling.
  • Consult Your Doctor: Given your history of thrombosis, it's essential to consult your doctor to rule out any complications.

What you should look out for

Given the severity and complexity of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Increased Swelling or Pain: If the swelling or pain worsens, seek immediate medical attention.
  • Fever or Chills: These could indicate an infection that needs prompt treatment.
  • Shortness of Breath or Chest Pain: These could be signs of a serious condition like a blood clot or heart issue.
  • Neurological Symptoms: Any new or worsening neurological symptoms, such as vision changes or severe headaches, should be evaluated immediately.

Remember, while I can provide information and suggestions, it's crucial to consult a healthcare professional for a formal diagnosis and treatment plan. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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People Also Ask


What could cause a swollen lymph node that is hard and tender?

A swollen lymph node that is hard and tender could be due to an infection or inflammation, or in more serious cases, it could indicate conditions like lymphoma. It's important to consult a healthcare professional for a proper evaluation.


What are the possible reasons for experiencing night sweats without a fever?

Night sweats without a fever can be caused by hormonal imbalances such as hyperthyroidism or menopause, chronic infections, or even certain medications. It's advisable to discuss these symptoms with a doctor to identify the underlying cause.


How can muscle pain and fatigue be managed effectively?

Muscle pain and fatigue can be managed through physical therapy, gentle exercises like yoga or swimming, ensuring adequate rest, and maintaining a balanced diet. It's also important to review current medications with a doctor to see if any adjustments are needed.


What are the potential complications of having a thrombosis stent?

Potential complications of having a thrombosis stent include venous insufficiency, which can cause swelling, and the risk of blood clots. Regular follow-ups with a healthcare provider are essential to monitor and manage these risks.


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