[54F] With fever, swollen lymph node, and persistent headache

Patient Description

A 54-year-old female presents with a tender, painful, and enlarged lymph node on the right side of the neck under the ear, which has been present for 2 weeks. The lymph node is described as hard and fixed in place. The patient has also been experiencing a fever ranging from normal to 101.8°F for approximately 12-13 weeks, along with night sweats. The patient reports a history of a bronchial infection lasting from early December to mid-January. Additionally, the patient is experiencing fatigue and headaches, which are described as aching, similar to sinus pressure, with an intensity of 3-4 on a scale of 10. The headaches are exacerbated by a lack of humidity and are a new symptom for the patient. The patient has a significant medical history of type 2 diabetes, hypertension, polycystic ovary syndrome (PCOS), and Hashimoto's hypothyroidism, all diagnosed over a decade ago. The patient reports allergies to latex and wheat. Current medications include Ozempic, Tirosint, Armour Thyroid, Valacyclovir, Montelukast, Lisinopril, and Basaglar. No changes in weight have been reported.

Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

Infection: An infection, such as a bacterial or viral infection, could cause swollen lymph nodes, fever, and fatigue. The infection could be localized to the neck or systemic.
- Treatment typically involves antibiotics for bacterial infections. Viral infections usually resolve on their own, but antiviral medications can be used in some cases.
Lymphoma: This is a type of cancer that affects the lymphatic system, which includes the lymph nodes. Symptoms can include swollen lymph nodes, fever, night sweats, and fatigue. However, lymphoma is relatively rare and there are many more common causes of these symptoms.
- Treatment typically involves chemotherapy, radiation therapy, and in some cases, stem cell transplant.
Other types of cancer: Certain types of cancer, such as head and neck cancer, can cause swollen lymph nodes in the neck. However, these cancers typically cause other symptoms as well, such as changes in voice or difficulty swallowing, which you did not report.
- Treatment typically involves surgery, radiation therapy, and chemotherapy.

What you can do

Given the duration and severity of your symptoms, it's important to seek medical attention. Here are some steps you can take:

Schedule an appointment with your primary care doctor. They can perform a physical examination and order tests to help determine the cause of your symptoms.
Keep track of your symptoms. This can help your doctor determine the cause of your symptoms and the best course of treatment.
Stay hydrated and rest as much as possible. This can help your body fight off an infection if that is the cause of your symptoms.

What you should look out for

Seek immediate medical attention if you experience any of the following:

Difficulty breathing or swallowing
Severe pain
A fever over 103°F (39.4°C)
Symptoms that are rapidly getting worse

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare professional for a formal diagnosis and treatment.

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11 mo ago

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