Lymph Nodes Behind the Ear: Causes and Treatment Options

Q: Lymph Nodes Behind the Ear: Causes and Treatment Options

Hello： Generally, lymph nodes that fluctuate in size are mostly benign changes. <br>However, if they continue to enlarge or cause discomfort, it is advisable to return to the hospital for follow-up. <br>If necessary, an ultrasound or other imaging studies may be arranged for diff

Two lymph nodes have developed below the head, behind the ear?

Hello Dr.
Zheng,
About a month ago (on October 25), I noticed a lymph node about 1 to 1.2 cm in size in my right ear, connected to my head.
A few days later, on October 31, I discovered another lymph node of the same size below the original one in the same ear.
Therefore, I visited the ENT department at Far Eastern Memorial Hospital on November 1.
The doctor examined me and said it probably wasn't cancer.
He only asked about my symptoms (I told him I had a runny nose and a sore throat, but I didn't feel feverish).
The doctor checked my throat and prescribed a seven-day course of antibiotics (four packets per day) for a bacterial infection.
He advised me to finish all the medication and to return if the lymph nodes increased in size after a week.
However, I only took one packet because my mother advised me to wait and see.

I also noticed that my left ear had a similar lymph node, symmetrical to the right ear, located behind the ear, measuring about 1 cm (only one node, unlike the two on the right).
After taking one packet of antibiotics, it seemed like the lymph node on the left side disappeared, so I stopped taking the medication.
As of now, November 8, the two lymph nodes in my right ear have not decreased in size, and my symptoms include occasional runny nose and cough.

Dr.
Zheng, is it serious that I keep developing lymph nodes? Currently, they feel firm and do not move around much or cause significant pain.
Initially, I felt a tight sensation when they first appeared, which prompted me to touch them.
Should I finish the antibiotics prescribed by Far Eastern Memorial Hospital, or would it be better to visit a smaller ENT clinic for a more detailed examination? I feel that large hospitals may not be thorough due to the high volume of patients.

I suspect that my symptoms may have started after I traveled to Hokkaido, Japan, between October 1 and October 15, where I ate sashimi and felt a bit under the weather, although I wasn't sure if I had developed lymph nodes at that time.
Upon returning to Taiwan, I also consumed some raw vegetables and sashimi, which could potentially have triggered a bacterial infection.
On a side note, I have urticaria, but it is not severe.
Recently, I noticed that the skin on the back of both of my calves had developed large areas of ulceration (the appearance is somewhat grayish, very itchy, and if scratched, it oozes and bleeds...
it has also extended to my ankles and a bit onto my feet).
Could this be related to diabetes? I researched online and it looks like acute eczema, but I believe I do not have diabetes (as my fasting hemoglobin A1c was 5.1 last year).
However, my skin condition seems to have worsened this year; I thought it resembled cellulitis.
Previously, when I visited a dermatologist, they diagnosed it as eczema and prescribed medication that mostly alleviated the symptoms.
I haven't seen a doctor this year because my symptoms improved significantly in the autumn and winter; if I don't scratch it, it doesn't bother me.

Additionally, I have been consuming fried foods quite frequently (three to four meals a week) and sugary drinks (one to two cups daily, mostly with reduced sugar).
I am now trying to control my intake of fried foods.
Thank you.

Noli, 30~39 year old female. Ask Date: 2017/11/08

Dr. Zheng Jueyi reply Otolaryngology

Hello: Generally, lymph nodes that fluctuate in size are mostly benign changes.
However, if they continue to enlarge or cause discomfort, it is advisable to return to the hospital for follow-up.
If necessary, an ultrasound or other imaging studies may be arranged for differential diagnosis.
Wishing you peace and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the ENT Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2017/11/08

More Info

The presence of lymph nodes behind the ear can be concerning, especially when they are swollen or tender. In your case, you have noticed two lymph nodes on the right side, measuring approximately 1 to 1.2 cm each, and one on the left side measuring about 1 cm. The fact that these lymph nodes have appeared in conjunction with symptoms such as nasal discharge and throat pain suggests that they may be reactive lymphadenopathy, which is a common response to infections.

Lymph nodes are part of the lymphatic system, which plays a crucial role in the immune response. When the body detects an infection, lymph nodes can swell as they produce more immune cells to fight off the pathogens. In your situation, the lymph nodes may be responding to a viral or bacterial infection, possibly related to your recent cold symptoms. The antibiotics prescribed by your doctor were likely intended to address a bacterial infection, but it is important to complete the full course of antibiotics as prescribed, unless advised otherwise by a healthcare professional. Stopping antibiotics prematurely can lead to incomplete treatment of the infection and may contribute to antibiotic resistance.

Regarding your concern about the lymph nodes being serious, the fact that they are not painful and have not changed significantly in size is a positive sign. However, persistent lymphadenopathy, especially if it lasts for more than a few weeks or is associated with other concerning symptoms (such as unexplained weight loss, night sweats, or fever), should be evaluated further. If the lymph nodes do not decrease in size after completing the antibiotics or if you develop new symptoms, it would be prudent to follow up with an ear, nose, and throat (ENT) specialist for further evaluation.

As for your dietary habits and skin issues, it is good that you are taking steps to improve your diet by reducing fried foods and sugary drinks. A balanced diet can significantly impact overall health and may help with skin conditions. The skin issues you described, such as the lesions on your legs, could be related to eczema or another dermatological condition, especially if they improve with topical treatments. While diabetes can cause skin changes, your recent blood sugar levels suggest that you are not diabetic. However, if you have concerns about your skin or if the lesions persist, it would be wise to consult a dermatologist for a thorough evaluation and appropriate treatment.

In summary, it is essential to complete the antibiotic course as prescribed, monitor the lymph nodes for any changes, and consult with a healthcare professional if symptoms persist or worsen. Additionally, maintaining a healthy lifestyle and seeking dermatological care for your skin issues will contribute to your overall well-being. If you have further questions or concerns, do not hesitate to reach out to a healthcare provider for personalized advice.

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