Persistent Sore Throat and Swollen Lymph Nodes: Should I Be Concerned?

I've had a sore throat for a while, and I'm a bit worried?

I have been experiencing unilateral sore throat for almost six months and have seen many ENT specialists.
They all said that my immune system is weak, which makes me prone to illness.
Recently, in the past few weeks, the lymph nodes in my neck have started to swell, with the largest being about 1.5 cm.
However, I have to dig into my neck to measure it (there are about 5 to 7 lymph nodes that are movable).
I am worried that I might have a malignant tumor.
In my last two visits, they used an endoscope (the standard type used in clinics), and the doctor said they did not see any tumors, suggesting it looks like an infection.
They advised me to go to the infectious disease department to check for EB virus antigens.
I am scheduled to have the test tomorrow.
Should I just proceed with this, or should I be concerned about needing further tests?

De De, 20~29 year old female. Ask Date: 2019/01/13

Dr. Lai Yicheng reply Oncology

Dear Dede's younger brother,
Regarding your symptoms, please visit a regional otolaryngology specialist for evaluation.
The doctor will perform a physical examination and confirm the diagnosis.
A specialist will conduct an endoscopy and assess whether a biopsy is necessary.
Please adhere to the prescribed medication schedule and do not discontinue the medication or use alternative remedies on your own, as this may interfere with the treatment.

Thank you for reaching out for consultation.
Sincerely,
Dr.
Lai Yi-Cheng
Department of Radiation Oncology
Changhua Hospital

Reply Date: 2019/01/13

More Info

Persistent sore throat and swollen lymph nodes can indeed be concerning symptoms, especially when they persist for an extended period, such as six months in your case. The fact that you have seen multiple ENT specialists and have been told that your immune system may be weak is a common explanation for recurrent infections. However, the recent development of swollen lymph nodes, particularly if they are larger than one centimeter and have increased in number, warrants further investigation.

Lymph nodes are part of the body's immune system and can become enlarged for various reasons, including infections, inflammatory conditions, or malignancies. In your situation, the presence of a persistent sore throat combined with swollen lymph nodes raises the possibility of a chronic infection or another underlying condition that may need to be addressed.

The recommendation from your ENT specialists to check for EBV (Epstein-Barr Virus) is a prudent step. EBV is known to cause infectious mononucleosis, which can lead to prolonged sore throat and lymphadenopathy (swollen lymph nodes). Testing for EBV antibodies can help determine if you have had a recent or past infection. If the results are positive, it may explain your symptoms and could guide treatment options.

However, if the EBV test comes back negative, or if your symptoms persist despite treatment, further evaluation may be necessary. This could include imaging studies such as an ultrasound or CT scan of the neck to assess the lymph nodes more closely. In some cases, a biopsy of the lymph nodes may be warranted to rule out malignancy, especially if there are concerning features such as rapid enlargement, firmness, or if the lymph nodes are fixed to surrounding tissues.

It is also essential to consider other potential causes of your symptoms. Chronic infections such as bacterial pharyngitis or even conditions like chronic tonsillitis can lead to persistent sore throat and lymphadenopathy. Additionally, autoimmune conditions or even certain malignancies can present with similar symptoms, so a thorough evaluation is crucial.

In summary, while it is understandable to feel anxious about your symptoms, taking the steps recommended by your healthcare providers is essential. Follow through with the EBV testing and any additional tests they suggest. If your symptoms do not improve or if you have new symptoms, do not hesitate to seek further medical advice. Keeping an open line of communication with your healthcare team will help ensure that any underlying issues are addressed promptly. Remember, early detection and intervention can significantly improve outcomes in many conditions.

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