Swollen Lymph Node in Neck for Over Two Weeks: What to Do? - Otolaryngology

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Swollen lymph nodes in the neck for over two weeks?


I have a hard lump on the right side of my neck that has been swollen for over two weeks.
It is slightly painful to the touch, but I have no other cold symptoms.
Will it go away on its own without taking antibiotics? Thank you.

Li, 30~39 year old female. Ask Date: 2020/11/25

Dr. Li Jiaxuan reply Otolaryngology


If antibiotics do not resolve the issue, consider visiting the hospital's otolaryngology department for ultrasound imaging or fine needle aspiration.
Wishing you well.

Reply Date: 2020/11/25

More Info


Swollen lymph nodes in the neck can be concerning, especially when they persist for more than two weeks. It’s important to understand that lymph nodes can swell for various reasons, including infections, inflammatory conditions, or malignancies. Given your situation, let’s break down your concerns and provide some guidance on what to do next.


Understanding Lymph Node Swelling
1. Duration and Characteristics: You mentioned that the lymph node on the right side of your neck has been swollen for over two weeks and is hard with mild tenderness upon touch. Typically, lymph nodes that are swollen due to infections (like viral or bacterial infections) may be tender and can fluctuate in size. If a lymph node remains swollen for an extended period, especially if it is hard and painful, it warrants further investigation.

2. Possible Causes: The most common causes of swollen lymph nodes include:
- Infections: Viral infections (like the common cold or mononucleosis) or bacterial infections (like strep throat) can cause lymph nodes to swell. In these cases, the lymph nodes are often tender and may resolve with time or with appropriate treatment.

- Inflammatory Conditions: Conditions such as autoimmune diseases can also lead to lymph node enlargement.

- Malignancies: While less common, persistent lymph node swelling can be a sign of lymphoma or other cancers.


What to Do Next
1. Observation: If the lymph node is not causing significant discomfort and you are not experiencing other symptoms (like fever, night sweats, or unexplained weight loss), you might consider monitoring it for a short period. However, since it has been swollen for over two weeks, it is advisable to seek medical attention.

2. Medical Evaluation: It is essential to consult a healthcare professional for a thorough evaluation. They may perform a physical examination and may recommend imaging studies, such as an ultrasound, to assess the lymph node's characteristics. In some cases, a fine needle aspiration (FNA) biopsy may be necessary to rule out malignancy or other serious conditions.

3. Antibiotics: If there is a suspicion of a bacterial infection, your doctor may prescribe antibiotics. However, if the swelling is due to a viral infection, antibiotics will not be effective, and the lymph node may resolve on its own.

4. When to Seek Immediate Care: If you experience any of the following symptoms, seek medical attention promptly:
- Rapid increase in the size of the lymph node
- Persistent fever or night sweats
- Unexplained weight loss
- Difficulty swallowing or breathing

Conclusion
In summary, while some lymph nodes may resolve on their own, the persistence of your swollen lymph node for over two weeks, along with the tenderness, suggests that it is prudent to consult a healthcare provider. They can provide a proper diagnosis and treatment plan based on a comprehensive evaluation. Early intervention can be crucial in addressing any underlying issues effectively. Remember, it’s always better to err on the side of caution when it comes to your health.

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