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Dr. Abby
Dr. Abby, US Board Certified MD
Category: Medical
Satisfied Customers: 10330
Experience:  Family Physician practicing medicine for over 10 years, United States
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hi doctor,I have a swollen lymph node on left side of neck

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hi doctor,I have a swollen lymph node on left side of neck which causes severe pain when swallowing. The pain started about 4 days ago and hasn't abated.I don't have the usual cold symptoms that go with a sore throat and it is strange that it is only the lymph node on left side
Hello,

What is the size of the lymph node?
Any fever?
Night sweats?
Weight loss?

Dr Abby
Customer: replied 6 years ago.
no its only been four days so no loss of appetite or night sweats but the pain when swallowing is reminds me of a swollen tonsil only I had those removed 30 years ago. The node is just under the left jaw near the ear. As for fever, none but feel headachy.
Thank you for clarifying...

Lymph nodes can become swollen for many reasons--dental infections, minute sores or cuts in the mouth, viral infections are common reasons. Lymph nodes can also become infected themselves. They become painful when enlarged due to stretching of the fibrous capsule that surrounds them.

If the node is larger than 1 cm and tender, it is possible that the node itself is infected.
Or, it may be responding to an unknown infection that you are not aware of...

I recommend applying a warm compress to the area, taking ibuprofen and seeing your doctor today.
Your doctor may treat you with antibiotics if no other cause for the enlargement can be seen. A blood count may also be done.

I hope that you feel better soon.

Feel free to ask any follow up questions you may have and I will be happy to answer them for you,

Dr Abby

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Customer: replied 6 years ago.
why just on one side? I am already taking ibuprofen but it is having miniminal affect. The node is tender and painful to the touch but doesn't seem enlarged. Why is it painful to swallow?
I am sorry, I misunderstood about the size of the node. You had stated in your initial description that it was swollen.

The lymph node itself should not be causing difficulty swallowing....especially if it is not enlarged significantly.

It is possible that you have a viral ulcer in the throat that you cannot see--this would explain the one-sidedness of the sore throat and a mild enlargement of the gland. This is not uncommon--in fact we see more of it in the fall.

It is most likely infectious, given the fact that your lymph node is reacting to it...
Try warm salt water gargles also


Dr Abby

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Edited by Dr. Abby on 11/4/2010 at 7:43 AM EST
Customer: replied 6 years ago.
I am traveling and won't be home until Monday so wondering if I can wait until then to see if the pain subsides. If it is a viral ulcer as you suggest, what is the long term treatment ? Are antibotics worth a try? I found salt gargles help for only for a short time but I haven't been able to do while traveling. The pain swallowing makes it hard to sleep which is why I am on the computer at 4 am in the morning. What is max dose of Ibuprofen I can take to ease the pain?
If it is viral, there is no treatment and it will simply be a matter of time.

If you can find throat lozenges, cepacol-for example, try those as well.

If you develop worsening difficulty swallowing or if you develop a fever, I do suggest you try to get to an urgent care. Otherwise, as long as you don't have any problems with ulcers or high blood pressure, you can take up to 800 mg ibuprofen every 8 hours (maximum dose is 2400 mg in 24 hours). Make sure you take it with food.

I hope that you feel better soon,

Dr Abby

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Customer: replied 6 years ago.
ok just took more Ibuprofen. Hopefully will be able to sleep. One last data point, I lost a filling on left side of mouth about a month ago and haven't had time to go to dentist. I am fastidious about removing food that gets caught there. Gums are not painful but I wonder if the left side of mouth - left side of neck might be related? I noted you mentioned dental infections as possible cause so wondered if this changed your diagnois? If this is a viral ulcer... how long does it take to subside typically and if gets worse what treatment would they propose?
If it is a dental infection, it could cause a painful gland but should not cause the pain in the throat itself/pain with swallowing.

Viral ulcers can take 7-10 days to resolve.
If you have worsening pain, one of the main reasons I suggest a doctor visit is so that you can accurately find out what is going on--if it is an ulcer the doctor can prescribe stronger pain medication and/or a numbing throat gargle.

Let me know if any other questions...

Dr Abby

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Customer: replied 6 years ago.
Thanks doctor.. so got another 5 days potentially to go if ulcer.. arggh. One last question, is the picture of you legit i.e. are you really a blonde as shown or is that just a model?
It is not me..although I am a blonde :)

Dr Abby

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Customer: replied 6 years ago.
Well thank you doctor. The "ulcer" seemed to abate on Thursday morning and the pain started going down. I also started taking an antibiotic on Thursday evening and by Friday I was feeling much better and today (Saturday) the throat doesn't hurt at all. So guess it was a viral ulcer after all. Thanks for your advice and I accept your answer.
I am glad you are feeling better!!
That is great news!!

Thank you,

Dr Abby