What should I do if I have swollen lymph nodes in my neck?

Swollen lymph nodes in the neck may be caused by infection or tumor. If the swollen lymph nodes are caused by a cold, they will subside after taking medication, but if it is a tumor, it needs to be removed surgically in time. Therefore, if you find swollen lymph nodes in your neck, you should seek medical attention immediately.

1. Causes

There are three causes of swollen lymph nodes in the neck: infection, tumor and other factors. Infectious factors: Bacterial - bacterial infection of teeth, tonsils, face or scalp, tuberculosis, syphilis, cat scratch disease, Lyme disease; Viral - herpetic stomatitis, infectious mononucleosis, HIV infection (AIDS); Parasitic - toxoplasmosis; Unknown cause: mucocutaneous lymph node syndrome (Kawasaki disease), subacute necrotizing lymphadenitis (Kikuchi disease). Tumor factors: primary - Hodgkin's disease, non-Hodgkin's lymphoma, leukemia, especially lymphocytic leukemia; secondary - cancer (oral cavity, salivary glands, nasopharyngeal metastatic tumors), malignant melanoma, Ewing sarcoma, other mesenchymal tumors. Other factors: sarcoidosis, sinus histiocytosis, angiofollicular hyperplasia (including Castleman disease, angiolymphoid hyperplasia with eosinophils (Kimura disease), and related disorders.

2. The symptoms of swollen lymph nodes in the neck need to be identified as follows.

1. Tonsillitis

Acute tonsillitis often has typical clinical manifestations and is not difficult to diagnose, but it should be differentiated from pharyngeal diphtheria, Vincent's pharyngitis, leukemia and scarlet fever. There is currently no satisfactory objective diagnostic method for chronic tonsillitis. The diagnosis can be made mainly based on the history of repeated acute attacks, combined with examination showing chronic congestion of the tonsils and palatoglossal arches, yellow-white emboli in the tonsillar pits, purulent discharge from the pits when squeezing the palatoglossal arches, enlarged or shrunken tonsils with scars and adhesions on the surface, etc. Bacterial culture, cytological examination of the pits, and titer determination of serum antistreptolysin "O", anti-hyaluronidase, and anti-streptokinase can all be used as references for diagnosis. Chronic tonsillitis should be differentiated from physiological hypertrophy of the tonsils (more common in children and adolescents, with no subjective symptoms and a history of repeated acute attacks), tonsillar keratosis, and tonsillar tumors.

2. Syphilis

Each stage of syphilis has its own special clinical symptoms and characteristics. If chancre is accompanied by swollen lymph nodes, which are widespread and symmetrical throughout the body, especially if there are macules or papules on the palms and soles without pain or itching symptoms, or if there are moist proliferative maculopapular masses (flat warts) in the genitals accompanied by systemic lymph node enlargement, the possibility of early syphilis should be considered. If the patient has a history of unclean sexual intercourse, the possibility of syphilis is greater. Laboratory tests should be performed at this time, including syphilis spirochete tests and syphilis serological reaction tests. The commonly used clinical method for spirochete examination is the dark field illumination method. The spiral of the syphilis Treponema is tight and regular, has strong refractive power, moves actively, and is easy to identify. The discovery of Treponema pallidum is very helpful for the diagnosis of primary syphilis, especially when chancre has appeared but the serum syphilis reaction has not turned positive.

Treponema pallidum can also be easily found in lesions such as mucosal plaques, moist papules and flat warts of secondary syphilis. There are many methods for syphilis serological tests, and the antigens used include two types: non-treponemal antigens (cardiolipid antigens) and Treponema pallidum antigens. In the past, crude bovine heart pseudolipid antigen was often used for precipitation tests (Kahn's test, once translated as Kang's test, etc.) and complement fixation tests (Wasserman's test, etc.). The Venereal Disease Research Laboratory (VDRL) slide test currently used uses pure cardiotonic lipid as the antigen, which is pure in composition and has stable test results. Tests using Treponema pallidum as antigen are commonly used internationally, such as the fluorescent treponemal antibody absorption test (FTA-ABS) and the Treponema pallidum hemagglutination test (TPHA), which have strong specificity and high sensitivity. Syphilis serological tests are very important for the diagnosis of syphilis at all stages, and early syphilis often has a strong positive reaction. Latent syphilis and asymptomatic neurosyphilis have no active clinical symptoms and are mainly diagnosed by syphilis serological tests. However, it should be noted that syphilis serological tests can have false positive reactions. Some non-syphilis diseases, such as malaria and systemic lupus erythematosus, can cause positive reactions, which are called biological false positive reactions. In the early stage of chancre, the syphilis serological reaction is often negative, and it may also be negative in late syphilis, especially in patients with tuberculosis dorsalis in late neurosyphilis, the negative rate can reach 30-50%.

3. Prevention and Treatment

Eat more light foods to avoid inflammation of the tonsils and other diseases caused by getting angry. Actively prevent infection, increase physical fitness, improve the body's immunity and disease resistance, and actively control infection as treatment. You can use penicillin intramuscular injection or drip 2-3 times a day. It is best to go to the hospital for examination to determine the cause of treatment. Drink plenty of water and don't eat spicy food.