Enlarged lymph glands arm and armpit

[nikki68]

Within the last 72 hours I have experienced the development of painful lump accompanied by swelling and pain in the inside of my right arm (at the elbow). I had an ultrasound performed immedtiately which indicated an infected lymph gland which caused a blood clot to form in that area. I was given an antibiotic (cephalexin 500 mg 4x/day) along with a script fo warfarin sod 5mg tabs 1x/day. I visted an ER 12 hours later because the pain and and swelling had spread to right torso and neck area. Blood was drawn and another ultrasound was performed. Blood lab results were negative for infection and the ultrasound was negative for blood clot.

I have begun the anitbiotic and have not yet begun the warfarin because I'm afraid to start taking it if it is unnecessary. Last evening a large lump appeared in my right armit. I would dercibe it as "sore", not painful to touch.

I live in a very rural area, so access to medical expertise is not readily availbale. Any guidance will be immensely appreciated.

nikki68

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Living in a medically under-served area may be a problem in times like this, when you have an undiagnosed medical problem.
The sudden appearance of epitrochlear (near the elbow) and then axillary (armpit) lymph nodes accompanied by pain and swelling points to an infective cause. Without a physical examination and appropriate tests, it is difficult to diagnose the specific cause. Possibilities include bacterial infection, sporotrichosis, cat scratch disease, etc.
Please visit your nearest medical facility immediately for a detailed workup. In the meanwhile, please continue the cephalexin tablets.
Do update me on your progress.
All the best, and God Bless!

[nikki68]

Thank you for your reply.  Since my last post, I have gone to the Emergency Room as I am very concerned about the large mass under my arm pit.  They repeated an ultrasound (I have had three in the last three days at different facilities) and confirmed that I do not have a blood clot in my arm.  I am glad that I did not take the warfarin as it is not necessary.  The ultrasound did confirm that the mass under my right armpit is a very large lymphnode and the mass on my lower arm (that I have had since Wednesday) is also a large lymphnode that was pushing on my brachial vein causing a pooling of blood but not a clot.  The doctor told me to go to our local cancer center to make sure that the lymphnode enlargement is not caused by a problem in my breast.  Two months ago, I had my first mammogram and that test found "multiple benign appearing lymph nodes with fatter hilum in both axillary tails, the largest is in the right axilla and measures about 1.1x0.8x1.1cm in diameter.  On the left side, the largest measures about 1.9x1.2cm in diameter.  There is also one lymph node on the left side theat measures 8x5mm in diameter."  I am a bit worried that maybe all of these enlarged lymph nodes in my arm, arm pit and breast area are connected and may mean breast cancer or a tumor.