Lymph node swelling

[lymphydom]

Hey Dr. Hook and HHH!,
First, thanks for your great service!
I have a question regrading a swollen axillary lymph node I noticed this morning. I'm not overly worried, as I know it can't be ARS (my last sexual activity - and it was only oral was over 4 months ago). I have two lymph nodes on the left side of my neck that haven't fully gone down since I was sick in the summer (I also have a wisdom tooth coming in on that side), but I'm not too sure why there is now a swollen lymph node in my left armpit.
I read from a few sources that a single lymph node could be due to early stage HIV and that with HIV one could get swollen lymph nodes anytime because of the disease, but I am unsure if that is true. I read on here that a single lymph node has really nothing to do with after ARS early HIV infection and that when one with HIV gets swollen lymph nodes, one doesn't just have one axillary lymph node swell up, but many, which I'm assuming is true? I have no major risk factors (I have only had unprotected oral and my last hiv test was in August - rapid, 6-7 weeks after any sexual activity), so can I safely assume that the swollen lymph node is not some odd after ARS HIV caused swollen lymph node?

[dreyton09]

A related discussion, axillary lymph nodes was started.

[worriedhiv1]

A related discussion, Swollen nodes in HIV was started.

[H. Hunter Handsfield, M.D.]

Oops.  I was also constructing a reply, failed to notice Dr. Hook was already doing so.  (Sorry, Ned.)  Since my comments already were written (with an even longer answer than Dr. Hook's), I'll post them -- you get two for the price of one.  As you will see, Dr. Hook and I are in complete agreement.

First, you may not have enlarged axillary lymph nodes, especially if you are not a health professionalr.  Self assessment of lymph nodes by medically untrained persons is very unreliable.

But let's assume you indeed have enlarged axillary nodes in one armpit.  As to the cause, I haven't a clue.  Certainly I see no reason to be concerned about HIV, which is a relatively uncommon cause of enlarged lymph nodes especially when involving only one or two node-bearing areas.  Most often, an inflamed node reflects a "downstream" infection or inflammation -- for the axillary region, that includes skin infection, injury, and such things of the hand or arm on the same side.

Your messages are mixed:  "I know it can't be ARS" is followed in the next paragraph by a string of "yes, but" questions.  The bottom line is that your rational thought is correct and the concerns in the second paragraph not valid.  If the problem persists, see a health care provider.  But don't worry about HIV.

Best wishes--  HHH, MD

[Edward W Hook, MD]

I would be willing to bet a large sum of money that the swollen lymph node that you have noticed has nothing whatsoever to do with HIV infection.  As you note, your risk is very, very low.  In addition, the lymphadenopathy associated with HIV infection is typically diffuse, involving lymph nodes in many parts of the body.  On the other hand, an axillary lymph node of the sort you note deals with inflammation from the arm and the chest wall and back on the side of the node.  You could have a swollen node as a result of almost any sort of inflammation.

This was a long answer to your question.  To summarize, there is really no way that your swollen lymph node is a manifestation of of ARS. You have nothing to worry about.  EWH