Lymph nodes swollen

I'm a 43 year old female. I noticed my left arm was swollen March 2 and felt like scrambled eggs underneath the skin. I went to the health clinic at work and she took some measurements of both arms starting from bicep to wrist and my swelling started in my upper arm but I just didn't notice it until it got to my forearm. Now I've noticed weakness in my arm and I'm not sure if I want to call it numbness but it feels almost like its a sleep but without the pin pricking in parts of it. It was aching off and on but that has subsided but the swelling isn't going down. I went to the ER and they put me on some strong antibiotics thinking its a case of cellulitus (staff infection) but I've been on the antibiotics for over a week and the swelling still isn't going down. A couple days after starting the meds I developed a cough and a fever and hot and cold spells and just feeling very weak. Since I had heart surgery a couple of years ago they looked for blood clots to see if this was the problem but the tests came back clean. I called my doctor after I developed the fever, cough, etc and she seems to think I got the flu bug on top of whatever this is going on with my arm. In the past week I've been to the ER, the health clinic at work, my primary care doc and my heart doc. All tests at heart doc are coming back good so far but my primary care doc said to just stay on antibiotics for now to see if there's a change. I just don't know what to make of this. The lady at the clinic felt my armpits for large lymphs but said they felt ok. So it seems to be in my left arm only from the shoulder and both sides of my arm all the way to my wrist (almost). Any ideas?

[Ken_PA]

Hi, if you're wondering whether this could be lymphoma, then I'd say that I've never heard of it acting that way.

Is there Lyme Disease where you're at? Lyme can cause enlarged nodes plus a variety of other symptoms. There doesn't always have to be the famous "bull's eye" rash, either.

Did your flu-like symptoms occur within hours of starting the antibiotic? If so, that could even be a Herxheimer reaction - which occurs as an infection is killed off.

[Ken_PA]

Also, is it correct that you don't have any redness or rash?

[kyhickchic]

Hi, and thanks for the feedback. There is Lyme disease here but I've not been bitten by anything. No bites, itching, redness, or rash. Just swollen lymph nodes, aching pain in my arm and tender in some areas like there is a a bruise but there's no bruise. I've not injured my arm in any way that I can recall and I've not lifted anything heavy. The flu symptoms occurred about 2 days into taking the antibiotics. First I started with a cough for about 2 days then a fever for a few days. The fever is gone now but the cough is still present and I'm extremely tired.

[Ken_PA]

Well, I would guess that cellulitis sounds reasonable, except you don't have the redness which usually shows because the infection is just beneath the surface.

When an infection like that goes deeper, it can then result in swollen nodes.

So maybe it is cellulitis, though an atypical case.

For a clot (thrombosis), you'd expect redness and maybe heat along with the swelling. I suspect they did a test called D-Dimer to rule out a clot, if not an ultrasound (or even a venogram). Arm clots are less likely than leg, but still possible. For you, though, a clot seems to be ruled out.

As far as I know a virus wouldn't cause the arm symptoms, so that's why the doc thinks you maybe had a flu by coincidence at the same time.

However, I'd still personally suspect Lyme... you can drop over to the Lyme group and confirm (or not) that a person can get it without knowing they were bitten. (I suspect that's true, but am not 100% sure.) Please let me know if you do that. There's also still the possible Herxheimer reaction from the antibiotic killing the Lyme spirochetes -- though maybe that was delayed in time for you. When their tiny bodies get burst open by the antibiotic, the contents get spilled into your bloodstream and that causes flu-like symptoms.

Or maybe it's a spider bite. Or a parasite.

Or a Herxheimer reaction from some other bacteria.

Maybe all of this helps you understand why the docs are unsure of what is going on.

But regardless, keep in mind for the future if you start to get joint pain, to think about possible "Lyme arthritis".

Good luck.

[kyhickchic]

Hi again,

Wow, you are full of information! Thanks for the info. I'm so glad I signed on this site. I'm still having some problems and can't get into my regular doc till friday so I went back to the clinic at work today. She's worried because my lungs sound bad even though I'm on antibiotics, so I had to go for an xray today. Haven't gotten the results back yet. I guess what really worries me is the weakness I'm feeling in the muscle in my arm and now I'm starting to feel a little bit of the same in my other arm but no where near as bad yet. I need to do some research on Lyme disease. I'll keep you posted what I find out. Thanks again for the info!

Lisa

[Ken_PA]

Glad to be of a little help, Lisa.

There are a lot of symptoms here which don't seem easy to attribute to a single cause. The best strategy to diagnose is at first to assume a single cause. In science that's called the Law of Parsimony. If a single cause doesn't account for everything, then we go to two causes.

Here are some thoughts:

Since an antibiotic won't do anything against a virus, then they won't help your lungs if you have a viral infection in the lungs. But they will presumably prevent a viral infection from paving the way for a more serious bacterial infection. Unless... there is a bacteria that is antibiotic-resistant.

So, were you tested for the infamous MRSA? That's the antibiotic resistant staph. It can start in the lungs. That usually shows signs on the skin but doesn't always have to.

Do you cough up anything colored? Clear = virus infection. Greenish or yellow = bacteria infection. Red or pink = bleeding.

Weakness in a muscle could conceivably be from inflammation due to an infection. It would also be natural to start feeling that weakness on the other side, even if it's not actually there. So you want to be sure that it is spreading to the other side. If so, then that could change everything - and maybe point to autoimmunity. This might be the biggest point of all - if it truly is on the other side now then it is unlikely to be an infection that leapfrogged over to there.

Btw, did you ever have a really bad case of mono? Do you have a family history of autoimmune conditions like lupus or rheumatoid arthritis or Raynauds?

Lastly, is your whole arm weak? Or is it harder to lift than to push, e.g.?

[kyhickchic]

Good morning,

No, I haven't been tested for MRSA. This has just been going on a few weeks now, so that test may come soon. I'm out of antibiotics now (been taking them for 10 days). My arm is still swollen and kind of blotchy looking. And to answser your question, the whole arm feels weak. I have noticed the weakness when lifting simeple things such as my purse. Since the weakness started, I don't hang it on my arm any more. I have to put it on my shoulder to carry it. It's not that I can't carry it at the elbow but that it just feels really weak when I do and uncomfortable. On my other arm (right) its like I can feel the weakness starting in certain muscle groups but not all of them. However, that arm is still pretty strong.

I am coughing stuff up but not enough to spit...but when blowing my nose it's yellowish/brown sometimes and then clear at other times...

I've been tested for rheumatoid arthritis because my hands (knuckles) bother me but it just seems to be osteo arthritis. I've never been tested for the others you mentioned and no one in my family (that I know of) has a history of them. However, no one in my family has superaventricular tachycardia either but I did until I had surgery to fix it a few years ago.

I looked up lyme disease last night but that don't fit the problem either because the pain is not in my joints.

Have a good day,
Lisa

[Ken_PA]

I'd call the doc ASAP and tell them you still have the yellowish/brown color - if you still do have it today. Maybe they'll continue the antibiotic.

Offhand, I don't know how the SVT would relate to this. Nor the ablation. (I know you weren't saying that it did.) But autoimmunity is more genetically related, while SVT might not be.

Keep in mind that the joint problems from Lyme are in the advanced stage, not for this soon.

Keep us informed how things go :)

[kyhickchic]

Sorry it's been a while since I posted. Here's an update...My left arm is still swollen and about 2" bigger in diameter. Now my other arm and both legs and the left side of my neck and shoulder are all swollen too. The pain is still located to my left arm and neck. I get tingling sensations in my legs and my arms and when pressed it leaves an indent in the skin for a few seconds on my arms and legs. My primary doc put me on water pills to see if that helps but it hasn't helped. I've been on them a few weeks now. I've lost 10lbs over the past 1 1/2 months. I've been tested for several things that cause inflammation but everything has come back normal. They did an MRI just of my left arm and it came back normal. Now I'm being sent to a neurologist. I go there for the consult on the 23rd. I just wish someone could figure out what's going on. Its going on 3 month now. My arm is killing me now. Even though my other extremeties are swollen, they aren't hurting at this point. However, I'm feeling a burning sensation in my calves. My legs feel swollen from the lower calves to a few inches above my knees. Funny thing is my hands and feet are not swollen. I just don't know what to make of this.

[Ken_PA]

Hi, the idea of being sent to a neurologist was unexpected, so I looked up "neurogenic edema" and indeed there is such a thing. My browser then crashed but I can look up the pages again if you like. Two things stood out: did you have any head injury? Do you spend lots of time with your hands up in the air, such as at work or in some sport?

[kyhickchic]

Hi again,

Sorry for the time it took me to get back to you. I didn't get an email saying you replied. I accidentally missed my appointment with the neurologist last week and now my appointment is tomorrow. I seem to be forgetting things a lot lately....think I just have too much on my plate to remember at work, lol. To answer your question, no I haven't had a head injury. My primary doc thinks it could be something to do with nerve damage or something. Not sure why...he seems to think the symptoms lean that way. Guess we'll see what the neurologist says. I had someone else tell me it might be secondary lympedema. And I have to say a lot of the symptoms fit for that too. So I don't know. I just know I'm tired of being swelled.

[Ken_PA]

Yes, the email notifications here aren't working. I hope your neurologist made some progress yesterday.