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headache and rib pain
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headache and rib pain


  I am a 25 year old female.  I have had a reactive lymph node, in
  front of my left ear, for about 6 weeks.  It appeared quickly,
  and was accompanied by a general ache in the surrounding area
  (especially the facial bones), a watering left eys, and a terrible
  migraine in the left frontal lobe.  The pain has not receded, although
  the node is not as large as it was in the first 3 weeks now.  I went
   to a ENT, who found no ear problems or throat problems.  Blood
  tests showed an elevated lymphocite count, but were otherwise normal.
   Tests for mono, lyme disease and CMV? were negative.  
  Along with the terrible head pain has been an increasing amount of
  pain in my ribcage.  The ribs all the way around are very sensitive,
  often waking me up when I roll over at night.  Occasionally, I will
  feel sharp, localized pains in the area as well.  Advil dulls the pain,
   but does not always relieve it.  It has become quite uncomfortable.
   My doctor has given me a course of strong antibiotics (in an effort
  to bring down the swelling in the node), which I completed a week ago.
   The node is still swollen, although it is not large.  I am not quite
   sure how to encourage my doctor in the right direction.  I am frustrated,
   and rather uncomfortable.  Do you have any recommendations?
  Thank you very much,
  Liz
    
    
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Dear Liz:
I am sorry to hear about your headache and rib pain.  Without examining you and seeing all the lab work it is impossible to give you the exact diagnosis over the internet.  Knowing that, let me tell you what I think might be going on.  The description that you give is classic for a viral process.  The lymph node in front of the ear is the place where it will show up.  The headache may or may not be part of the viral infection.  The elevated lymphocyte count would be confirmation that this is a viral infection.  The pain in the ribs could also be explained by the viral infection, chondritis is not uncommon with viral infections although yours sounds pretty bad.  The enlarge lymph node is probably the reaction to the virus and the antibiotic would have little effect.  Now that is what it could be.  There is such a wide range of viruses that can infect in this manner so it may be hard to isolate it.  CMV, mono, EBV, etc. usually do not affect this particular lymph node.  The pain in the ribs is likely an
inflammatory response and a strong NSAID would likely help with that pain.  These things usually take a few weeks to clear up.  If things do not get better, I would revisit your physician and investigate the other possibilities.  I hope things get better soon.
Sincerely,
CCF Neuro[P] MD





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