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Pneumonia and C.Diff.
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Pneumonia and C.Diff.

I ended up in my local ER on 12/16 with bacterial pneumonia.  I was treated with 2 rounds of Z-paks since it would not go away.  So, last Monday, I went to my family doctor and she listened to my lungs, which sounded good to her.  I told her about horrible diarrhea and so she took samples and diagnosed me with c.difficile.  I've been sick more than not over the past 2 months.  Anyway, more antibiotics (Vanmyacin - sp?) and Diflucan for yeast build up.  I am free from the horrible diarrhea now, but my throat hurts and my glands in my neck on swollen and it just won't go away.  It's been going on for so long now, and I'm getting frustrated about it.  It hurts to swallow and the only thing that helps my throat pain is drinking soft drinks.  

Why won't the swollen glands and sore throat go away?  Any ideas?  My doctor is out of town until the beginning of February!  

Thank you!!!!
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It is highly likely that the C difficile was due to the azithromycin and the diarrhea it caused, unrelated to your sore throat and lymph node enlargement.  The sore throat and enlarged nodes may or may not be related to your pneumonia, but if the cause of the pneumonia were to be determined, that information might provide clues to the cause of your throat soreness and node enlargement.

Whether your sore throat and enlarged nodes are related to the pneumonia or not, these signs and symptoms suggest a throat infection, with secondary enlargement of the nodes.  You should have a completed blood count (CBC) and throat culture.  The throat culture should be a general bacterial culture, not just a culture for strep throat.  There are many causes of enlargement of the cervical lymph nodes in the neck including infection, lymph node cancer such as Hodgkin’s disease, inflammatory reactions such as mononucleosis and sarcoidosis and immunologic diseases.  The characteristics of the nodes may provide clues, such as tender if due to most infections and rubbery if caused by lymphoma.  Given the possibility of an opportunistic infection, you should also have human immune deficiency virus (HIV) testing.

You should have a chest x-ray.  If a diagnosis to explain the enlarged nodes is not forthcoming, then you should have an magnetic resonance imaging (MRI) of the neck to check for the possibility of an indolent pharyngeal abscess.

If the nodes are seemingly unrelated to throat infection, including unusual infection such as diphtheria and tuberculosis (TB) – called Scrofula and if the features of your illness and laboratory findings do not suggest mononucleosis or sarcoidosis, then serious consideration should be given to a lymph node biopsy with cultures for TB and fungi.  Attempts to establish a diagnosis should proceed with some urgency, given the duration and intensity of your symptoms.

Given the likelihood of infection and the advantage of ruling it out, if that is not the problem, consultation with an infectious disease specialist should also be considered.

You may also want to share the above with your doctors.

Good luck.
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