Painless swollen lymph nodes in 12 yr son

Question

Over a week ago (09/01) my son brought my attention to his lymph nodes along his jaw line that were really swollen, they didn't seem to hurt to the touch nor did they deem warm, but had no other problems, symptoms, or fever. When I took him to the E.R. the doctor asumed that it was an staph or something and sent us home with an antibiotic. The next morning (09/02) the lymph node up by his ear was swollen, on the same side as the jaw line ones. Since he had dental work earlier in the week I took him back to his dentist, who then said that it was not an oral problem what so ever, he then referred me to the ENT. Since Blake was already on meds they scheduled to see him at the end of the next week. On (09/03) I noticed that his face was becoming more swollen so I took him to an urgent care center where they thought he had a stone in his gland, they ran a CBC and said it was a little off and to bring him back on Monday (09/05) better or worse to re-check and to continue taking meds. Monday the swelling was no better when we returned and more lymph nodes were swollen on the back of the neeck, the urgent care doc then said she pretty sure that it wasn't stones and that his CBC results were about the same. Tuesday (09/06) we got him into the ENT who decided that a biopsy was the best choice. He removed the 2 largest lymph nodes, which he said the tissue was black in color along his jaw line and sent them off to a pathology lab and changed his antibiotic to something stronger. Days after the surgery the gland beside his ear and on the back of his neck continued to grow in size still with no pain with any of them. On Friday (09/09) the ENT said that blood test had ruled out bacterial and common virual infections mentioning Ebstein-Barr (mono), rhino virus, cat scratch fever, toxoplasmosis, lyme disease by name. On (09/13) we returned to the ENT for a wound check the doctor said that all blood test had come back negative and we were now waiting pathology results from the the lymph node tissue and he also noticed that he had gotten a new lump around the one at the back of his neck. The wait is killing me esp. since we have a huge family history of non-Hodgkins lymphoma. What other causes could I be looking at?

darseygirl · Answer

Just returned from the doctors office because today after he got home from after school activities the whole left side of his face was swollen and the back of his neck. While since the surgery the nodes had continued to grow in size they had not caused any real swelling in the rest of his face. Going back to the ENT first thing in the morning so they can take a look. Thanks for the ideas as to what ot could be but no its not allergies, tonsils; because he doesn't have them, no ear infections, lyme, or any basic thing. He really has no aches or pains associated with this. The only reoccuring problems we run into with him is chronic nosebleeds and stomach pain. Besides his lymph nodes completely healthy. He weighs 81.5 lbs, about 5 ft tall, very active in sports and does extremly well in them.

mrsmaiese · Answer

could be severe allergies, scarlet fever, lyme disease, TB, tonsilitis, an abscess...or he could just have swollen glands.

KMathurMD · Answer

Hi 
Welcome to the MedHelp forum!
Neck lymph nodes can be the result of tonsillitis, pharyngitis (infection of upper throat), infection in mouth, caries in tooth, internal ear infection, outer ear infection, eczema, dermatitis, dandruff, breast cancer, fungal infection, other cancers like lymphoma etc. If he had flu like symptoms initially then it could be due to infectious mononucleosis too (but ruled out).
Since one side of face was swelling, I would suggest you consult a skin specialist as well to rule out cellulitis or under the skin infection, an abscess due to dental procedure, and  dermatitis like reaction of antibiotics etc. All these can cause lymph nodes to swell as well.
Take care!