About bumps in neck

[riley11]

Dear Doctor,

I will try to make this short and sweet.  

Just a week ago I noticed that behind my left jaw I had some pain and then suddenly noticed that there was a bump there.  I figured it was a lymph node but it was only about a centimeter in diameter, which I thought was the normal size of lymph nodes but there was not one on the other side. Well, my earring hole was a little infected, making it ooze out some fluid and it became crusty at times. Well, now last night I noticed pain now on the OTHER side of my next and felt a painful little bump, smaller than a pea, and took a look at that earring hole and I could squeeze puss out. Now my concern is, can this have NOTHING to do with my infected earring holes and more a concern of HIV?  I had a risky exposure about a year and a half ago but the last time I tested was 4 months after the exposure! And it was negative! I'm scared that these little bumps could be symptoms of HIV if my test missed the virus. Some questions:

1.) When people with HIV get swollen lymph nodes, do they appear over night like mine did? and are they painful?
2.) When they are due to HIV how big do they usually get?
3.) Could my infected earring holes be a cause of these painful bumps behind my jaws?

Please help me doctor, I am freaking out because I know swollen lymph nodes are a symptom of HIV.

[H. Hunter Handsfield, M.D.]

Thanks for the kind words.

[riley11]

Thank you very much. I would like to say that this forum is a great place, not only to become more knowledgeable about HIV prevention but also a place to calm my fears. With your knowledge about HIV, I feel much better that you have assessed my situation and I am confident that I can trust your opinion.  Thank you.

[H. Hunter Handsfield, M.D.]

HIV related lymphadenopathy appears early in HIV infections (in the first few weeks) then goes away.  So in addition to the things I said above, the timing is aganist HIV as the cause.

Your negative test result makes HIV impossible, even if the symptoms were typical -- which they are not.  Trust me, you don't have HIV.

[riley11]

Thank you that helped a lot.  Just so I'm on the right page, when people have enlarged lymph nodes from HIV, this happens in the first few weeks of infection, right?  Basically, what I am trying to ask is, do lymph nodes appear in the beginning of the infection and stay like that in the body forever, or every now and then do lymph nodes pop up out of no where? thats what Im mostly concerned about.  I hope you can clear that up for me.

[H. Hunter Handsfield, M.D.]

As far as HIV is concerned, you can relax.  There isn't anything in this that even hints at HIV.  And a negative HIV test 4 months after the last possible exposure is proof positive you were not infected.  That test result proves your current symptoms cannot be due to HIV, even if they were typical for HIV -- which they are not.

To your specific questions:

1) The lymphadenopathy (lymph node inflammation) due to HIV occurs in many areas of the body at once, not localized to one area like the neck.  Even in people with such widespread lymphadenopathy, that symptom never occurs alone, only with fever and other symptoms. And even then, things other than HIV are much more common causes.

2) Size of nodes has nothing to do with it.

3) Indeed, it sound possible that an infection related to ear piercing is a possibility.

You should see a health care provider about these symptoms.  If you have a localized bacterial infection, which seems likely, there is a small but definite risk of serious complications.  You might need an antibiotic.  But don't worry about HIV.

I hope this helps.  Best wishes--  HHH, MD