painefull lymph nodes in neck

[mganp]

Age 36, female with two kids, painfull lymphnodes in right hand side neck, for more than 3 weeks. doctor gave antibiotics, nothing change. so underwent FNA biopsy. However continued antibiotics. lymph nodes became small, and less painfull.  after one week  biobsy reults came. It says there are spectrum of cells resemble to myeloid series present in the smear.
due to side effects of antibiotic constipation started. so I doctor said to stop antibiotics. now again painfull lympnodesare there.
Family history have tuberculosis.
ESR normal
mantau test negative
please help me
Poor mother

[Dennis MD]

Hi.
Thanks for the update.
How are you doing now?
There is still a need to investigate further the cause of your lymphadenopathy.  Chronic infection as the source of your lymphadenopathy should be rule-out.  Other possible causes would be collagen diseases or a neoplasm in the head and neck region.  A consult with an infectious diseases specialist, rheumatologist, or an oncologist may be needed for further evaluation.  
Good luck.

[mganp]

Thank you very much for your reply.
I got bone marrow aspiration report. wish to submit for your kind perusal.
Aspirated with ease from right posterior superior iliac spine
paricles: Normocellular

Cell Trails: Milddly hypercellular
Erythropoiesis: Active, Mild nuclear cytoplasmic asynchrony
Granulopoeisis: Active, all stagees of maturation seen, No excess blasts
Megakaryocytes: Normal in number and morphology
Lymphoid cells: Not increased
macrophage activity: Seen within normal limits
Plasma cells: 3% normal morphology
Differential count:(%)
Erythroids 25
Blasts       01
Promyelocytes 01
myelocytes 09
Bands/metas 35
neutrophils 14
plasma cells 03
Comments: reactive marroe showing trilianeage haemopoeisis
Trephine biopsy report to follow

Thank you very much SIr.

[Dennis MD]

Hi.
Thanks for the clarifications.
Supportive measures can be given for the symptoms you are experiencing until the result of the bone marrow biopsy and other laboratory examinations come out.  You can take Paracetamol for the fever and Metoclopramide for the vomiting.  
Please do post the result of your bone marrow biopsy.  
Good luck to you.

[mganp]

Thank you very much for your kind attention.
FNA biobsy in lymph nodes reveal that spectrum of cells resembling myeloid series present. they sugested further investigations ,  blood picture/bone marrow test and lymph node biopsy(open).
How ever  laboratory doctor said blood picture is normal. Bonemarrow results pending. no other symptoms such as night sweating, fatigue, or any swelling in abdomen,  
but I have fever in the evening and night time,  I want to eat, but I feel bad taste of food (like more bitter or salty taste). some times vommiting

thank you

[Dennis MD]

Hi.
Just have some clarifications.  What is the result of your lymph node biopsy?  Aside from biopsy, were there any other examinations done?  What are your symptoms?
Chronic infection like tuberculosis can cause enlargement of cervical lymph nodes.  Involvement of the lymph nodes by tuberculosis can occur and cause lymph node swelling.  This is called TB adenitis.  Sometimes, the lymph nodes would drain into the skin and would appear as a discharging mass, with associated ulcerations and tenderness.  You tested negative in your Mantoux test.  That can rule-out tuberculosis as the cause of your cervical lymph node swelling.   However, there are false negative reactions to Mantoux testing.  Examples of causes of false negative reactions include infections, immunosuppression, and steroid intake.  
There are times when a patient would complain of constipation after intake of antibiotics.  But this should not alarm you.  Regular bowel movement will resume after discontinuing the antibiotic.