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Questions for Dr. Kennedy
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Swelling and Inflammation
Posted by: Jonathan
Date: May 28, 2005 7:14 PM

Last August the left side of my neck became swollen, I can feel the swelling when I swallow. The inner tissue of my neck (not my throat) became inflamed, pain spread to left ear, along with swelling under ear, inflammation spread to left nostril, behind my eye, over my eye, under my eye, and into one small section of my upper left gum just above a tooth. I have headaches. Headaches feel like the top of a broom handle pressing down on one spot on the left side of my head. The ENT doc said chronic sinusitis - CT scan, negative blockage. He could see swelling in my throat. Full mouth x-Ray - negative. Not a sinus infection (I've had them). The same inflammation pain I'm having under the surface of my neck is the same pain that's radiating into my sinuses. The pressure in the sinuses is different than sinus infection pressure. Swollen lymph node, left side, that hasn't gotten any bigger in 9 months. All symptoms exclusive to left side. I have seen two doctors and they've both thrown Flonase at me and pushed me out the door. Any ideas at what this could be? Would Cortisone shots take care of it?

RE: Swelling and Inflammation
Posted by: Ron Kennedy, M.D.
Date: May 28, 2005 10:27 PM

One always wants to rule out tumor, cancer, etc. I am not saying this is what you have, but a complete blood count and a biopsy of that lymph node would be items most docs might think of. Assuming that is not the problem, infection would be the next consideration. If there is any fluid to be extracted from this situation, a culture and sensitivity (to antibiotics) could be very illuminating. The way you describe it spreading by disregarding normal tissue boundaries suggests cellulitis. If this is the case, and I am not saying it is, but if this is the case, then antibiotics are in order. However the duration of the illness speaks against cellulitis. An outside possibility is allergy, in which case you should see an allergist. The key is getting to the right doc. Don't give up.



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