Swollen Lymph Nodes

The most common symptoms of swollen lymph nodes are as follows:

• Pain in the lymph nodes
• Swelling in the lymph nodes, which can either be equivalent to the size of a kidney bean or sometimes larger
• Sometimes the lymph nodes can become hard 

Since the swelling in the lymph nodes is usually due to some disease, the person may have other symptoms too such as a sore throat, cough, or fever.

Our lymph nodes become enlarged when our blood cells are fighting against a microorganism that is trying to attack the body. Sometimes the lymph nodes also swell up due to proximity to the infection site. However, the most common causes of lymph node swelling are as follows: 

• Upper respiratory tract infections such as common cold, sore throat, pharyngitis and others 
• Influenza 
• Sinus infections (such as sinusitis)
• Streptococcal pharyngitis (strep throat)
• Mononucleosis (glandular fever)
• Infections in the ear 
• Infected tooth (abscess in the tooth)
• A wound on the skin 
• Cellulitis (skin infection)

The less common causes of lymph node swelling are as follows:

• Toxoplasmosis: Toxoplasmosis is a parasitic infection caused by Toxoplasma gondii. The infection spreads when you come in contact with the faeces of an infected cat or eat undercooked meat. The cnfection can also spread from an expecting mother to her child during pregnancy.
• Rubella: Rubella is a viral infection that leads to fever and small red-pink coloured skin rashes that usually stay for up to three days.
• Measles: Measles is a highly infectious viral disease which results in distinctive red or brown spots on the skin along with high fever.
• Cytomegalovirus: Cytomegalovirus infection is a common illness which spreads through bodily fluids such as saliva and urine.
• Tuberculosis: Tuberculosis (TB) is a bacterial infection which usually affects the lungs but can affect the other organs too. It spreads through infected cough droplets. (Read more: What is droplet transmission?)
• Syphilis: Syphilis is a sexually transmitted disease which affects the genitals, rectum or mouth.
• Cat scratch disease: It is a bacterial infection that occurs when an infected cat licks a person's open wound, or bites or scratches.
• HIV: Human immunodeficiency virus (HIV) attacks the immune system of the body and thus weakens its ability to fight infections.
• Sarcoidosis: Sarcoidosis is an inflammatory disease that affects multiple organs in the body—but mostly the lungs and lymph glands—and forms small patches of red and swollen tissue, called granulomas, in them.

There are some immune system disorders which can lead to swelling of the lymph nodes:

• Systemic lupus erythematosus (SLE): SLE, also known as lupus, is a chronic inflammatory disease in which the immune cells of the body starts attacking the joints, skin, kidneys, blood vessels, heart and lungs.
• Rheumatoid arthritis: Rheumatoid arthritis is a chronic inflammatory disease in which there is inflammation, pain and stiffness in the joints of the body. 

Sometimes, swelling of the lymph nodes could be an indication of cancer. However, various other investigative tests are needed to be done to diagnose cancers. Some of the cancers that may lead to lymph node swelling are:

• Lymphoma: Lymphoma is the cancer of those immune cells of the body that help in fighting an infection such as lymph nodes, spleen, thymus and bone marrow. 
• Leukaemia: Leukaemia (blood cancer) is the cancer of the body's blood-forming tissues such as the bone marrow and the lymphatic system. 

It also includes all the other cancers that might not have originated from the lymph nodes but have spread to them, for instance, breast cancer which can easily metastasize (spread) to the axial lymph nodes (in the armpits).

You cannot prevent the swelling of lymph nodes as this only occurs in the presence of a viral or bacterial infection in the body. This is, in fact, a sign that your body has a healthy and robust immune system which is working against infection by an invading virus or bacterium.

Swollen lymph nodes are not a disease but a symptom, which means that there is something wrong in your body which needs diagnosis. To diagnose swelling in a lymph node, the doctor would ask for your medical history along with evaluating the lymph node via a physical exam. In the physical exam, the doctor would check the size, consistency (whether hard or rubbery) and location of the lymph nodes, pain and tenderness on touching and the mobility of the lymph nodes (whether the lymph nodes are fixed or moving). 

In the medical history, the doctor would ask for the medications that you would have been taking—some drugs can also cause swelling in the lymph nodes. Example: phenytoin, an anti-epilepsy medication which can cause swollen lymph nodes.

If the person does not have any signs of other physical illnesses such as upper respiratory infection or skin infection that can explain the swelling, the doctor would recommend further tests such as complete blood count and imaging tests such as an ultrasound, computed tomography (CT) scan or magnetic resonance imaging (MRI) scan of the lymph nodes. Sometimes if the doctor suspects any malignancy (cancer) in the lymph node, they would recommend a biopsy of the swollen lymph node.

Usually, the swelling in the lymph node is temporary and gets better on its own—all you need to do is drink plenty of fluids, take rest and relieve the pain at home by using over-the-counter pain-killers such as paracetamol and ibuprofen.

Mostly, the swelling in the lymph nodes is an indication of an infection in the body—most infections take at least a week to settle down.

If the swelling is in one lymph node, it is not so serious and could reduce in some time. If the swelling does not come down on its own, you will have to go to the doctor for an examination. The doctor may prescribe an antiviral or antibiotic to clear the infection in some cases.

If the swollen lymph nodes are found in two or more areas, it could indicate systemic disease. The doctor would investigate the cause of the swelling and would treat it accordingly.