Swollen Lymph Nodes: Common Causes and When to Be Seen

What it involves

MedlinePlus explains that lymph nodes are present throughout the body and are an important part of the immune system, helping the body recognize and fight germs, infections, and other foreign substances. The term swollen glands refers to enlargement of one or more lymph nodes. The medical name is lymphadenopathy.

Who this is for

• Adults with a tender lump in the neck, armpit, groin, or under the jaw
• Patients whose swollen nodes have lasted more than a few weeks
• Patients who also have a fever, night sweats, or weight loss they cannot explain
• Parents unsure whether a swollen node in a child needs to be seen

What to expect

• Questions about when the swelling began, whether it came on suddenly, and whether it hurts
• An exam of the nodes in your neck, armpits, and groin and of the areas that drain into them
• A plain explanation of whether the pattern looks like an infection or needs more testing
• A plan for follow-up, blood tests, or a referral if the cause is not clear

Where you can feel them

MedlinePlus lists the common places where lymph nodes can be felt with the fingers:

• The groin and the armpit
• The neck, where a chain of nodes runs down the front, both sides, and the back
• Under the jaw and chin
• Behind the ears and on the back of the head

Infections are the most common cause

MedlinePlus says infections are the most common cause of swollen lymph nodes, including an abscessed or impacted tooth, an ear infection, colds, flu, and other infections, inflamed gums, mononucleosis, mouth sores, tonsillitis, tuberculosis, skin infections, and sexually transmitted illness. The cold and flu guide and the sore throat guide cover two of the illnesses that most often set off tender nodes in the neck. A bite or sting can leave nearby lymph nodes tender, and the insect bites and stings guide explains the infection signs worth watching for.

Less common causes

MedlinePlus also names immune and autoimmune disorders such as HIV and rheumatoid arthritis, and cancers such as leukemia, Hodgkin disease, and non-Hodgkin lymphoma. It notes that many other cancers may cause swollen nodes and that a nearby node is often the first place a cancer spreads. Some medicines can do it too, including seizure medicines such as phenytoin and the typhoid immunization. Which nodes swell depends on the cause and the body parts involved.

What the pattern can tell you

MedlinePlus says swollen lymph nodes that appear suddenly and are painful are usually due to injury or infection, while slow, painless swelling may be due to cancer or a tumor. That contrast is the reason a provider asks when the swelling began and whether it hurts. It is a clue, not a diagnosis, and only an exam can sort one from the other. Swollen glands can accompany shingles along with fever and headache, as the shingles guide explains, and the timing of treatment is part of why it is worth a quick call.

Home care

MedlinePlus says painful lymph nodes are generally a sign that your body is fighting an infection. The soreness usually goes away in a couple of days without treatment, though the node may not return to its normal size for several weeks.

Signs you should be seen

MedlinePlus says to contact your provider if:

• The lymph nodes do not get smaller after several weeks, or they keep getting larger
• They are red and tender
• They feel hard, irregular, or fixed in place
• You have a fever, night sweats, or unexplained weight loss
• Any node in a child is larger than 1 centimeter (0.4 inch) across

What a visit involves

MedlinePlus says your provider performs a physical exam and asks about your history and symptoms. Tests it lists include blood tests such as liver function tests, kidney function tests, and a complete blood count with differential, a lymph node biopsy, a chest x-ray, and a CT scan of the chest and abdomen. The complete blood count guide and the liver function tests guide explain two of those blood tests. A biopsy or imaging would be arranged through a referral, and treatment depends on the cause.

Sources

• MedlinePlus — Swollen lymph nodes
• MedlinePlus — Lymphatic Diseases