Hello doctor, I am a 22-year-old male. I do no substance abuse, alcohol, and smoking. I have a painful post auricular lymph node swelling for four days. Yesterday evening one more post auricular lymph node was noticed which is swollen, sudden in onset and painless. I am taking antibiotics Augmentin duo (Amoxicillin and Clavulanic acid) and painkillers for three days. I am worried because one more lymph node started swelling and I even worried about cancer. Please help. Blood test was done lymphocytes - 55% and neutrophils - 30%, rest all values are normal.
Hi. Your complaint is suggestive of some ear or scalp infection, as it is painful. Please send a picture of the lesion, as it is possible that what you think is the painful lymph node is actually folliculitis and the painless thing is actually the real lymph node. In that case, the antibiotics that you are currently taking are appropriate. The dose should be Augmentin Duo 625 (Amoxicillin 500mg and Clavulanic acid 125 mg) twice a day for five days. Do not stop before five days. Take tablet Combiflam (Ibrufen 400mg and Paracetamol 325mg) twice a day for two to three days. Regarding the risk of cancer, size of the painless lymph node is a very important parameter in deciding further investigation. If the size is more than 1.5 cm then FNAC (fine needle aspiration cytology) of the lymph node is usually recommended. This test needs to be done if after taking the above-mentioned treatment for five days the swellings continue to persist. Gram stain and culture of any discharge. Acute lymphadenitis. Lymphoma. Folliculitis. Continue antibiotics to complete total of five days. Painkillers as required. Hot and cold fomentation. Maintain scalp hygiene. Followup is must if the swelling persists more than a week. Follow up with pictures both before medicines and after a week.