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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Multiple Neck Swelling, Rising Temperature, Weakness, Multiple Palpable Lymph Nodes, Loss Of Appetite, Breathlessness. Explain Situation

28yr old man complaints of multiple neck swelling x 2wk fever with evening rise of temperature and generalised weakness. Pt was apparently asymptomatic till 1wk back when he started to have multiple palpable lymphnodes on neck. pt also gives h/o night sweat x 4-6 days, given H/O loss of appetite an wt loss (71kg-67kg over two months), given H/O cough expectoration about one month back and it resolved spontaneously.,no H/O breathlessness/ chest pain.no h/o any high risk behaviour. consumer alcohol 60-120ml . Pt had taken Tab erythomycine500mg on onset of neck swelling

o/e
GC ; fair
pulse 76
BP; 120/80
no, pallor, cyanosis/iclerus/clumbbing/pedal edema
Local examination;-multiple firm lymphnodes on both sidesof neck,Largest measuring approx 1.5cmx1cm,nodes are immobile and non tender
S/E; R/S-Normal vasicular breathsounds, chest B/L clear,abd;mild haepatomegaly present,
no neurological deficit
Haematology;- HB-13% ,TLC-9600,DLC-50%,Lymhocytes 44%,Eosinophils 06%,ESR-10,
Bi0-Chemistry;-RBS-100,SGOT-145.9,SGpT 199.4
HIV;-Non-Reactive
Urine examination;-BIL-Large,KET-negative,GLU-negative,SG->=1.030,BLO Trace-intact,pH 06.0,PRO 30mg/dl,
URO 0.2 E.U./dl, NIT-positive, LEU-negative
Fri, 24 May 2013
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General & Family Physician,  's  Response
Hello dear palpable lymph nodes in neck ,,,,,,,loss of apetite weight loss ,,,,,,,dear are the nodes hard,painhpfulll,,,,,,,,,,
Dear these symptoms are quite common n tuberculosis ....ther are many type pf tuberculosis ,,,some effect lunge,some bones,some lymph nodes,,,i would suggest do an x.ray chest ,skin sensitivity test,sputum afb and manage patient accordingly
Second.y if you think nodes are hard ,adherent to skin,rubbery you might think of some cancerous condition ,,,,plus this hepatomegaly is also not normal for this do a peropheral smear of patient with sp empheis on cell morphology and abdominal ultrasound
Hope for the best of things to occur
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Multiple Neck Swelling, Rising Temperature, Weakness, Multiple Palpable Lymph Nodes, Loss Of Appetite, Breathlessness. Explain Situation

Hello dear palpable lymph nodes in neck ,,,,,,,loss of apetite weight loss ,,,,,,,dear are the nodes hard,painhpfulll,,,,,,,,,, Dear these symptoms are quite common n tuberculosis ....ther are many type pf tuberculosis ,,,some effect lunge,some bones,some lymph nodes,,,i would suggest do an x.ray chest ,skin sensitivity test,sputum afb and manage patient accordingly Second.y if you think nodes are hard ,adherent to skin,rubbery you might think of some cancerous condition ,,,,plus this hepatomegaly is also not normal for this do a peropheral smear of patient with sp empheis on cell morphology and abdominal ultrasound Hope for the best of things to occur