Merck Manual

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Some Causes and Features of Swollen Lymph Nodes

Some Causes and Features of Swollen Lymph Nodes


Common Features*



Fatigue, fever, and weight loss

With acute leukemia, often easy bruising and/or bleeding

Complete blood count and specialized blood tests (for example, peripheral smear and/or flow cytometry)

Bone marrow examination

Painless lymph node swelling (local or widespread)

Nodes often rubbery and sometimes clumped together

Often fever, night sweats, and weight loss

Lymph node biopsy

Specialized blood tests

Metastatic cancers (often of the head and neck, thyroid, breast, or lung)

One or several painless nodes in the neck

Nodes often hard, sometimes unable to be moved when pushed

Tests to identify the primary tumor, often including imaging studies, blood tests, and biopsy

Connective tissue disorders

Tender swollen nodes in the neck in a child

Fever, usually higher than 102° F (39° C), rash on the trunk, prominent red bumps on the tongue, peeling skin on the palms, soles, and around the nails

Only a doctor's examination

Painless lymph node swelling that may be widespread

Often cough and/or shortness of breath, fever, malaise, muscle weakness, weight loss, and joint pains

Chest imaging (plain x-ray or CT)

Sometimes lymph node biopsy

Widespread node swelling

Typically painful and sometimes swollen joints

Sometimes red rash affecting the nose and the cheeks and other skin sores

A doctor's examination plus blood tests


Dental infection

Neck nodes on one side are affected (often tender)

Painful tooth

Only a doctor's or dentist's examination

Generalized lymph node swelling

Usually fever, malaise, rash, and joint pain

Often in a person known to have been exposed to HIV or to having exposure to a high-risk activity (such as being stuck with a needle used by another person or high-risk sexual activities)

HIV blood testing

Swelling on both sides, typically in the neck but sometimes under the arms or in the groin

Fever, sore throat, and severe fatigue

Typically in an adolescent or a young adult

Blood test for mononucleosis

Except for the secondary stage of syphilis, only swollen nodes in the groin

Often urinary symptoms (such as pain during urination) and urethral or vaginal discharge

Sometimes sores on the genitals

For the secondary stage of syphilis, often widespread sores on the mucous membranes and widespread lymph node swelling

STD testing

Usually a visible cut or infection of the skin near the swollen node

Usually only a doctor's examination

Sometimes blood tests to identify antibodies to the infecting organism

Swollen nodes on both sides of the neck and under both arms

Sometimes flu-like symptoms and an enlarged liver and spleen

Often history of exposure to cat feces

Blood tests

Usually swelling of nodes in the neck or above the collarbone

Sometimes lymph nodes inflamed or draining

Often in a person who has HIV infection

Tuberculin skin testing or blood tests for tuberculosis

Usually lymph node biopsy

Neck nodes are affected with only little or no tenderness

Sore throat, runny nose, or cough

Only a doctor's examination


Drugs: Common drugs include allopurinol, antibiotics (for example, cephalosporins, penicillin, and sulfonamides), atenolol, captopril, carbamazepine, phenytoin, pyrimethamine, and quinidine

History of using a causative drug

Except for phenytoin, rash, joint and muscle pain, and fever

Only a doctor's examination

Silicone breast implants

Node swelling under the arms in a woman with breast implants

A doctor's examination and often tests for other causes of node swelling

* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present.

CT = computed tomography; HIV = human immunodeficiency virus; STD = sexually transmitted disease.