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15 months swollen nodes, can this be something other than cancer or hiv?
May 26, 2002

Dr. Dezube: Thank you for the information you provide and for the attitude you take as you respond. I was concerned about being infected with hiv. After 2 tests, on at 6 months past possible exposure, and one at 12 months; I was reasonably assured that I was negative. My Doctor did find during that time that I was positive for cmv, and ebv. I have had few symptoms this past year, but I do have purple sores on inside of cheek, that tend to come and go. I also have some lower back pain that has been persistant for some time now; however my main concern is with swollen nodes. Could ebv, and cmv keep nodes swollen for 15 months now, or would there be an underlying cause. I would be very grateful if you could help me with this. My doctor is a great guy, but I'm in a small community, and wonder if I need to see another doctor for a second opinion. My family doctor says that it might take another 6 months for my lymph nodes to return to normal.

Response from Dr. Dezube

Lymph node swelling is very common; it typically represents nothing more than the body's immune system revving up as it tries to fight off an infection. We worry more about lymph nodes which continue to grow; when one lymph node is way our of proportion to other lymph nodes; or if you were to have systemic symptoms (fever, chills, night sweats, and weight loss).

You raise two important questions. How long will it take for them to go back to normal, and what is the role of EBV and CMV infections (these are two infections by herpes-like viruses)? Most lymph nodes in HIV-negative folks will in time go back to normal. Your doctor is correct in that it could take another 6 months. These lymph nodes may indeed be normal (i.e. swollen lymph nodes are worrisome to the patient, yet the vast majority of them are really normal findings). So long as they don't grow and so long as you don't develop systemic symptoms, you should be okay. EBV and CMV infections are VERY VERY common. Most folks do not even know that they have had such infections. I'm not sure the fact that you have had these infections in the past, as evidenced by blood work, has anything to do with your current lymph nodes.


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