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Swollen neck lymph nodes and MAC
Oct 6, 2005

I was diagnosed hiv+ in late June 2005. My initial counts were CD4 30/VL 650,000. My numbers 60 days later after starting Sustiva and Epzicom therapy were CD4 75/VL 513. I also tested positive for MAC as part of the immune resonstitution syndrome as per my doctor. I've been on MAC thereapy for about 8 weeks and my swollen lymph node (under my right jawbone) has not dimished, even with a period of steroids to "speed" the healing. My doctor has now requested another CT scan (an earlier one showed the mass is nothing more than a bunch of nodes) and a visit to a specialist that may surgically remove the mass. Any thoughts would be appreciated.

Response from Dr. Henry

Sometimes one has to be patient to get through the initial phases of treatment particulary if immune reconstitution is resulting in an enhanced response to an active infection such as MAC. Use of anti-inflammatory agents like ibuprofen and low-moderate dose corticosteroids sometimes is helpful as is diagnosis and treatment of any other underlying infections (like MAC). In your case with no obvious response at least a biopsy of the mass under the jaw may be key to proper management. KH

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