Question 1

I'm really worried about my mom. She's a diabetic patient and recently had some pain and inflammation in her right underarm. We went to a breast center where they did a mammogram with contrast, and the report said something about necrotic right axillary lymphadenopathy, described as BIRADS 4, and suggested a biopsy. They also mentioned some masses in her right breast, probably benign, and suggested to follow up in 6 months. There was also a simple cyst in her left breast and retroareolar duct ectasia in the right one, but they said it's benign.

After that, she had a USG guided FNAC, and it came back with something called necrotising granulomatous lymphadenitis, which they said could mean TB. But we did all the TB tests like AFB smear, pus stain, X-ray, AFB stain, culture, and gene xpert, and everything was negative. They also did a biopsy by removing a lymph node, and it showed no malignancy. The doctor mentioned there were many lymph nodes, and a few had pus, so they checked for infections like HIV, HCV, and HBsAg, and those were negative too.

I'm trying to understand why she has multiple lymph nodes, some with pus, and if this is something serious. Should we be seeing a specific specialist or doing any additional tests? This is so worrying, and we're not sure what steps to take next.

Accepted Answer

consult rheumatologist  immunologist

Question 2

I've been tested for VDRL and RPR, and both came back negative, but my TPHA result was positive with a titer of 1160. I haven't had any lesions, rashes, or other symptoms, and this is my first time testing positive for syphilis. I've done the VDRL test four times in the last two years, and they've always been negative. Can you tell me which stage of syphilis this might indicate and if a titer level of 1160 is something to worry about? What would the treatment be?

Accepted Answer

Consult a healthcare provider: It's important to discuss your results with your doctor. They can confirm whether you have latent syphilis and guide you through the necessary treatment.
Possible further testing: Your doctor might order additional tests or monitor your condition to see if there are any signs of active infection.
Even though you're not showing symptoms, treatment is crucial to prevent complications and transmission to others.

Question 3

I'm really concerned because I've been having a fever that sometimes goes above 103C for the last four months. We've done all sorts of tests like for malaria and typhoid, and they've all come back normal. Blood cells are normal, urine culture, 2D echo, and blood culture are also normal. The fever seems to spike at night, reaching up to 103C, and taking DOLO P650 just makes me sweat a lot but doesnt really help long-term. What's going on here? Why is the temperature still high when everything else seems normal?

Accepted Answer

The persistent fever of over 103C for four months, despite normal test results, suggests a possible underlying condition that might not be easily detected through routine tests. It could be due to an autoimmune issue, chronic infection, or inflammatory disorder. It's important to follow up with a specialist for further evaluation and possibly more advanced testing.

I'm really worried because I had unprotected sex with a sex worker a few days ago, and now I'm planning to get tested for STDs within the next couple of days. What should I be looking out for, and is there anything else I should do right now? I'm feeling really anxious about this whole situation.

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