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I would ask about cat scratch disease/fever. For example - if your son gets a scratch on his arm (from the/a cat, especially if it goes outdoors), even one barely noticeable, that could very well cause swelling of lymph nodes in the upper extremities/nearest to the site of initial contact such as the armpit and/or neck. It's also considerably likely, if the vomiting accompanied the use of Zithromax and stopped after use, that particular antibiotic has a high propensity to cause stomach pain, vomiting and/or diarrhea.
Generally, if a person was already ill with some sort of infection, whether it be bacterial or viral, it can take a while for lymph node swelling/prominence to subside. From personal experience, I came down with a horrible flu-like illness back in June. A lymph node in my groin area became swollen and painful during and remained so WEEKS after having been sick. This obviously posed concern, so I went for extensive testing (vaginal swab, blood work and ultrasound) on said lymph node and nothing. I was given antibiotics as a "just in case", then 2 months later... GONE.
Despite the aforementioned, I second further testing for your son.
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Posted by mother1991
My son is 17. He has had a sudden swellng of the lymph nodes on left side of neck below jaw line in front of ear that is tender and painful to the touch. No known infections or illnesses prior to this. Has been going onfor two months now. He has been hiking in tick infested areas. His labs have all come back normal except for Vitamin D defiency and high triglycerides. He has been having some upper right quadrant pain with periods of vomiting appoximately 1-2 hours after eating but no pattern as it happens at all times day or night. He has always complained of legs hurting at times since he was 5 but always thought it was growing pains andwas evaluated by Ortho and noting was found at that time. His Mono test has come back negative but Lyme disease was not tested. We also have a cat that he cleans the litter box as part of his chores. He has an appointment to see an ENT in about 10 days to evalute this further. My child has a high pain threshold. He just saw the dentist in November of 2008 and had two cavities filled and teeth cleaned and X-rays were taken at time and no other dental problems found. He also completed about three weeks ago a course of antibiotic ( Z pack) in case the lymph node was infected. There is also noticiable swelling on left side of neck as well. Any ideas on what to also ask when he sees the ENT to see if other things can ruled out as well. I was thinking possibly tests for Lyme disease, toxoplasmosis, and possibly a CT of neck and upper chest to make sure nothing is being missed, or other ideas to look into.