Swollen lymph nodes with severe pain can be caused by viral or bacterial infections, tuberculosis and other diseases. 1. Viral or bacterial infection. Inflammation caused by viral infections such as rubella virus and measles virus is common and can cause swollen and painful lymph nodes in the neck and behind the ears, which can be treated with antiviral drugs such as ribavirin and acyclovir. In addition, bacterial infection of the subcutaneous tissue can also lead to lymph node swelling and pain, some people may have severe pain, can be used to use cefixime, levofloxacin and other antibiotic treatment. 2. Tuberculosis. Lymph node tuberculosis caused by Mycobacterium tuberculosis can lead to lymph node enlargement and pain, often combined with the use of anti-tuberculosis drugs, such as isoniazid, rifampicin and so on for treatment. It should be noted that when the lymph nodes are enlarged, severe pain, should promptly consult a doctor under the guidance of the examination and treatment.