How to properly treat lymphadenitis. Cervical lymphadenitis Repeated lymphadenitis

The lymph nodes located under the skin in the groin are most often affected. armpit, on the neck, under the lower jaw, under the back of the head. Purulent lymphadenitis often occurs, in which the lymph node gradually melts and turns into an accumulation of pus.

Reasons for the development of lymphadenitis

The main reason for the development of lymphadenitis is the entry of pathogenic microorganisms into the lymph node - streptococci and staphylococci. Most often, the pathology develops as a complication of another purulent-inflammatory disease, for example, phlegmon (purulent inflammation of adipose tissue), (purulent inflammation of the finger), caries and pulpitis, tonsillitis, osteomyelitis (purulent inflammation of the bone), etc.

Special forms of lymphadenitis occur with syphilis, tuberculosis, actinomycosis and some other diseases.

When a focus of purulent inflammation appears in the body, pathogenic microorganisms penetrate from it into the lymphatic vessels and reach the lymph nodes. Since the lymph nodes serve as a natural immune barrier, germs linger here and can cause inflammation. This is how lymphadenitis develops. One or more adjacent nodes may be affected.

Signs of lymphadenitis

In acute lymphadenitis, swelling and redness of the skin and pain occur. If the affected lymph node is on the arm or leg, its inflammation leads to impaired movement. The lymph node itself can be felt under the skin in the form of a dense lump; it is enlarged in size. When suppuration occurs, a cavity filled with pus appears at the site of the node. Body temperature rises. There is a deterioration in the general condition: chills, malaise.

If the body cannot cope with the infection and there is no treatment, the acute form of lymphadenitis becomes chronic. The symptoms subside for a while. The pain goes away, the body temperature drops to 36.6 - 37⁰C. Subsequently, there is an alternation of exacerbations and normalization of the condition. This leads over time to a decrease in immunity, penetration of pathogens into other organs, and the development of autoimmune diseases.

Often the symptoms of lymphadenitis are so severe that the underlying disease, which resulted in inflammation of the lymph node, fades into the background.

Complications of lymphadenitis

If lymphadenitis is accompanied by suppuration, then over time several neighboring lymph nodes melt, and in their place a large cavity with pus is formed. At the same time, the patient's condition worsens. When pathogens spread into the adipose tissue surrounding the lymph node, purulent inflammation develops. A complication of lymphadenitis can be thrombophlebitis - inflammation of the vein wall and the formation of blood clots on it. When the immune defense is impaired, the infection enters the blood and spreads throughout the body, purulent foci appear in various organs - it develops. With chronic purulent lymphadenitis, a fistula can form - an opening connecting the lymph node to the surface of the skin. During exacerbations, it opens every time and pus is released from it.

What can you do?

Chronic lymphadenitis, especially if it is not accompanied by suppuration, can exist for a long time. During exacerbations, the affected lymph node enlarges and becomes painful, and the body temperature may rise. The rest of the time there are no symptoms. Even if an inflamed lymph node does not cause any particular problems, chronic inflammation contributes to decreased immunity and an increased risk of autoimmune diseases. Therefore, lymphadenitis requires treatment in any case. If symptoms of the disease occur, you should immediately consult a surgeon.

What can a doctor do?

Examination for lymphadenitis includes, may include ultrasound and biopsy of the lymph node (a fragment of lymph node tissue is taken using a special needle and sent for examination to the laboratory).

If acute lymphadenitis is not accompanied by suppuration, then it can be treated without surgery. The doctor prescribes antibiotics and physiotherapy (UHF therapy). It is very important to eliminate the main source of inflammation from which the infection penetrated into the lymph node.

For purulent lymphadenitis, surgical treatment is always performed. During the operation, the abscess is opened, all the pus is removed from it, it is washed with antiseptics and drainage is installed for several days.

For chronic lymphadenitis, surgical treatment is also carried out: it is necessary to eliminate the inflamed lymph node and other foci of infection. If there is a fistula, it is completely excised. After surgery, antibiotics are prescribed.

Surgeries for lymphadenitis are usually performed in a hospital.

The immune and lymphatic systems are closely related to each other. But when immunity decreases, a malfunction occurs in the functioning of the lymph nodes - an inflammatory process begins, and, as a result, chronic lymphadenitis.

Depending on the duration of the disease, chronic and acute forms are distinguished, and according to the type of pathogen - specific and nonspecific varieties. And also according to the degree of progression, purulent and non-purulent forms of the disease are noted.

Acute inflammation is characterized by a rapid course of the disease, with a sharp increase in symptoms, which, with proper treatment, gradually subside.

Chronic lymphadenitis is characterized by a sluggish course of the disease, which lasts for a long time. In the presence of other chronic diseases, it can last up to several years.

How does the inflammation process occur?

The lymphatic system, or as it is called, the “cleansing system” consists of intercellular fluid - lymph, capillaries, lymph nodes and vessels. The lymphatic system covers all soft tissues of the body, and lymph circulating through the vessels promotes intercellular metabolism. It also removes decay products from tissue fluid, dead parts of cells, toxins, foreign microorganisms, viruses, bacteria, and delivers them to the filters - lymph nodes. Particles and bacteria that enter the lymph nodes are filtered and destroyed by lymphocytes, and the purified bacteria continues on its way.

During illnesses, antibodies are produced in the lymph nodes, which the lymph delivers through vessels and capillaries to the site of infection along with lymphocytes. But with weakened immunity, it may happen that lymphocytes cannot cope with the attack of pathogens, and as a result, enlargement and inflammation of the lymph nodes occurs - lymphadenitis.

Chronic nonspecific form

Chronic lymphadenitis is characterized by a long-term inflammatory process in the lymph nodes. Most often, lymphadenitis occurs with a nonspecific form.

The main causes of the disease

Staphylococcal and streptococcal infections.
The presence of purulent wounds, ulcers, boils on the body.
Otitis media, tonsillitis, bronchitis.
Chronic tonsillitis, sinusitis.
Erysipelas of the skin.
Rheumatoid arthritis.
Thrombophlebitis.
Oral infections.

A chronic type of nonspecific form of lymphadenitis is a consequence of inflammatory processes in the body. That is, even with the slightest cold or relapse of any chronic disease, inflammation of the lymph nodes begins.

Chronic specific lymphadenitis

Lymphadenitis of a specific origin occurs against the background of severe infectious diseases. In most cases, the underlying disease may be in the initial stage and not manifest itself in any way, but inflamed lymph nodes indicate that not everything is in order with the body.

Infections causing a specific form

Tuberculosis bacillus.
Causative agents of plague and syphilis.
Gonorrhea.
Anthrax.
HIV AIDS.
Fungal diseases.

With tuberculous lymphadenitis, the lymph nodes in the cervical, intrathoracic and axillary areas most often become inflamed. The gonorrheal form is characterized by enlargement of the inguinal lymph nodes.

Symptoms of chronic lymphadenitis

Lymphadenitis is not an independent disease; it is a consequence of infection entering the lymph nodes.

Unlike acute inflammation, chronic lymphadenitis has less severe symptoms.

Common symptoms of the nonspecific form of the disease are hardening and enlargement of the lymph nodes, which persist for a long time. The nodes remain mobile and practically painless. The connective tissue around the inflamed lymph node grows and scleroses, which leads to impaired lymph movement, swelling and lymphostasis.

When the nodes under the lower jaw are inflamed, pain in the ears often appears, redness of the oral mucosa, and an increase in temperature are noticed. Most often, children prone to respiratory diseases suffer.

Chronic cervical lymphadenitis characterized by fever, headaches, loss of appetite, weakness. In acute form appearance the node resembles a boil.

In the groin area, symptoms of chronic lymphadenitis include pain when moving, malaise, and high fever. The main cause of the inflammatory process is infectious diseases of the genital organs, intestines and adjacent tissues.

Inflammation in axillary area most often occurs in adulthood. A peculiarity is that in the armpits the nodes are faintly palpable and may not be immediately detected. The disease is accompanied by insomnia, headaches, and loss of appetite.

You should immediately consult a doctor if:

Body temperature is above 38.5.
Labored breathing.
Swelling or redness over the inflamed site.
Strong pain.

The specific form is accompanied by severe intoxication, frequent temperature fluctuations, loss of appetite, nervousness and irritability are noticed. The lymph nodes are greatly enlarged and without proper treatment, necrotic processes may begin in them.

You should pay attention to the following symptoms characteristic of non-Hodgkin lymphoma:

Enlarged and elastic lymph nodes.
Excessive sweating.
Increased fatigue.
Fever of unknown origin.
No symptoms of colds or infections.

If you have these symptoms, you should immediately consult a doctor. this is a malignant manifestation of lymphadenitis, in other words, an oncological disease.

Diagnostic methods

Diagnosis of the disease is based on studying the symptoms of the disease and examining the patient. In most cases, to diagnose lymphadenitis, it is enough to study the course of the disease.

In case of doubtful data or for a more accurate diagnosis, the following examinations are carried out:

General blood analysis.
Blood chemistry.
X-ray or ultrasound of the lymph nodes.
CT scan.

If specific lymphadenitis is suspected, tests for infections are prescribed:

HIV and AIDS.
Syphilis.
Tuberculin tests.

Only after making a diagnosis can a doctor prescribe the correct treatment.

Treatment

Chronic lymphadenitis, treatment of which is started on time, goes away after the cause of inflammation is completely eliminated.

Treatment of specific inflammation occurs over a long period of time. In some cases, it takes more than one year. First of all, therapy is aimed at curing the primary disease. The prescription of medications depends on the form of the disease.

The main drugs in the treatment of nonspecific lymphadenitis are antibacterial and anti-inflammatory drugs. They are selected by the doctor depending on the causative agent of the disease. Antihistamines, antipyretics, restoratives and immunity-enhancing drugs are also used.

Compulsory physical therapy course:

Microwave, UHF.
Electrophoresis.
Phonophoresis.
Paraffin therapy.

In some cases, homeopathic medicines are prescribed to improve lymph circulation and boost immunity.

The patient is strictly contraindicated from wearing tight clothing and shoes.
Do not overcool or overheat.
You should monitor your oral cavity and treat carious teeth in a timely manner.
Thoroughly disinfect wounds and scratches.

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The inflammatory process in the lymph nodes is often purulent in nature and is called lymphadenitis. A common disease among children and adult patients, it is most often detected in the axillary, submandibular, groin area or neck area.

Based on the severity of the course, lymphadenitis is divided into the following subtypes:

with the formation of pus and non-purulent;
acute and chronic type;
single and multiple lesions (according to the number of affected lymph nodes);
specific and nonspecific form.

The nonspecific form of the disease is caused by strepto- and staphylococci, as well as other pyogenic microflora. The clinical picture is aggravated by the release of toxins and breakdown products from the primary lesion. The causative agents can be microorganisms from boils, carbuncles, upper respiratory tract infections (sore throat, pharyngitis, bronchitis, etc.), bacteria from erysipelas or trophic ulcers.

Specific pathology is caused by “disease cat scratch", tuberculosis, syphilis, etc. In this case, the provocateurs of lymphadenitis are specific infectious agents: Candida fungi, Koch's bacillus, actinomycetes, etc.

Lymphadenitis: code according to ICD-10

The International Classification of Diseases, tenth revision, includes class XII - “Infections of the skin and subcutaneous tissue” with a rubricator in which acute lymphadenitis corresponds to the coding L04. If there is a need to indicate the infectious agent, use additional identification with code B95-B97.

In turn, acute lymphadenitis ICD is divided into:

L04.0 – pathological lesions are located in the face, neck, and head;
L04.1 – lymph nodes of the body are inflamed;
L04.2 – disease detected on the upper extremities (shoulders, armpits);
L04.3 – identification of affected nodes (the pathology is acute) on the lower extremities (pelvic area);
L04.8 – localization in other zones;
L04.9 – acute lymphadenitis of unspecified type.

The nonspecific form of lymphadenitis I88 is included in the heading “Diseases of the veins, lymphatic vessels and nodes”, class IX:

I88.0 – mesenteric lymphadenitis of nonspecific type (acute/chronic);
I88.1 – chronic course of the disease, excluding mesenteric;
I88.8 – other nonspecific lymphadenitis;
I88.9 is a nonspecific process of an unspecified nature.

ICD-10 code

I88 Nonspecific lymphadenitis

L04 Acute lymphadenitis

I88.1 Chronic lymphadenitis, other than mesenteric

Causes of lymphadenitis

Lymphadenitis is a consequence of infection of the lymph node by pathogenic microorganisms; as a primary and independent disease, it develops extremely rarely. Bacteria that provoke the pathology are: streptococcus, staphylococcus, Pseudomonas aeruginosa, Escherichia coli, pneumococcus. The lymph node enlarges as a result of the accumulation of cells in the inflammatory zone. Microorganisms can also enter the lymph node through lymphatic flow from the original lesion. For example, as a result of caries, purulent rash on the skin, boil, etc.

Often the causes of lymphadenitis lie in diseases of the internal organs. The presence of inflammatory processes in the intestines, infections in the ovaries, various diseases liver is dangerous due to the hematogenous spread of pathogenic particles (through the bloodstream) settling in the lymph system and causing inflammation lymph node

The contact method of infection is the rarest, when microbes enter the lymph node directly, which is possible when the integrity of the skin is lost (for example, wounded) of the lymph node.

Nonspecific infection is the most common cause of compaction, growth and inflammatory reaction in the lymph nodes. Caused by conditionally pathogenic microorganisms, lymphadenitis is typical for: submandibular, cervical, elbow, inguinal, axillary, femoral, popliteal areas. Favorable conditions for the proliferation of pathogenic microorganisms will be injury, hypothermia, stressful or painful conditions, etc.

Lymph nodes are protective filters that prevent the penetration and reproduction of pathogenic microflora in the human body. When the level of infectious particles (elements of dead cells, microorganisms, tumor components, etc.) is excessively high, the lymphatic system may not be able to cope and an inflammatory process develops. Lymphadenitis indicates a weakened immune system due to various factors– an elderly or, on the contrary, a young, immature body, mental or physical fatigue, previous illnesses, etc.

Enlarged lymph nodes should not be confused with the inflammatory process in their tissues. The growth of the lymph node is due to the production of a larger number of lymphocytes, in which antibodies are produced to combat a potential threat, which in itself indicates the performance of a protective function by the lymphatic system and does not relate to pathology.

How long does lymphadenitis last?

Remembering the types and characteristics of the course of lymphadenitis, we can answer the question: “How long does lymphadenitis last?” An acute process is characterized by a sudden onset with severe symptoms and a duration of up to two weeks. Inflammation of the lymph nodes of the chronic type is a sluggish, latent pathology without obvious manifestations, which develops for more than a month.

It should be noted that non-purulent and purulent lymphadenitis can occur in both acute and chronic forms. Although the formation of suppuration is often caused by sharp deterioration general condition characteristic of the acute course of the disease. The purulent process requires sanitation and cleaning of the affected tissues. When the lymph node melts after opening the abscess, the cavity is drained. The speed of healing of the wound surface also affects the duration of recovery.

As for specific lymphadenitis, the therapeutic effect is achieved in at least eight months. Depending on the severity of the primary inflammatory process, treatment can last up to one and a half years.

Symptoms of lymphadenitis

The symptoms of the disease largely depend on the type of lymphadenitis and help the specialist make the correct diagnosis, as well as choose the right treatment tactics. Common signs are: swelling, local redness of the skin, temperature, limited mobility of the limb, chills, and an increase in the number of leukocytes in the blood.

The following symptoms of lymphadenitis are distinguished:

nonspecific chronic inflammation is a sluggish, hidden process, long time not showing itself at all. It is characterized by slight swelling of the skin adjacent to the affected lymph node and low-grade fever (37 o C);
acute lymphadenitis – has pronounced symptoms, namely: severe pain and enlarged nodes, limiting motor ability. Often the condition is aggravated by aching or dull headache, general weakness, fever;
the state of the purulent process is determined by a twitching, sharp pain syndrome. On palpation the patient feels pain. The skin is red. As the disease progresses, the affected lymph nodes grow together with each other and with adjacent tissues, forming immobile seals;
serous type pathology - dull pain syndrome is localized in the area of regional lymph nodes, which are enlarged and dense. The initial stage is characterized by the absence of signs of inflammation on the skin; only after destructive processes in the lymph node tissue and accumulation of purulent contents do necrotic areas appear;
adenophlegmon is the stage into which purulent inflammation passes without proper therapy. The skin has signs of hyperemia, swelling has blurred boundaries with areas of softening. Among the obvious signs of pathology are high fever, rapid heartbeat, chills, severe weakness, headache.

It must be remembered that lymphadenitis is a secondary disease that can mask serious problems(plague, tumors, tuberculosis, etc.). Only a competent specialist can differentiate the pathological condition, so it is important to seek advice in a timely manner.

Cervical lymphadenitis

Enlargement of the cervical lymph nodes occurs as a result of infectious and inflammatory processes of the upper respiratory tract (sore throat, pharyngitis, purulent otitis media, etc.). Cervical lymphadenitis occurs mainly in children, as a consequence of influenza, acute respiratory viral infections, and pneumonia. In adulthood, it may indicate serious diseases such as tuberculosis or syphilis.

Submandibular lymphadenitis

In clinical practice, the most common cases of inflammation of the submandibular lymph nodes. This pathology develops due to chronic tonsillitis, inflammation of the gums or advanced caries. Submandibular lymphadenitis is characterized by a gradual increase in symptoms. If at the first signs of pathology it is possible to determine the source of infection, then recovery occurs quickly.

Inguinal lymphadenitis

Acute lymphadenitis

The presence of an infection in the body, such as a boil, purulent wound or scratch, allows bacteria to enter the lymphatic channel. Lymph brings pathogenic flora to the lymph nodes, which become inflamed. This is how acute lymphadenitis occurs, manifesting itself as sharp, increasing pain, increased temperature and deterioration of the general condition.

Subacute lymphadenitis

A very rare disease, subacute lymphadenitis, in clinical manifestations, is in many ways reminiscent of an acute inflammatory process in the lymph nodes. This pathology is differentiated by the primary immune reaction. The subacute variety is characterized by a more intense red coloration of the skin in the area of the infected lymph node, which has a dense consistency than in acute lymphadenitis. To confirm the diagnosis, a visual examination is not enough, so cytological and histological examination is used.

Cytology detects macrophages with a large number of cellular particles and leukocytes, as well as follicular hyperplasia at the cellular level. The analysis reveals single mastocytes, basophilic cells and a huge number of lymphoblasts. The histological method makes it possible to determine the sharp outline of lymphatic follicles and an increase in blood vessels filled with blood.

In the subacute form, a significant increase in body temperature is possible if pus forms. In other cases, the temperature is close to low-grade fever.

Chronic lymphadenitis

The chronic course of lymphadenitis is a consequence of an acute process or occurs as an independent disease, bypassing acute stage. This difference is associated with the microorganisms that cause the disease.

Generalized lymphadenitis

Simultaneous inflammation of several lymph nodes or their sequential damage is generalized lymphadenitis. Enough rare disease is a consequence of a primary infectious process, for example, generalized tuberculosis. Often the disease manifests itself and proceeds vividly with severe intoxication, and also progresses quickly. In this case, all groups of lymph nodes are significantly enlarged, inflammation rapidly covers nearby tissues, spreading to internal organs. The generalized form can become chronic, gradually depleting the body's defenses.

Inflammation of the lymph nodes of a generalized type is possible with the following diseases:

bacterial infections - tuberculosis, syphilis, sepsis, etc.;
malignant/benign tumors – leukemia, lung cancer, sarcoidosis, etc.;
autoimmune problems - dermatomyositis, rheumatoid arthritis, lupus, etc.;
storage diseases – Niemann-Pick and Gaucher diseases;
reactions to medications and chemical compounds – hay fever, allergic reactions to medications.

Hemorrhagic lymphadenitis

Hemorrhagic lymphadenitis is a special form of inflammation of the lymph nodes, in which dysfunction of capillary permeability leads to saturation of the lymph node with blood. A similar thing is observed with anthrax or plague.

Anthrax inflammation is characterized by lymphangitis and regional lymphadenitis, but enlargement of the lymph nodes occurs painlessly. The inflammatory process has a long course. Initially, nodes located in close proximity to the carbuncle are affected, and then distant ones. However, suppuration of the lymph nodes is extremely rare.

Granulomatous lymphadenitis

Granulomatous lymphadenitis is characterized by the presence of granulomas or the formation of groups of histiocytes. Along the course, the disease is divided into granulomas with epithelioid histiocytes and a purulent process.

The diagnosis is confirmed by bacteriological, immunohistochemical or serological methods, as well as specific skin tests and molecular testing (PCR).

The lesion most often covers regional lymph nodes, into which pathogenic flora collects from the entrance gates of infection, but disseminated infection can develop. The degree of enlargement of the node and the intensity of pain depend on the course of the inflammatory disease, its characteristics and the clinic of the primary focus.

Specific lymphadenitis

Serious diseases such as tuberculosis, syphilis, HIV, plague and others cause infection of the lymphatic system, which is manifested by enlarged lymph nodes. Moreover, the underlying disease may still be in its infancy, and the lymph nodes promptly “signal” about a hidden problem.

Specific lymphadenitis is classified into:

viral;
tuberculosis;
actinomycotic;
fungal;
syphilitic;
vaccine, etc.

The specific form of inflammation of the lymph nodes is characterized by a wide range of clinical manifestations. Damage to the cervical nodes often indicates tuberculous lymphadenitis; enlarged nodes in the groin area indicate specific peritonitis. The supraclavicular nodes respond if the primary infection is localized at the pulmonary apex. Pathology of regional lymph nodes is observed after vaccinations. The tumor is detected on one or both sides. “Infantile prurigo” or scrofulosis also causes generalized growth of nodes.

Specific lymphadenitis most often has a chronic form with characteristic periods of exacerbation. Symptoms of the disease vary depending on the type of infection. The pathogen is identified based on a blood test.

Tuberculous lymphadenitis

Penetration of the tuberculosis bacillus into the lymphatic system causes an increase in the nodes in the neck and submandibular zone. Over time, the lymph nodes soften, the pathological process covers nearby cells, and when the lymph node capsule is opened, gray purulent mass of crumbly consistency. Often, tuberculous lymphadenitis, developing against the background of primary or secondary tuberculosis, is the cause of symmetrical inflammation of the lymph nodes. The tuberculous form of inflammation rarely spreads to the inguinal lymph nodes.

When differentiating the disease, it is necessary to exclude fistulas in the neck, nonspecific type lymphadenitis, metastasis of malignant tumors, and lymphosarcoma. Install accurate diagnosis Microscopic analysis of intracapsular pus helps.

Symptoms of inflammation of the lymph nodes largely depend on the progression of tuberculosis and the degree of tissue damage to the node. Palpation in the initial phase of the lesion does not reveal pain, which is characteristic of the caseous period of decomposition and fistula formation.

Caseous lymphadenitis

Caseous lymphadenitis is a form of tuberculous lymphadenitis, characterized by caseous decay of lymph node tissue. In order to understand the aspects of the formation of this process, one should turn to the concept of primary tuberculosis, which develops when microbacteria enter the lungs. Infection is possible both by aerogenic and nutritional methods. Primary tuberculosis is detected more often in childhood and is divided into stages:

the appearance of a primary lesion in the lung;
lymphangitis – spread of infection to the draining lymph vessels;
lymphadenitis – damage to regional nodes.

In the area of inflammation, tissue necrosis is observed, and serous edema gradually develops, leading to caseous-type pneumonia. The size of the primary tuberculous area depends on the affected area (alveolitis, lobe, acinus or segment). Specific inflammation quite quickly covers the lymphatic vessels adjacent to the primary lesion. Formed to root of the lung, lymphostasis and characteristic swelling with tubercles in the peribronchial and perivascular tissue make the hilar nodes accessible to infection. This is how the second stage begins - lymphangitis, which spreads to the regional lymph nodes, where caseous necrosis soon appears. The growth of lymph nodes in size determines the total defeat and the onset of caseous lymphadenitis.

Nonspecific lymphadenitis

Staphylococcal and streptococcal infections are the cause of nonspecific lymphadenitis. The primary source of inflammation is a festering scratch or wound, erysipelas, boils, skin ulcers, etc. Pathogenic microorganisms infect lymph nodes, spreading through the flow of lymph, blood, or directly when a node is injured.

Nonspecific lymphadenitis is classified according to the type of course into:

acute - more often as a serous form. There may be an enlargement of one or a group of lymph nodes that are painful and elastic in consistency;
chronic – acts as a primary disease (the result of chronic inflammatory processes: tonsillitis, dental problems, etc.) or is a consequence of acute inflammation of the lymph nodes.

The acute course is characterized by the absence of symptoms or a slight change in the general condition of the patient. The severity of inflammatory signs of lymph nodes largely depends on the primary focus. Development of the disease from the serous form to purulent stage causes an increase in temperature, weakness, and malaise. The next signs of progression of inflammation will be pain and immobility of the lymph node.

The chronic type of nonspecific process is not characterized by the formation of pus. The lymph nodes remain enlarged for a long time, practically painless and not fused with the surrounding tissues. Sometimes the spread of connective tissue in the lymph node is fraught with problems with lymph circulation, swelling, lymphostasis, and elephantiasis.

Reactive lymphadenitis

Reactive lymphadenitis is a stage of inflammation of the lymph nodes, caused by local disorders in the body. The reactive form is characterized by the development of a pathological focus in the absence of predisposing factors. For example, with tuberculous lymphadenitis, the pathogenic bacillus did not give any symptoms (hidden process), only the diagnosis of enlarged lymph nodes revealed the pathogen.

We can say that the reactive phase often accompanies the acute course of inflammation. However, it also occurs during a chronic disease during an exacerbation period, characterized by an active reaction on the part of the body.

Reactive lymphadenitis manifests itself as a result of the failure of the immune forces of children or due to a prepared organism that already knows the microorganism and has antibodies to suppress it. Let's remember the mantu test, which shows the body's response to the tuberculosis bacillus. The presence of a skin pellet indicates recognition of an infection. A similar immune response mechanism is displayed by the lymph nodes.

The reactive course of inflammation is always a rapid process, meaning a fight against the source of infection, when the remaining parts of the body’s defense system have not yet had time to “engage in confrontation.” The reactive phase changes quite quickly. This is how recovery can occur if the infectious agent was suppressed in time by the body’s immune forces.

Lymphadenitis behind the ear

Quite often, inflammation of the lymph nodes behind the ears is observed. The reason for the increase in size of the node is the complication of purulent and inflammatory processes in the body due to the proliferation of pyogenic agents. Predisposing factors are colds (sore throat, pharyngitis, runny nose, etc.), pathologies of the eyes, ears (fungal infections, herpes, etc.) or allergic reactions.

Lymphadenitis behind the ear can be purulent/non-purulent, occur in acute/chronic form, and involve one or a group of nodes. The clinical picture of the disease manifests itself with the formation of a behind-the-ear lump, which is painful and the pain spreads into the ear, which often confuses the patient. The general condition worsens: a headache appears, a temperature is observed during the purulent course of the disease, the pain syndrome acquires a “shooting” character, and in some cases, redness of the skin of the area of the inflamed lymph node is possible.

The growth of the behind-the-ear nodes in size is sometimes caused by lymphoma and various cancers of the lymph nodes. Active hair loss on the head, annoying itching and peeling of the skin often indicate a fungal infection. In any case, you should not independently diagnose or prescribe treatment. Timely contact with a specialist will save you from mistakes that provoke irreparable complications.

Postauricular lymphadenitis

The growth of lymph nodes behind the ears signals the need to undergo examination. Inflammation of the nodes can indicate both the reaction of the body's defenses and the presence of an infectious agent. Diseases of the throat, ears, eyes, and some allergic manifestations cause the spread of pathogenic flora with the lymph flow. A large volume of pathogenic microorganisms settling in the lymph nodes often provoke postauricular lymphadenitis. The inflammatory process can be a harbinger of serious diseases such as cancer.

Lymphadenitis has a direct connection with the primary lesion of a viral, fungal or viral nature. Thus, peeling of the scalp, severe hair loss and incessant itching are symptoms of a fungal disease. Frequent colds, various diseases of the upper respiratory tract make it possible for microorganisms to enter the lymphatic system. Problems with the oral cavity, untreated or neglected caries, diseases of the organs of vision are also the cause of inflammatory enlargement of the lymph nodes.

The location of the primary and secondary lesions in close proximity to the brain poses a danger to the patient in the form of complications, severe course of the disease and long recovery. Only timely application for medical care will allow you to avoid all negative consequences and restore health in a short time.

Lymphadenitis of the face and neck

The face is the location of the cheek, mandibular, chin, parotid, as well as the smallest lymph nodes located near the nasolabial fold and in the inner corners of the eyes. On the neck there are chains of superficial and deep (retropharyngeal) lymph nodes. The retropharyngeal nodes receive lymph from the posterior parts of the nasal cavity, partly from the palate. Lymph from the oral cavity, paranasal sinuses, teeth, mucous membrane, jaws, salivary glands flows into the lymph nodes of the cheeks, mandibular and submandibular, and chin. Diseases of these organs contribute to the spread of infection through the lymphatic system and cause lymphadenitis of the face and neck.

Inflammation of the nodes of the submandibular, mental and cervical zones can be odontogenic or non-odontogenic. Odontogenic processes are characterized by a pathological relationship with the dental system and often develop against the background of periostitis during the exacerbation period, chronic periodontitis, acute pericoronitis. Inflammations of the lymph nodes of the non-odontogenic type include otogenic, rhinogenic and stomatogenic (formed as a result of stomatitis, otitis, glossitis, gingivitis, etc.).

Lymphadenitis of the throat

Viruses that provoke various diseases of the upper respiratory tract (sore throat, pharyngitis, laryngitis, etc.) or the oral cavity (stomatitis, diphtheria, etc.) can cause inflammation of the lymph nodes in the neck, as well as in the submandibular area. Being a secondary pathological process, lymphadenitis of the throat often disappears when the underlying cause is treated. For example, the cervical lymph nodes return to normal with appropriate treatment for angina.

Symptoms of inflammation of the lymph nodes in the throat area:

node growth in size - the size varies from a small pea to chicken egg;
the presence of pain – discomfort is felt during swallowing or during palpation;
general malaise– weakness, fever, headache, etc.

Damage to the lymph nodes of the throat area is possible without concomitant disease, against the background of a significant weakening of the body’s immune forces. In this case, the clinical picture is mild: there is a slight enlargement of the lymph nodes, and slight pain may be present during examination and when swallowing. The patient's body is usually weakened by frequent colds.

Occipital lymphadenitis

Identifying the reasons why occipital lymphadenitis develops helps to quickly eliminate the primary disease and cope with inflammation of the lymph nodes. For example, infections of the scalp, occurring against the background of dermatophytosis or pediculosis, create conditions for damage to the occipital lymph nodes.

Generalized viruses serve as an important diagnostic factor for occipital lymphadenitis that accompanies rubella measles. With this pathology, inflammation of the posterior cervical nodes is also possible, and sometimes a generalized type of lymphadenopathy is formed. Symptoms of a secondary pathological process appear before skin rashes differentiate. In the case of occipital lymphadenitis, the nodes are slightly enlarged, have a soft-elastic consistency, easily move when palpated, without pain.

Diseases that cause the growth of occipital lymph nodes include chicken pox. Characteristic manifestations of the disease will be fever, skin rash, and upper respiratory tract disorders. Specific infections of syphilis and tuberculosis extremely rarely affect the cervical and occipital lymph nodes.

Posterior cervical lymphadenitis

Lymphadenitis of the neck area is dangerous due to its close proximity to the brain, so it is important to diagnose the disease at an early stage and undergo appropriate treatment.

Posterior cervical lymphadenitis is a common finding in rubella. In addition to enlarged lymph nodes, patients complain of limited neck movement due to severe pain. In parallel, inflammation of the nodes near the ears, as well as the occipital region, is observed. An interesting fact is that the pathological growth of lymph nodes occurs before the appearance of the characteristic red rash.

Identifying the causes of the inflammatory process and the increase in the volume of lymph nodes located on the back of the neck is difficult in most cases. This is due to the fact that inflammation can be provoked not only by an infectious disease, but also by more severe illnesses, such as tuberculosis. In the process of differential diagnosis, it is necessary to provide for the possibility of the formation of lymphoma, the development of lymph node metastases due to malignant neoplasms of the neck and head.

Mesenteric lymphadenitis

Disease of the lymph nodes of the intestinal mesentery develops more often in children and occurs with signs of intoxication and characteristic pain in the abdominal area. There can be many reasons for the occurrence of pathology:

viruses of acute respiratory processes (adeno-/enteroviruses);
cytomegalovirus;
causative agent of tuberculosis;
intestinal infections (campylobacter, salmonella, etc.);
staphylo- and streptococci;
Epstein-Barr virus.

It should be noted that there are a large number of lymph nodes in the abdominal cavity, so mesenteric lymphadenitis can occur when any pathogenic microorganisms of a viral or bacterial nature enter them from the primary focus of inflammation.

The disease begins with acute pain to the right of the navel, but the patient's general condition remains stable. As the inflammation progresses, nausea and vomiting are observed, which do not bring relief, and the patient develops a fever. The clinical picture is complemented by stool disturbances. Such symptoms last for several days and require immediate consultation with a specialist, since the lack of proper treatment can lead to serious complications.

Intestinal lymphadenitis

Mesadenitis is called intestinal lymphadenitis, which is classified into the following forms:

nonspecific inflammation:

simple/purulent;
pseudotuberculosis/tuberculosis.

by flow type:

chronic/acute.

Inflammation of the lymph nodes of the peritoneal zone occurs hematogenously (through the bloodstream), directly through the intestines (saliva, sputum). The causative agents of the pathology are infections of the upper respiratory tract, inflammatory processes of the appendix and other parts digestive tract. When making a diagnosis using differential diagnostics, the following should be excluded:

attack acute appendicitis;
helminth infection;
abdominal vasculitis of hemorrhagic type;
lymphogranulomatosis.

Intestinal lymphadenitis is manifested by pain in the lower abdomen near the navel. The disease is accompanied by fever, nausea, slight increase in temperature, disturbance excretory function(constipation or diarrhea). If the main focus is in the upper respiratory tract, then the pathological condition is aggravated by the signs of a cold (runny nose, cough, etc.).

Among the complications of the disease are suppuration of the mesenteric nodes, leading to an abscess, sepsis, intestinal obstruction due to adhesions.

Lymphangitis and lymphadenitis

The secondary inflammatory process in the capillaries and trunks of the lymphatic bed is called lymphangitis. Pathology is observed in purulent-inflammatory diseases as a result of superficial (scratch, wound) or deep damage (carbuncle, boil). Infectious agents in most cases are strepto- and staphylococci, but in clinical practice there are such pathogens as: Proteus, Escherichia coli and tuberculosis coli and other microorganisms.

Quite often, lymphangitis and regional lymphadenitis are detected simultaneously, accompanied by swelling, hyperemia along the lymph vessels, pain syndrome, fever, chills and general weakness. Manifestations of superficial lymphangitis outwardly resemble erysipelas; seals in the form of a cord or rosary are felt along the vascular bed. Damage to the deep vessels of the lymphatic system is not accompanied by severe hyperemia, but swelling is clearly visible and pain persists.

For diagnostic purposes, computer thermal scanning, ultrasound angioscanning, determination of the source of infection and isolation of the pathogen are used. In the treatment of lymphangitis, an important place is occupied by the elimination of the primary focus of suppuration and the use of antibiotics. Compresses and ointment dressings are applied locally, mud therapy and X-ray treatment are used.

Odontogenic lymphadenitis

An acute serous inflammatory process in the submandibular lymph nodes without the necessary treatment transforms into a new stage called odontogenic lymphadenitis. The lymph node is enlarged, the pain syndrome is of a shooting nature. Body temperature often rises, appetite and the general condition of the patient worsen. In the case of pus formation, the face can become asymmetrical due to the accumulated infiltrate. The skin becomes swollen with a red tint. Palpation causes discomfort. An acute purulent process covers nearby tissues, and symptoms of intoxication appear.

The cause of the pathology is dental disease. Infection of the oral cavity penetrates not only into the perimaxillary nodes, but also into the parotid, buccal, mental, superficial and deep cervical lymph nodes. The pain in the area of the affected nodes intensifies when moving the head. Difficulty opening the mouth is observed only if the purulent process spreads to the masticatory muscles.

Complications of odontogenic lymphadenitis are an abscess or adenophlegmon.

Lymphadenitis of the cervical lymph nodes

The specific nature of cervical lymphadenitis of a tuberculous nature has a number of distinctive features:

the affected lymph nodes are fused to each other, but do not involve nearby tissues in the pathological process;
most often occurs without pain, as confirmed by palpation;
inflammation in most cases is asymmetrical.

Tuberculous lymphadenitis of the cervical lymph nodes most often becomes chronic. Moreover, only in half of the cases the primary focus is found in the lungs. In clinical practice, there are atypical forms of mycobacteria that are difficult to treat traditional therapy, so lymph nodes often have to be excised.

The presence of primary syphiloma on the head (as a rule, this is the area of the tongue/lips) causes the appearance of cervical lymphadenitis, in which the nodes are densely elastic, not fused with each other and the surrounding tissue, and are mobile. During examination of patients, the latter note the absence of pain, and the size of the inflamed lymph nodes varies in each case.

The cervical nodes of children under 5 years of age become inflamed with Kawasaki disease, accompanied by fever, skin rash, erythema on the soles and palms. The peculiarity of the disease is that it cannot be treated with antibiotics.

Lymphadenitis of the lower extremities

The lower extremities contain two groups of large nodes: popliteal and inguinal, which in turn are divided into superficial and deep. Lymph from the abdominal region, genital area and gluteal area enters the inguinal nodes, so the presence of infection in these organs provokes their inflammation. Viruses and bacteria that cause a pathological lesion in the legs (for example, a purulent wound) can also spread to the popliteal and inguinal nodes. Malignant tumors can metastasize to the nodes of the groin area, thereby causing their growth.

The onset of the disease is determined by enlarged lymph nodes and pain when pressed. Purulent lymphadenitis of the lower extremities causes an increase in temperature and swelling of the affected area. The spread of pus onto nearby tissues is dangerous due to the formation of phlegmon.

Therapy includes the use of antibacterial complexes under the supervision of a specialist. Lack of treatment threatens to spread the infection to neighboring lymph nodes, as well as throughout the body.

Femoral lymphadenitis

The growth of femoral and inguinal lymph nodes is observed in the bubonic form of plague. The disease is accompanied by severe fever, as well as signs of intoxication. A week later, suppuration of the node develops and a lymphatic fistula is formed.

Femoral lymphadenitis is sometimes diagnosed with cat scratch disease, although the axillary and ulnar lymph nodes are more often inflamed. If the pathological process is started, then a fluctuation with purulent softening of the nodes is detected.

The popliteal lymph nodes receive lymph from the area of the feet, so wounds, abrasions on them should be promptly treated, abscesses and other purulent formations should be opened.

The inguinal lymph nodes become inflamed due to chlamydia, the pathology is caused by genital infections ( venereal disease, syphilis, AIDS, Nicolas-Favre disease). Moreover, the lesion often involves a group of nodes, welded together and with surrounding tissues.

The causes of femoral lymphadenitis are carbuncles, boils, and thrombophlebitis of the lower extremities. Infections are not only bacterial in nature, but are caused by viruses and protozoa. If it is impossible to determine the root cause of inflammation, then inflammation continues in the lymph node, which can lead to suppuration and melting of the node.

Lymphadenitis of the abdominal cavity

Infectious practice indicates the widespread occurrence of nonspecific mesenteric lymphadenitis, which is most common in childhood, but is also detected in adult patients.

Mesadenitis or lymphadenitis of the abdominal cavity is formed during acute respiratory processes, under the influence of pathogens of intestinal diseases, as well as as a result of the presence of bacteria that provoke mononucleosis and tuberculosis. The peritoneal area is a favorite breeding ground for pathogens. If the immune system cannot cope with the number of viruses, then the main blow falls on the mesenteric lymph nodes.

The first signs of pathology can easily be confused with ordinary indigestion or symptoms of intoxication. The pain is localized near the navel on the right, more towards the lower abdomen. The pain syndrome intensifies as inflammation develops, acquiring an aching, cramping character of varying intensity. The condition is complemented by fever, nausea, vomiting, and impaired excretory function. The formation of pus in the capsule of the affected lymph node is expressed by chills, fever, tachycardia and a sharp deterioration in health.

Lymphadenitis of the abdominal cavity requires qualified treatment, otherwise complications are possible - peritonitis, adhesions of the peritoneal organs, abscess and sepsis.

Lymphadenitis of the lungs

Inflammation of the intrathoracic lymph nodes is a form of primary tuberculosis that develops immediately after infection. This disease has become widespread, especially among children, in adolescence, which is associated with vaccination and insufficiently strengthened immunity of patients in this age group.

Pulmonary lymphadenitis manifests itself in different ways, depending on the location of the inflammation, the degree of spread of the pathological focus and the enlargement of the lymph nodes. Symptoms of the disease:

cough, as with whooping cough, especially tormenting the patient at night;
development of a dry, non-productive cough into a wet cough with sputum production;
noisy breathing;
irritability;
night chills;
feverish condition;
chest pain;
signs of intoxication;
weakness.

Clinical practice knows cases of asymptomatic disease, when pulmonary lymphadenitis is diagnosed only during a routine examination. An increase in superficial nodes helps in differentiating pathology.

Inflammation lung tissue often combined with lymphadenitis and lymphangitis. Damage to the lymph nodes is detected by x-ray methods.

Lymphadenitis of the mammary gland

The mammary gland is conventionally divided into four parts:

two quadrants outside;
two quadrants inside.

Lymphatic drainage from the outer quadrants enters the axillary lymph nodes. The inner quadrants of the chest communicate with the parasternal lymph nodes. It should be noted that the mammary gland undergoes changes at various stages of the menstrual cycle, during pregnancy and breastfeeding.

Regional inflammation refers to local damage to the lymph nodes. Symptoms of the disease begin with a pathological process in the nodes of the axilla, mammary glands, sub- and supraclavicular lymph nodes. Lymphadenitis of the mammary gland is most often provoked by streptococci and staphylococci, less often by gono- and pneumococci. The infection comes from primary foci of inflammation located directly on the chest (purulent wounds, skin diseases), or through the lymphogenous/hematogenous route from other affected organs and systems.

The clinical picture includes: enlarged and painful lymph nodes, the skin over the affected node is hyperemic and tense. The patient's condition worsens when purulent discharge forms at the site of inflammation.

Left-sided lymphadenitis

Lymphadenitis is a disease that causes a single inflammation of a lymph node (local lesion) or a group of nodes (regional lesion). Pathology can be detected on one or both sides simultaneously, most often in the armpits and groin. Active growth of lymph nodes in size and severe pain indicate the development of a pathological focus.

A complication after BCG vaccination is considered to be tuberculous inflammation of the lymphatic system, which affects children. The causes of the disease are:

decreased resistance of the body as a result of frequent colds, severe diathesis, rickets, etc.;
vaccination of premature babies;
administering too much vaccine.

The consequence of vaccination will be axillary left-sided lymphadenitis with a characteristic pain syndrome, often accompanied by lymphangitis.

Atypical mycobacteria of the face and oral cavity provoke unilateral inflammation lymph nodes of the lower jaw. Damage to the cervical nodes on the left or right is observed due to an infectious and inflammatory process in the body (sore throat, flu, tonsillitis, pneumonia, etc.).

Right-sided lymphadenitis

Right-sided lymphadenitis occurs in various pathologies. For example, the culprits of inflammation of the lymph nodes to the right below the navel are infections of viral etiology such as gastroenteritis, ENT diseases. The attacks occur in an acute form, resembling inflammation of the appendix with severe symptoms of intoxication.

Enlargement of the submandibular lymph nodes on the right side is caused by pathologies of the oral cavity of the same part of the face (untreated caries, gum disease, various chronic diseases).

The only sign of infectious mononucleosis is inflammation of the cervical lymph nodes on one side or symmetrically. With odontogenic lymphadenitis, the patient's face becomes skewed towards the side where the pathological process of the lymph node has formed. If there is an infected tooth on the right side of the jaw, then right-sided lymphadenitis develops. Inflammation begins from nearby nodes (the area of the main collector); later, signs of the disease are detected along the flow of lymph or spread through the bloodstream.

Bilateral lymphadenitis

Severe bilateral lymphadenitis is formed as a result of:

infectious mononucleosis;
secondary type syphilis;
infiltrative lesion;
detection of toxoplasma;
phenytoin therapy and other diseases.

When infected primary syphilis A symmetrical inflammatory process of the inguinal and submandibular nodes up to the size of a large bean or nut is common. In parallel, pathology is detected in the lymphatic vessel leading to the affected lymph node.

A disease such as rubella provokes an increase in the behind-the-ear, posterior-cervical and occipital nodes, often on both sides. The growth of lymph nodes is observed in the absence of a characteristic red rash. Patients' complaints boil down to pain when turning the neck.

Odontogenic source of infection in acute or chronic leukemia, as a rule, is localized in the lymph nodes of the neck, submandibular zone and on the face. In this case, inflammation is often unilateral, but bilateral damage also occurs due to a decrease in the body's defenses.

Supraclavicular lymphadenitis

When the supraclavicular lymph nodes become inflamed, lymphoma, infectious and tumor processes of the breast organs, infections and tumor neoplasms of the peritoneal organs should be excluded. Tumors of the gastrointestinal tract often cause enlargement of the lymph nodes above the collarbone, predominantly on the left. Neoplasms of the genital area, mammary glands, and lungs can also metastasize to the area of the supraclavicular lymph nodes.

An important differential feature is supraclavicular lymphadenitis. For example, the growth of a node in the right supraclavicular fossa is detected with a malignant lower lobe lesion of the lung.

Inspection and diagnosis of inflammation of the supraclavicular nodes is carried out as follows:

the patient is in a sitting position with his arms down, his gaze directed forward;
the doctor stands behind the patient;
the chance of detecting enlarged nodes in the supraclavicular fossa increases in the supine position;
a Valsalva maneuver is performed to help move the angle closer to the surface of the skin (sometimes even a slight cough helps).

Lymphadenitis in adults

The adult body is able to resist various viruses and bacteria. This becomes possible thanks to the lymphatic system, which provides protective and drainage functions. Enlarged lymph nodes indicate the presence of infection in the body and that the immune system has responded by producing antibodies to pathogens.

Lymphadenitis in adults often occurs asymptomatically or with a slight deterioration in health. First of all, the cervical, submandibular, axillary and inguinal nodes become inflamed. The cause of the pathology is purulent processes various organs(furuncle, erysipelas, etc.), serious illnesses(tuberculosis, plague, etc.). Factors that provoke lymphadenitis in adult patients are: stress, hypothermia, decreased defenses. As a primary disease, inflammation of the lymph nodes is extremely rare with direct infection of the node due to damage (trauma).

The lymph nodes of the groin area become inflamed more often in adulthood and indicate problems with the genital organs and may portend the presence of a sexually transmitted disease. Lymphadenitis of the cervical nodes is considered a rather serious pathology in adults and requires immediate consultation with a dentist or otolaryngologist.

Lymphadenitis in children

Inflammation of the lymph nodes in childhood manifests itself much more clearly and proceeds more intensely than in adult patients. Lymphadenitis in children is provoked various infections, most often the upper respiratory tract. Diseases such as: sore throat, ARVI, tonsillitis, caries, etc. contribute to the enlargement of the submandibular lymph nodes. In clinical practice, cases of damage to the cervical, popliteal, and axillary nodes are much less common. Inguinal lymphadenitis in children is an even more rare phenomenon, differentiated as a result of strangulation of the inguinal hernia.

Lymphadenitis in pregnant women

Inflammation of the lymph nodes during pregnancy occurs due to infectious and inflammatory processes and decreased immunity. Lymphadenitis in pregnant women mainly occurs in catarrhal and purulent forms.

Purulent inflammation is dangerous due to its consequences:

lymphangitis – the disease spreads to the walls of the lymphatic vessels;
thrombophlebitis - damage to the circulatory system;
disruption in the functioning of organs or body systems of the expectant mother.

Chronic processes often manifest themselves during pregnancy; for this reason, women are recommended to be examined before conception. A visit to the dentist and otolaryngologist is considered mandatory.

Detection of lymphadenitis after pregnancy requires immediate contact with a specialist. Therapy is carried out with antibiotics, often cephalosporins or macrolides. Purulent formations in the lymph nodes are subject to surgical treatment.

The lack of proper and timely treatment threatens with irreparable consequences for the fetus (developmental delay, infection, etc.). The presence of chronic inflammation can affect subsequent pregnancies.

Why is lymphadenitis dangerous?

The progression of the inflammatory focus in the lymph nodes often entails hemorrhagic, fibrinous, serous purulent changes. Advanced stage lymphadenitis without proper treatment provokes irreversible processes: tissue necrosis, abscess formation, ichorous destruction of lymph nodes, sepsis (blood poisoning).

Simple inflammation does not spread beyond the lymphatic capsule. Pathology with destructive manifestations covers nearby tissues, greatly enlarging the affected area. The nonspecific form of the disease tends to develop into thrombophlebitis with the formation of metastatic foci of infection (septicopyemia, lymphatic fistula).

The chronic inflammatory process is dangerous because in most cases it occurs latently, without pronounced symptoms, indicating a decrease in the body’s defenses and threatening degeneration of the lymph nodes. The characteristic complications of chronic lymphadenitis are not specific type are: swelling, elephantiasis (overgrowth of connective tissue), lymphostasis, dysfunction of lymph circulation.

Consequences of lymphadenitis

Lymphadenitis is dangerous due to the possibility of infection and cancer cells spreading throughout the body through the bloodstream or lymphatic system. The lack of an effective and correct treatment regimen can lead to death.

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Initial diagnosis of lymphadenitis includes palpation inflamed nodes, after which instrumental and laboratory techniques are prescribed:

study of blood composition;
histological analysis (taking a tissue sample from the affected node);
in case of lymphadenitis of a specific type, attention is paid to the possibility of contact with a carrier of tuberculosis and skin tests are done with laboratory testing (blood, sputum), as well as x-rays;
purulent inflammation requires surgical opening of the lymph node capsule and, if necessary, drainage of the wound;
an increase in inguinal nodes is a signal to exclude a hernia in the groin;
examination of children begins with suspicion of Quincke's edema, tumor formations cervical area and exclusion of congenital cysts;
often used - ultrasound, consultation with an ENT doctor, CT scan, HIV test.

Blood test for lymphadenitis

Quantitative and qualitative characteristics of the composition make it possible to identify a blood test for lymphadenitis. In addition to the general analysis, they calculate the leukemia formula and the level of LDH (lactate dehydrogenase), characteristic of leukemia and lymphoma. An excess of ESR indicates inflammatory and tumor processes. Mandatory smear test required peripheral blood for the purpose of determining infectious mononucleosis.

Uric acid and transaminases (indicative of hepatitis) in a blood biochemistry test are the basic criteria for systemic pathologies (autoimmune diseases, malignant neoplasms).],

Lymphadenitis on ultrasound

Ultrasound examination helps to monitor the effectiveness of antibacterial therapy. For this purpose, the size of the affected node is recorded before and at the end of treatment.

Lymph nodes normally have an oval or bean-shaped shape and are located in groups. The characteristics of the nodes (shape, size, structure, number, location) vary depending on the age and individual characteristics of the patient’s body.

Lymphadenitis on ultrasound is noted by a number of features:

nodes are increased in size;
the lymph node capsule is tense;
the vascular pattern is enhanced;
the cortical and pericortical zones are significantly expanded;
swelling is determined;
anechoic areas may be present;
hyperplastic and fused nodes are observed;
sometimes metastatic changes are detected.

Which doctor treats lymphadenitis?

Inflammation of the lymph nodes is a reason to contact a therapist, who will refer you for a consultation with an endocrinologist, surgeon or oncologist. The choice of specialist largely depends on the nature of the course of lymphadenitis and the severity of the initial lesion. An examination by an infectious disease specialist, hematologist or rheumatologist is often required.

The duration of treatment for a specific type of lymphadenitis depends on the severity of the underlying disease and the correctness of the therapeutic regimen.

Prevention of lymphadenitis

Prevention of acute and chronic inflammation of the lymph nodes consists in timely treatment of primary diseases: tonsillitis, tonsillitis, purulent skin lesions, osteomyelitis, rhinitis, gingivitis, boils, carbuncles and various infectious diseases (influenza, ARVI, etc.). Prevention of lymphadenitis also includes anti-caries measures: systematic visits to the dentist for the treatment of caries, stomatitis and other pathological lesions of the oral cavity.

Nursing mothers are advised to carefully monitor the hygiene of the mammary glands and prevent the development of lactostasis. In cases of infectious diseases, it is important to follow all the instructions of the attending physician regarding antibacterial therapy. You should not independently reduce the period of taking antibiotics or replace the prescribed drug with another drug.

Preventive measures to prevent inflammation of the lymph nodes include timely removal of splinters, treatment of abrasions, microcracks and cuts with the application of antiseptic dressings.

Immunocorrective programs help increase the body's defenses and more effectively fight pathogenic microflora.

Prognosis of lymphadenitis

Nonspecific acute lymphadenitis at the beginning of its development, when provided with quality treatment, most often has a favorable prognosis. The destructive course of the inflammatory process ends in the destruction of the lymph node with subsequent scarring. The progression of acute forms of lymphadenitis of the extremities provokes a violation of lymphatic drainage, the formation of lymphostasis, and subsequently – elephantiasis.

The purulent type of inflammation threatens with periadenitis (the pathology spreads to the surrounding tissues); an abscess or phlegmon/adenophlegmon is formed around the melted node, requiring long-term treatment. The outcome of the disease is often thrombophlebitis and lymphatic fistulas.

The prognosis of chronic lymphadenitis is favorable when the root cause of inflammation is established and timely treatment is performed. Negative consequences Scarring and swelling of the tissue over the affected node may occur. As a result of wrinkling and hardening of the lymph node, a proliferation of connective cells and impaired lymph circulation are observed.

Lymphadenitis can resolve on its own if the underlying purulent-inflammatory disease is treated promptly and effectively. Therefore, at the first symptoms of inflammation of the lymph nodes, you must visit a doctor and strictly follow his instructions.

Lymphadenitis is an inflammation of the lymph nodes that occurs as a result of the ingress of various microorganisms and their toxins into them. It is characterized by an increase in the size of the lymph nodes and severe pain in the affected area. Only in rare cases does lymphadenitis represent an independent disease. Most often, this is nothing more than a symptom signaling some kind of problem in the body.

What kind of disease is this, what are its first signs, causes, why lymphadenitis is dangerous for humans if left untreated - we will consider further.

Lymphadenitis is inflammatory disease lymph nodes, often purulent. Occurs when staphylo- and streptococci enter the body.

The disease occurs after microorganisms, toxins, and tissue breakdown products enter the lymph nodes with lymph. Penetration can occur through lesions on the skin, mucous membranes, and also through the hematogenous route.

Typically, lymphadenitis occurs as a complication of primary inflammation of any localization. Infectious pathogens (microorganisms and their toxins) penetrate the regional lymph nodes with the flow of lymph, which flows from the primary purulent focus. Sometimes, by the time lymphadenitis develops, the primary focus has already been eliminated and may remain unrecognized.

In other cases, lymphadenitis occurs when infection directly enters the lymphatic network through damaged skin or mucous membrane.

Signs most often appear on the neck, as well as in the axillary area and groin. Enlargement of lymph nodes can be single or observed simultaneously in different parts bodies.

General symptoms include local and general increase in body temperature, severe pain, skin hyperemia, chills and itching. Lymphadenitis is a pathology that can develop in any person, regardless of gender and age.

Classification

According to the duration of the disease, lymphadenitis can be, like many other diseases, acute and chronic, according to the type of infectious agent - specific and non-specific, according to its progression - purulent and non-purulent.

Classification of lymphadenitis depending on the intensity and duration of the inflammatory process:

Acute lymphadenitis

The onset of development of the pathological process is acute. The main reasons for the progression of the pathology: wound infection, the presence of an acute infectious disease in the body, surgical intervention.

Forms of acute inflammation:

catarrhal (simple inflammation);
hyperplastic (with active growth of lymphoid cells);
purulent.

Acute - manifests itself with vivid symptoms and turns into a purulent form if not treated. In the purulent form, the lymph nodes melt and the disease affects neighboring tissues.

There is redness and swelling around the lymph node, the contours of the node are blurred, the lymph node is fused with the surrounding tissues, movements in this area bring pain. As pus accumulates and tissue melts, movement of pus inside the node is noted. If it doesn't happen surgical treatment, an abscess in the area of the node can break out or into the depths of the tissue.

Chronic lymphadenitis

This pathology is directly related to the progression of cancer or the presence of an infectious process in the body that does not subside for a long time.

With chronic nonspecific lymphadenitis, inflammation in the lymph nodes is prolonged. This inflammation is productive. Its transition to a purulent form practically never occurs.

Symptoms of chronic nonspecific lymphadenitis include enlarged lymph nodes, they are dense, are not painful on palpation, and are not fused together. The lymph nodes remain enlarged for a long time, but gradually they decrease. In rare cases, the proliferation of connective tissue can lead to lymph circulation disorders and swelling.

By location:

Submandibular;
Cervical;
Axillary;
Parotid;
Mesenteric (mesadenitis);
Inguinal.

By prevalence:

Single;
Regional;
Total.

During acute lymphadenitis, three successive stages are distinguished:

catarrhal (with redness, dilation of blood vessels in the area of the node),
hyperplastic (with an increase in the size of the node, impregnation with plasma)
purulent (formation of a purulent cavity inside the node).

Simple lymphadenitis is distinguished by the fact that the inflammatory process does not extend beyond the capsule of the node itself. In destructive forms, the inflammatory process spreads to surrounding tissues. Changes in the surrounding tissues may be limited to serous inflammation or, in a more complex case, may develop into purulent inflammation with the subsequent formation of adenophlegmon.

Causes

Lymphadenitis in adults develops against the background of harmful work and when running forms diseases. Both men and women tend to neglect their own health when they are sick. Self-treatment of infectious diseases is often attempted. This approach provokes suppuration of the lymphatic tissues, causing the disease to become chronic.

As a rule, lymphadenitis is a consequence of primary septic inflammation. Pathogenic (pyogenic) microflora - streptococci and staphylococci, and the toxins they produce migrate from the lesion through the lymphogenous route, or through the bloodstream. It is also possible for infectious agents to be introduced into the lymphatic vessels through injured skin or mucous membranes (contact route).

Inflammation of the tissues of the lymph nodes develops due to the influence of infectious and non-infectious factors.

Often lymphadenitis occurs as a result of inflammation in the oropharynx with tonsillitis, adenoiditis, influenza, scarlet fever. Lymph nodes can become enlarged due to childhood infections - rubella, mumps or diphtheria.

Common non-infectious causes of lymphadenitis include the following:

oncology of lymph nodes (lymphoma);
metastatic (secondary) cancer that has spread from other areas of the body;
inflammation as a response to the introduction of a foreign body.

Symptoms of lymphadenitis in adults

Signs of lymphadenitis largely depend on its type and stage. So, for example, if the symptoms of acute lymphadenitis cannot be ignored, then the so-called simple lymphadenitis is generally painless and does not cause concern for the time being.

Symptoms:

Edema and hyperemia are local phenomena that characterize the struggle of lymphocytes with viruses and pathogenic bacteria.
Loss of appetite, weakness, headache - develop against the background of poisoning of the body with toxins released by inflammatory agents.
Suppuration in the area of the lymph node - if pus forms, then we are talking about the development of an abscess; sometimes purulent melting of the lymph node occurs.
Development of tachycardia - when the process is neglected, inflammation increases and causes complications on the cardiovascular system.
Gas crepitus - when palpating the affected lymph node, a slight crunching sensation is felt.
Violation of the functional characteristics of the location of inflammation - due to severe pain, a person cannot move an arm or leg, neck, depending on the area in which the lymph node is inflamed.

Symptoms of acute lymphadenitis

Signs of acute lymphadenitis depend on the form of the disease and the nature of the inflammation. Basically, the general condition of the patient with catarrhal lymphadenitis is not particularly disturbed. Symptoms may include:

pain in the area of regional lymph nodes.
In this case, there is an increase in lymph nodes and their pain during palpation.

If the disease process progresses and periadenitis develops, then the described symptoms may worsen.

Painful sensations become sharper, the skin over the lymph nodes becomes hyperemic, and when palpating the nodes the patient feels pain.
Lymph nodes, which previously could be very clearly palpated, now merge with each other and with the surrounding tissues, and they also become immobile.

Signs of chronic form

Chronic lymphadenitis is divided into primary, as a result of penetration of weakly infectious microflora into the body, and acute, which has taken a protracted form. The clinical picture of these forms of lymphadenitis includes the following symptoms:

lymph nodes are dense and painless on palpation,
have no adhesions.

Often their own cells are replaced by connective tissue, this leads to disorders of lymphatic circulation, lymphostasis and extensive swelling.

The increased sizes can last a long time, but then the nodes decrease due to the proliferation of connective tissues. The general condition of a person with chronic lymphadenitis is not disturbed, the body temperature is normal.

Specific lymphadenitis also has its own characteristics:

in the gonorrheal form, the inguinal nodes are excessively painful and enlarged;
the tuberculosis form gives severe weakness (due to intoxication) and a sharp increase in temperature, which can last for a long time, the surrounding tissues become inflamed;
the syphilitic nature of inflammation occurs as a one-sided process. Lymph nodes resemble a “chain”. When palpated, they are free, not welded together and rarely contain pus.

Lymphadenitis	Symptoms
Cervical	Pressing on the formed compaction of the lymph nodes causes pain. In addition to inflammation with cervical lymphadenitis: the general health of the patient worsens, he develops a headache and fever. In the acute form, severe suppuration forms in the area of the lymph nodes
Submandibular	Pain. It intensifies as the disease progresses. Changes in the skin over the lymph nodes: redness swelling local temperature increase of 1-2 degrees Suppuration of the lymph nodes (develops with a bacterial infection).
Inguinal	Lymph nodes increase in size, pain is noted, both at rest and during palpation. When walking, patients feel: feeling of discomfort in the lower abdomen sharp pain. Associated symptoms include: high temperature, weakness and chills. Inguinal lymphadenitis is complicated by: localized edema skin hyperemia.
Axillary form	Symptoms of the axillary form of pathology: enlarged lymph nodes and their suppuration; increased body temperature; sharp pain in the nodes; phenomena of general intoxication; swelling of surrounding tissues; it is possible for the abscess to break outward (with the formation of fistulas in the armpit) and inward (formation of adenophlegmon).

Some symptoms of lymphadenitis indicate the development of serious conditions that are potentially life-threatening. If they are present, it is necessary to seek qualified help as soon as possible, sometimes the count is literally hours and minutes. We are talking about such signs as:

elevated body temperature (above 38.5C);
difficulty or rapid breathing;
severe pain, swelling, pronounced redness;
cardiopalmus.

When the first symptoms of lymphadenitis appear, such as pain in the lymph node, swelling, fever, you should immediately consult a physician or surgeon. These specialists will help directly determine the cause and prescribe the correct treatment or further diagnosis. Under the mask of lymphadenitis, various diseases can be hidden, such as plague, tuberculosis, and various tumor processes.

Complications

Among the local complications of lymphadenitis, one should remember the likelihood of the development of suppuration (usually in childhood). Progressive inflammation of the lymph nodes without proper treatment often entails:

abscess formation;
tissue necrosis;
blood poisoning;
formation of fistulas;
thrombophlebitis of adjacent veins.

Purulent lymphadenitis can be complicated by the development of phlegmon, corrosion of the walls of blood vessels with bleeding.

Diagnostics

Lymph nodes in a healthy person are soft, not enlarged, displaced relative to adjacent tissue, and painless. Very often, in people with a normal physique, the lymph nodes cannot be felt. They are easily detected in children and adolescents of thin build.

When diagnosing, the doctor will first examine the lymph nodes and identify all of the above signs. Next, guided by the data obtained, the issue of laboratory and instrumental diagnostic methods will be decided.

Examinations for the diagnosis of lymphadenitis:

clinical blood test;
HIV test;
allergic skin tests;
CT scan;
X-ray examination;
node biopsy.

When examining children, it is necessary to exclude or confirm Quincke's edema, congenital tumors and cystic neoplasms in the neck. When examining patients with inguinal lymphadenitis, it is necessary to exclude the presence of an inguinal hernia and sexually transmitted diseases.

Many people confuse the concepts of “lymphadenopathy” and “lymphadenitis” because these words sound similar. In fact, only the second is the name of the disease, since the first is only a symptom or a painless reaction of the body to a rather serious pathology (AIDS, syphilis, etc.). Of course, in such cases the diagnosis requires clarification. Only after examination and testing is the patient given a diagnosis.

Treatment of lymphadenitis

So, if the initial stages of lymphadenitis occur, then the treatment is quite conservative:

creating rest conditions for the affected area;
physiological treatment: electrophoresis, ultrasound therapy, galvanization;
anti-inflammatory ointments and drugs.

In most cases, hyperplastic and catarrhal lymphadenitis, which occurs in an acute form, is treated conservatively. The patient is recommended to provide a state of rest for the affected area and is prescribed antibiotic therapy taking into account the sensitivity of the pathogenic flora, as well as vitamin therapy and UHF therapy.

In case of chronic nonspecific lymphadenitis, elimination of the underlying disease that maintains inflammation in the lymph nodes is required. Specific lymphadenitis is treated taking into account the etiological agent and the primary process (syphilis, gonorrhea, tuberculosis, actinomycosis, etc.).

The main thing is to treat the underlying disease, against which inflammation of the lymph nodes has developed. Medicines that are used in the treatment of lymphadenitis are:

Non-steroidal anti-inflammatory drugs: Ketorolac, Nimesulide;
Antihistamines: Cetirizine;
Antibiotics: Amoxiclav, Ceftriaxone, Clindamycin, Benzyllenicillin;
Antiviral drugs: Acyclovir, Rimantadine;
Anti-tuberculosis drugs: Ethambutol, Rifampicin, Capreomycin;
Antifungals: Fluconazole, Amphotericin B.

Operation

Surgical treatment is resorted to in the event of the development of purulent complications of lymphadenitis - abscess and adenophlegmon.

Operation stages:

Under local or general anesthesia, the purulent focus is opened, pus and destroyed tissue are removed.
The prevalence of the purulent process and the degree of damage to nearby organs and tissues are determined.
At the end of the operation, the source of suppuration is washed with antiseptic solutions (for example, furatsilin), the wound is sutured and drained - a special tube (drainage) is installed into the wound cavity, through which inflammatory fluid and pus flow out, and various antiseptic solutions can also be injected.

Prevention

Prevention of lymphadenitis implies:

prevention of skin microtraumas;
preventing infection of resulting abrasions, wounds and other damage to the epidermis;
timely elimination of foci of infection (for example, treatment of dental caries or sore throat), autopsy
purulent pathological formations (boils and felons);
timely, accurate diagnosis and adequate treatment of diseases causing specific
forms of lymphadenitis (gonorrhea, tuberculosis, syphilis, actinomycosis and others).

Lymphadenitis as a disease immune system signals the presence of pathogenic flora in the body, so it is necessary to treat not only the inflamed lymph node itself, but first of all the illness that contributed to lymphadenitis.

Cervical lymphadenitis is a disease in which the cervical lymph nodes become enlarged and painful. A disorder occurs because the lymphatic system is part of the immune system, and when various pathogenic microflora (viruses, bacteria, fungi) enter the body, the number of lymphocytes increases. Next, we will consider what cervical lymphadenitis is, what are its main causes and symptoms, as well as diagnostic methods and treatment options.

Lymphadenitis of the neck is rarely an independent disease, more often it is a consequence and concomitant symptom of other diseases. However, according to the international classification of diseases (ICD 10), acute lymphadenitis is classified as a separate group and has an ICD code of L04. Acute cervical lymphadenitis is more common in adults than in children.

Causes of neck lymphadenitis

Most often, acute lymphadenitis is caused by the following reasons:

Infectious diseases of various origins(viral, bacterial or fungal). This includes all groups of acute respiratory viral infections and acute respiratory infections, diseases of the ENT organs (tonsillitis, pharyngitis, rhinitis, sinusitis, sinusitis, otitis, etc.), dental disorders of an infectious-inflammatory nature (stomatitis, periodontal disease, caries, periodontitis, etc.) , measles, jaundice, scarlet fever, meningitis, tuberculosis, skin diseases. Some sexually transmitted diseases (for example, syphilis) can cause not only cervical lymphadenitis, but also inguinal lymphadenitis.
Diseases such as HIV and AIDS should be included in a separate group, since their immediate manifestation is enlargement of the lymph nodes, often in several places simultaneously (neck, armpits, groin).
Autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, autoimmune thyroiditis and etc.
Installation of various implants (silicone, metal, plastic, etc.). The immune system perceives the implant as a foreign object and may begin to reject it.
Pathologies of the thyroid gland.
Oncological diseases. Moreover, this includes both oncology of the lymphatic system itself and other organs.
Other reasons:

decreased immunity due to seasonal vitamin deficiency and colds, stress, chronic diseases;
drafts. In this case, lymphadenitis will be an independent disease when the lymph nodes are simply blown through by an open window or air conditioner;
allergic reactions;
alcohol abuse.

Symptoms

Clinical manifestations of cervical lymphadenitis can be divided into main and accompanying ones.

The main ones include pain in the neck, enlargement and swelling of the lymph nodes themselves, discomfort when turning the head and pressing on the neck. The lymph nodes may be slightly red and hot..

Associated symptoms with cervical lymphadenitis depend on the cause of the disease:

increased body temperature (from low-grade to high);
sore throat, runny nose, cough;
sneezing (allergic or cold);
difficulty swallowing;
weakness, general malaise associated with intoxication of the body by infectious agents;
headaches, poor appetite, etc.

Types of disease

There are several classifications of lymphadenitis, they differ on the following grounds:

According to the duration and severity of the course, acute and chronic types are distinguished. Acute develops as a reaction to an infection entering the body (for example, with a sore throat). The chronic form most often occurs in the case of chronic throat diseases (pharyngitis, tonsillitis). In this case, the lymph nodes are only slightly enlarged, and there may be no pain at all.
Depending on the cause of occurrence, cervical lymphadenitis can be specific or nonspecific. The first is the most dangerous and more difficult to treat, as it is caused by serious infectious diseases (syphilis, tuberculosis, plague). Nonspecific usually occurs with colds and acute respiratory viral infections, and is easily eliminated with the cure of the underlying disease.
Depending on the cellular composition The inflamed lymph node is divided into serous, purulent and simple. Serous occurs with a viral course of the disease or with oncology, purulent - with a bacterial one. Purulent lymphadenitis is the most dangerous, as an abscess or phlegmon may occur (spread of purulent contents beyond the lymph node capsule to neighboring tissues). It is purulent lymphadenitis that is fraught with the development of sepsis. That is why, if symptoms such as redness of the skin on the lymph node, its severe enlargement, pain and hotness of the skin appear, you should immediately consult a doctor.

How to determine cervical lymphadenitis

To make a correct diagnosis and determine a treatment strategy, diagnosis must take place in several stages:

Collection of anamnesis and symptoms. The doctor finds out what symptoms are bothering you and collects a medical history.
External examination and palpation allows you to determine which group of lymph nodes is inflamed, how enlarged and painful they are. Also at this stage, the doctor can diagnose the presence of a purulent process.
Blood tests. For reliable result You need to take several tests: general, “sugar”, biochemical, SOI, C-reactive protein, tumor markers. If you suspect the presence of sexually transmitted diseases, blood is also donated.
Ultrasound. It is done, if necessary, to determine the structure of the lymph node, whether there are any pathologies in it, as well as disruptions in the functioning of neighboring tissues.
Puncture. This is a fine-needle biopsy (sampling a small amount of lymph node tissue) to determine its cellular composition.
If you suspect specific diseases the doctor prescribes additional tests. For example, if pulmonary tuberculosis is suspected - fluorography; MRI (magnetic resonance imaging) or CT (computed tomography).

Only after all the necessary laboratory and clinical tests have been carried out, the doctor makes a diagnosis and prescribes specific medications.

Treatment of cervical lymphadenitis

Treatment of lymphadenitis is based, first of all, on eliminating the cause that caused it (only if lymphadenitis is not an independent disease). For this, various drugs (drug treatment) and physical therapy are prescribed. Traditional medicine recipes can also be used.

Drugs

Medications are selected only by the attending physician on an individual basis. In most cases, the following is prescribed:

Antibiotics to eliminate bacterial infections. Antibiotics currently come in different groups and spectrums of action, so to select the correct drug, it is necessary to find out which pathogen caused the disease. Most often, the doctor prescribes antibiotics complex action, since there may be more than one pathogen.
Antiviral agents can be used either independently or simultaneously with antibacterial agents. The most popular antiviral agents are Kagocel, Ingavirin, Arbidol, Oscillococcinum.
Antifungal agents are needed when the fungus appears primarily or after antibiotic therapy. For example, Candida fungus is a normal representative of the throat microflora, but after antibacterial drugs its number may increase. Therefore, Fluconazole or Nystatin is prescribed.
Drugs to correct immunity (immunomodulators and immunostimulants) can be prescribed by the attending physician to children in case of severe disease, when oncological diseases, during chronicization of pathologies of the ENT organs and in many other cases. The most effective drugs in this group: Cycloferon, Viferon, Immunal, echinacea extract, Interferon, Lykopid.
For allergic manifestations of lymphadenitis, antihistamines (Suprastin, Tavegil, Claritin, etc.) are prescribed.
Therapy for thyroid diseases is quite specific, and if lymphadenitis is a consequence of thyroid pathologies, then treatment and the choice of remedies will depend on the specific disease.

Seasonal lymphadenitis, caused by decreased immunity, must be treated with measures aimed at strengthening the body's defenses, and the prevention of colds must also be present.

Physiotherapy

Physiotherapy allows you to eliminate the inflammatory process at the cellular level and quickly cure lymphadenitis. For these purposes, ultrasound with hydrocortisone ointment is widely used. The popularity of this procedure is growing among those patients whose cervical lymphadenitis is caused by chronic throat diseases (tonsillitis, pharyngitis). Among the positive reviews, there is information that after a course of ultrasound, discomfort in the neck disappeared, and the condition of the throat improved significantly.

Since it is prohibited to heat the lymph nodes, physiotherapy using heat (UHF) is not used to treat lymphadenitis.

Home Remedies

It may take considerable time until the underlying disease is eliminated. Until this point, a number of measures can be taken to alleviate the symptoms of lymphadenitis.

If your doctor allows it, you can make gauze compresses using ichthyol ointment or Vishnevsky ointment. You can also simply wrap a wool scarf around your neck. Heating lymph nodes is strictly prohibited even in the absence of a purulent process.

Cervical lymphadenitis is a rather dangerous disease. It can be a consequence of a harmless cold, or it can hide more serious pathologies. Therefore, at the first signs of inflamed lymph nodes, you should immediately consult a doctor.

Lymphadenitis– inflammation of the lymph nodes, resulting from the ingress of various microorganisms and their

toxins

It is characterized by an increase in the size of the lymph nodes and severe pain in the affected area. In most cases, lymphadenitis is not an independent disease, but only indicates the presence of pathology in a particular organ or part of the human body. Meanwhile, the long-term presence of an inflammatory process in the lymph nodes can develop into an independent pathology and lead to a number of serious complications, often life-threatening.

Lymphadenitis is a fairly common pathology. Inflammation of regional lymph nodes accompanies almost all infectious diseases, but the absence of lymphadenitis does not exclude the presence

infections

in organism.

Interesting Facts

More than 80% of people experience painless enlargement of the submandibular lymph nodes, which is considered normal. No other groups of lymph nodes are normally palpable.
The development of lymphadenitis is a natural protective reaction of the body that occurs in response to the introduction of foreign agents (bacteria, viruses, fungi). The purpose of this reaction is to prevent the infection from spreading throughout the body.
Not all enlarged lymph nodes are lymphadenitis. There are a number of diseases (various tumors, systemic rheumatic diseases) that lead to enlargement of the lymph nodes without signs of inflammation in them.

The structure of lymphatic vessels and lymph nodes The lymphatic system is part of the body's vascular system. It takes part in metabolism and also performs a protective function, which is to neutralize various microorganisms and other foreign particles.

The lymphatic system includes:

spleen;
lymphatic fluid (lymph);
lymphatic vessels;
The lymph nodes.

Spleen During embryonic development, blood cells are formed in the spleen. After birth, the processes of hematopoiesis in it are inhibited, and it turns into the central organ of the lymphatic system, in which differentiation occurs (acquisition specific functions) the main cells of the immune system - lymphocytes.

Lymphocytes are a type

leukocytes

- the so-called white blood cells that provide

immunity

protecting the body from various external and internal influences

). Lymphocytes are produced in red bone marrow, which is located inside the body's bones (

in the bones of the pelvis, vertebrae, ribs, sternum and others

). Immature forms of lymphocytes are released from the bone marrow into the bloodstream and enter the spleen, where their differentiation processes are completed.

Lymph formation occurs in almost all tissues of the body due to the passage of a small amount

and parts of the fluid from the blood capillaries (

smallest blood vessels

) into lymphatic capillaries. Blood vessels that carry blood to organs and tissues (

), gradually branch out and decrease in diameter. The smallest vessel in the human body is the capillary. At the capillary level, part of the fluid and a small amount of proteins leaves the vascular bed (

filtered

) and enters the organ tissue (

intercellular space

). Most of The filtered liquid returns to the blood capillaries. They form larger vessels (

venules, veins

), through which the outflow of venous blood from organs to

A certain proportion of proteins and about 10% of fluid from the intercellular space does not return to the circulatory system, but enters the lymphatic capillaries. In this way, lymph is formed, which, in addition to proteins and plasma, contains various

microelementsfat

carbohydrates

As well as cellular elements (

predominantly lymphocytes

Lymphatic vessels

When several lymphatic capillaries merge, larger lymphatic vessels are formed. They carry out the outflow of lymphatic fluid from all tissues of the body to the lymph nodes, which correspond to a specific organ or part of the body.

Efferent lymphatic vessels emerge from the lymph nodes, which also merge to form large lymphatic trunks and ducts. Through them, lymphatic fluid is transported to the large veins of the body, thus returning to the systemic circulation.

There are several large lymphatic ducts in the human body:

Thoracic lymphatic duct - collects lymph from the legs, pelvic organs, abdominal cavity and left half chest.
Left subclavian trunk - collects lymph from the left hand.
Left jugular trunk - collects lymph from the left half of the head and neck.
Right lymphatic duct - is formed by the fusion of several lymphatic trunks and collects lymph from the right half of the head, neck, right half of the chest and right arm.

Lymph nodes Lymph nodes are round or oval-shaped formations, small in size (from a few millimeters to 1 - 2 centimeters), which are located along the lymphatic vessels that carry lymph from various organs and tissues. The surface of the lymph node is covered with a connective tissue capsule, under which there is an accumulation of lymphoid tissue containing many cells - lymphocytes.

Lymphocytes are formed in the lymph nodes, starting from the period of embryonic development. Their main function is the recognition of foreign agents (

viruses, fragments of bacteria and their toxins, tumor cells and so on

) and activation of other protective systems of the body aimed at neutralizing them.

Lymph entering the lymph nodes slowly leaks through narrow, slit-like spaces called sinuses. Thus, it is cleansed from various foreign bodies, and contact between foreign agents and lymphocytes is also ensured.

The main function of the lymph nodes is to prevent the spread of pathological processes in the body. This is realized due to the presence of several groups of lymph nodes, which filter lymph from different parts of the body. They are located in such a way as to become a barrier to infectious processes and prevent foreign antigens from entering various organs and tissues.

The main groups of lymph nodes in the human body are:

lymph nodes of the head and neck (cervical, submandibular, occipital and others);
lymph nodes of the chest cavity;
lymph nodes of the abdominal cavity and abdomen (mesenteric, iliac, pelvic);
lymph nodes of the lower extremities (inguinal, popliteal);
lymph nodes of the upper extremities (axillary, elbow).

Each group of lymph nodes collects lymph from the tissues and organs of a specific area of the body. Before entering the systemic circulation, the lymphatic fluid is sequentially filtered in several lymph nodes, as a result of which it is almost completely cleared of foreign inclusions that may be present in it. In addition, it is enriched with lymphocytes, which enter the systemic circulation and are carried through the bloodstream to all tissues and organs where they perform their functions. protective functions.
Development of the inflammatory process in the lymph node

If foreign agents appear in any organ (

viruses, bacteria, toxins

), then some of them, together with the interstitial fluid, pass into the lymphatic capillaries and are delivered with the lymph flow to the regional lymph nodes. In addition, the infection can enter the lymph nodes by hematogenous (

through blood

) or by contact (

with direct spread from nearby tissues and organs

). In rare cases, it is possible to introduce pathogenic

microflora

directly from the environment (

when a lymph node is injured

In the lymph nodes, foreign antigens interact with lymphocytes, as a result of which the latter are activated and begin to produce specific antibodies - an inflammatory process develops. A large number of other types of leukocytes enter the lymph node from the bloodstream, which contribute to the development of inflammation and the destruction of foreign substances.

The migration of a large number of leukocytes to the site of inflammation, as well as the activation of lymphocyte growth processes in the inflamed lymph nodes, leads to the proliferation (hyperplasia) of lymphoid tissue, which is externally manifested by an increase in the size of the lymph node. The release of a large amount of biologically active substances causes increased sensitivity and pain in the inflamed area.
When do lymph nodes become inflamed?

As mentioned earlier, the main function of the lymph nodes is to prevent the spread of pathological processes in the body. Any infectious agent that gets into them is retained and destroyed by lymphocytes. However, with a massive influx of foreign microorganisms, the existing lymphocytes may not cope with their function - in this case, they begin to multiply intensively, and also stimulate the entry of other types of leukocytes into the site of inflammation, which leads to an enlargement of the lymph nodes.

Causes of lymphadenitis Lymphadenitis is caused by various pathogenic microorganisms that enter the lymph nodes.

Depending on the type of infection, lymphadenitis can be:

nonspecific;
specific.

Nonspecific lymphadenitis Nonspecific lymphadenitis is caused by a number of microorganisms that are different in structure and virulence (infectiousness), but have similar development mechanisms and clinical manifestations.

The causes of nonspecific lymphadenitis may be:

Bacteria and their toxins. A bacterium is a living cell that is capable of existing and multiplying in various organs of the human body, infecting them. Inflammation of the lymph nodes can be caused by the ingress of staphylococcus, streptococcus, E. coli and many other microorganisms into them. Some of them, during their life activity (or after their death), release certain toxic substances, which can also cause lymphadenitis.
Viruses. Viruses are small fragments of nucleic acids - DNA (deoxyribonucleic acid) or RNA (ribonucleic acid) that can only reproduce inside living cells. In the cells of the human body, nucleic acids are contained in the nucleus and are responsible for the processes of cell growth, the performance of specific functions, as well as for storage and transmission genetic information. When infected by a virus, its DNA is introduced into the genetic apparatus of the host cell, as a result of which it begins to produce new viral particles. When an infected cell is destroyed, the newly formed viruses are released into the surrounding tissue and infect neighboring cells. Some of the viral fragments seep into the lymphatic capillaries, lingering in the regional lymph nodes and causing the development of an inflammatory process in them.
Mushrooms. Fungi are a special class of bacteria-like microorganisms that can grow in the human body. Science knows many types of fungi (yeast, mold, and so on). Some of them are dangerous to humans and, if ingested, can cause the development of various diseases (mycoses). Others are normal inhabitants of the skin and mucous membranes and acquire pathogenic properties only when the functions of the immune system are impaired - for example, in AIDS (acquired immune deficiency syndrome).

Specific lymphadenitis Specific lymphadenitis develops as a result of entry into the lymph nodes certain types microorganisms.

The cause of specific lymphadenitis may be:

Mycobacterium tuberculosis;
Treponema pallidum (the causative agent of syphilis);
plague bacillus (causative agent of plague);
actinomycete (pathogenic fungus, causative agent of actinomycosis);
Brucella (causative agents of brucellosis);
tularemia bacteria (causative agents of tularemia).

Infection with these microorganisms leads to the development of a specific clinical picture characteristic of each disease. With the lymph flow, pathogens enter the lymph nodes, causing specific changes in them.
Types of lymphadenitis

Depending on the type of microorganism and its virulence, the inflammatory process in the lymph nodes can develop differently.

Depending on the speed of development of the inflammatory process, the following are distinguished:

Acute lymphadenitis. Develops as a result of damage to the lymph nodes by a highly virulent infection. It is characterized by rapid and severe inflammation of the lymph nodes, often against the background of general manifestations of the infectious process (fever, general weakness, headaches and muscle pain). Without appropriate treatment, acute lymphadenitis can turn into a purulent form, which will ultimately lead to purulent melting of the lymph node and damage to surrounding tissues (the development of an abscess or adenophlegmon).
Chronic lymphadenitis. It develops when infected with a weakly virulent infection or is the outcome of untreated acute lymphadenitis, when the inflammatory process takes a protracted course. Also quite often, specific lymphadenitis (tuberculous, syphilitic) is characterized by a chronic course.

Depending on the nature of the inflammatory process, there are:

Catarrhal (simple) lymphadenitis. Characteristic of the initial stage of the disease. Violation of capillary permeability in an inflamed lymph node leads to the fact that the liquid part of the blood leaves the vascular bed and permeates the tissue of the lymph node. There is also a moderate migration of leukocytes to the site of inflammation.
Hyperplastic lymphadenitis. It is a later stage of the development of the disease and is characterized by the proliferation (hyperplasia) of lymphocytes in the inflamed lymph node, as well as pronounced infiltration by leukocytes (neutrophils, eosinophils and other cells).
Purulent lymphadenitis. It is the last stage of development of bacterial lymphadenitis, when suppuration and purulent destruction of the lymph node occurs. The outcome of this form of the disease can be the formation of an abscess (a limited space filled with pus) or the development of adenophlegmon (a diffuse purulent process that spreads far beyond the primary focus of infection).

Causes of lymphadenitis in various areas

As mentioned earlier, lymph from different areas of the body is collected in different groups of lymph nodes. Consequently, an infectious lesion of a certain area will initially manifest itself as inflammation of the corresponding regional lymph nodes.

If regional lymph nodes fail to cope with their barrier function (

in case of a severe infectious disease or as a result of a weakening of the body’s defenses

), infectious agents can enter the systemic bloodstream and spread to other organs and tissues, which can lead to the development of generalized lymphadenitis (

inflammation of various groups of lymph nodes throughout the body

Causes of submandibular lymphadenitis

The submandibular lymph nodes are located medially from the angle of the lower jaw. Their total number is 8 – 10 pieces.

The organs from which lymph flows into the submandibular lymph nodes are:

skin and soft tissues of the face (lower eyelids, cheeks, nose, lips, chin);
oral cavity (mucous membrane of the palate, back of the tongue);
gums and teeth;
submandibular and sublingual salivary glands.

The development of infection in any of these areas can lead to inflammation of the submandibular lymph nodes.

Causes of submandibular lymphadenitis

Facial skin infections	Injuries and abrasions in the facial area - through them infection with various pathogenic microorganisms can occur. Furuncle – purulent inflammation of the hair follicle (usually of staphylococcal etiology). Carbuncle – purulent inflammation of a group of hair follicles and sebaceous glands. Hidradenitis – purulent inflammation of apocrine sweat glands located in the skin of the wings of the nose and eyelids. Impetigo – an infectious disease caused by streptococcus, characterized by the formation of many small pustules in the facial area. Erysipelas (erysipelas) – acute infectious disease caused by hemolytic streptococcus. Herpes – viral disease, caused by the herpes virus type 1. Shingles - viral disease caused by a virus chickenpox and manifested by the appearance of a small rash on the skin along the nerve trunks.
Oral infections	Gingivitis – infectious inflammation of the gums caused by staphylococci and certain types of fungi (actinomycetes). Caries – the process of destruction of tooth tissue, caused mainly by staphylococci and streptococci. Glossitis – inflammation of the tongue associated with its traumatization and infection with various microorganisms that are constantly present in the oral cavity. Infectious stomatitis – inflammation of the oral mucosa caused by various bacteria, viruses or fungi.
Salivary gland infections	Viral infections – mumps (mumps), cytomegaly (caused by cytomegalovirus). Bacterial infections – staphylococcal, streptococcal and others.

Causes of cervical lymphadenitis

The cervical lymph nodes filter the lymph flowing from the head and neck. Consequently, any infectious processes in this area can lead to inflammation of the cervical lymph nodes.

There are several groups of lymph nodes in the neck area:

Superficial. Collect lymph from the skin and soft tissues of the neck and head (except muscles).
Deep. They drain lymph from the internal organs of the neck (from the pharynx, larynx, trachea, upper esophagus, thyroid gland and neck muscles), as well as from the nasal cavity, mouth, ear and other organs. In addition, the draining lymphatic vessels from the submandibular and other smaller lymph nodes of the head and neck flow into them. Therefore, all of the above infectious processes can cause cervical lymphadenitis (if barrier function submandibular lymph nodes).

The cause of inflammation of the cervical lymph nodes can also be:

Fungal diseases of the scalp– trichophytosis (ringworm), microsporia, scab.
Otitis – inflammation of the ear caused by pathogenic microorganisms (pneumococci, staphylococci).
Tonsillitis – inflammation of the lymphoid formations of the oral cavity (tonsils), caused by the ingress of pathogenic bacteria or viruses into them.
Pharyngitis – infectious inflammation of the pharyngeal mucosa.
Rhinitis – inflammation of the nasal mucosa.
Sinusitis – inflammation of one or more paranasal sinuses - the maxillary sinuses (sinusitis), frontal sinuses (frontal sinusitis), sphenoid sinus (sphenoiditis) and ethmoidal labyrinth (ethmoiditis).
Infectious thyroiditis – inflammation of the thyroid gland caused by viruses or bacteria.
Infectious mononucleosis - a viral disease in which primary damage occurs to the cervical and subsequently other groups of lymph nodes.
Rubella – a systemic viral disease that develops when a pathogen enters the body through the mucous membranes of the respiratory tract (airborne), which leads to inflammation of the cervical and subsequently other groups of lymph nodes.
Adenoviral infection - a group of colds of the upper respiratory tract caused by adenoviruses.
Flu - acute respiratory viral infection (ARVI) caused by the influenza virus.
Festering wounds in the head and neck area.

Causes of axillary lymphadenitis Axillary lymph nodes are also divided into superficial and deep. They collect lymph from the skin, soft tissues and bones of the upper limb, as well as from the upper part of the abdominal wall, chest and mammary gland.

The cause of inflammation of the axillary lymph nodes may be:

Purulent-inflammatory diseases of the skin of the upper limb - boil, carbuncle, hidradenitis of the axillary sweat glands, impetigo, erysipelas (described earlier).
Suppuration of cuts and abrasions in the arms, chest and upper abdomen.
Fungal skin lesions– sporotrichosis, trichophytosis, microsporia.
Osteomyelitis of the hand bones – an inflammatory process caused by pyogenic microorganisms and affecting bone tissue.
Panaritium – a purulent-inflammatory process of the soft tissues of the fingers, which can spread to tendons, bones and joints.
Mastitis – an inflammatory disease of the mammary gland in women, most often occurring during breastfeeding.

Causes of inguinal lymphadenitis Inguinal lymph nodes collect lymph from all tissues of the lower limb, as well as from the external genitalia, perineum, lower abdominal wall and back.

All infectious diseases of the skin, soft tissues and bones described earlier can cause inflammation of the inguinal lymph nodes if lymph flows into them from the area of the body in which the source of infection is located.

The cause of inflammation of the inguinal lymph nodes can also be:

Gonorrhea – an infectious disease caused by gonococcus, which is sexually transmitted and is characterized by purulent inflammation of the mucous membranes of the external genitalia (mainly in men, very rarely in women).
Balanoposthitis – inflammation of the skin of the glans penis and foreskin caused by various infectious agents (usually due to poor personal hygiene).
Colpitis – infectious inflammation of the vaginal mucosa.
Vulvitis – infectious inflammation of the external female genitalia.

Symptoms of lymphadenitis in various areas Manifestations of lymphadenitis are caused, first of all, by the presence of an inflammatory process in the lymph nodes, as well as the spread of infection in the body.
Symptoms of submandibular lymphadenitis

The manifestations of this form of the disease depend on the size of the lymph nodes, as well as on the nature of the inflammatory process.

Symptoms of submandibular lymphadenitis are:

Enlargement of the submandibular lymph nodes. To the touch (by palpation) they are defined as dense, painful formations of a round or oval shape, located in submandibular region on one or both sides, not fused with the surrounding tissues (easily move under the skin from side to side). The size of the lymph nodes varies from a few millimeters in the initial stage to several centimeters in the hyperplastic stage of the disease. Quite often, inflamed lymphatic vessels are palpated in the submandibular region - dense, thin, thread-like structures extending from the inflamed lymph node.
Pain. In the initial stage of the disease, mild pain upon palpation of the submandibular region may be noted. As the disease progresses, the pain intensifies, accompanies any movement of the jaw (when talking, while eating), and can also appear at rest.
Changes in the skin. In the initial stages, the skin over the lymph nodes may not change. As the inflammatory process develops, redness and swelling of the skin above the source of inflammation and in the surrounding area is noted (which is due to expansion and increased permeability small vessels). There is a local increase in temperature (by 1 - 2 degrees compared to normal skin).
Suppuration of the lymph nodes (develops with a bacterial infection). In the purulent stage, the lymph nodes grow together and with surrounding tissues, turning into dense, almost immobile formations. The skin over the source of inflammation is bright red, tense, and swollen. There is pronounced pain on palpation and at rest, which limits movement of the lower jaw and neck.
Systemic manifestations. When the infection spreads beyond the lymph nodes, there is a general increase in body temperature to 38 - 40ºC, general weakness, drowsiness, muscle pain, and headaches.

Symptoms of cervical lymphadenitis The manifestations of this form of the disease are determined by the size of the lymph nodes, their location and the nature of the inflammatory process.

Symptoms of cervical lymphadenitis are:

Enlarged cervical lymph nodes. They can be located on the front or side of the neck, above the collarbone. When palpated, they are characterized by the same signs as inflamed submandibular nodes (described above). With inflammation of the superficial lymph nodes, inflamed lymphatic vessels may be palpable.
Pain. There is pain on palpation, when turning the head, when talking, while chewing and swallowing food.
Changes in the skin. With cervical lymphadenitis, swelling and swelling of the skin is noted at the site of inflammation, as well as beyond it. As the purulent form develops, the skin becomes red in color, and small breakthroughs of pus may be visible on its surface. The general symptoms are very pronounced - there is an increase in body temperature up to 40ºC, weakness, sleep disturbance, headaches.
Limitation of movements. Associated with pain syndrome developing on late stages disease - with any turn or tilt of the head, the patient experiences severe acute pain in the area of inflammation. In addition, a pronounced increase in deep lymph nodes can lead to compression of various organs of the neck - vocal cords, trachea, esophagus, large vessels, which will be manifested by corresponding symptoms (change in voice, difficulty breathing, disruption of the process of swallowing food).

Symptoms of axillary lymphadenitis Manifestations of axillary lymphadenitis depend on the activity of the inflammatory process in the affected lymph nodes. In addition, compression (by enlarged lymph nodes) of tissues, nerves and vessels located near the source of inflammation can lead to the appearance of certain symptoms.

Symptoms of axillary lymphadenitis are:

Enlarged lymph nodes in the axillary region. More often one is detected, less often – several enlarged lymph nodes. Their palpation characteristics do not differ from lymphadenitis in other areas. Inflamed lymphatic vessels can be detected (with inflammation of the superficial lymph nodes).
Pain. There is severe pain in the axillary region, which can spread to the shoulder and lateral surface of the chest on the affected side. The patient often takes a forced position with his arm moved to the side, which reduces pressure on the inflamed lymph nodes and somewhat reduces pain.
Skin changes in the armpit area. When the axillary nodes are inflamed, the color of the skin over them may remain unchanged for a long time. Only with the development of the purulent process does the skin acquire a purplish-red color, become swollen, and tense.
Impaired hand movements. The pain intensifies when touching the area of the inflamed lymph nodes and when moving the hand, which can limit the patient’s daily activity. Movement may also be limited as a result of a pronounced enlargement of the axillary lymph nodes, reaching several centimeters in diameter.
Swelling of the hands on the affected side. They may occur as a result of compression of the large veins of the shoulder and axillary region by enlarged lymph nodes. In this case, the outflow of fluid from the upper limb is hampered; it leaves the vascular bed and permeates the surrounding tissues, leading to the development of edema.
Loss of sensation in the hand on the affected side. This symptom may appear in the case of pronounced enlargement of the axillary lymph nodes. This will lead to compression of the nerve trunks passing in the axillary and shoulder areas, which can be manifested by paresthesia (tingling sensation, crawling on the skin) in the arm area on the affected side, impaired sensitivity, pain and various motor disorders.

Symptoms of inguinal lymphadenitis Symptoms of this form of the disease are determined by the localization and severity of the inflammatory process, as well as the size of the enlarged lymph nodes and the degree of compression of nearby tissues.

Symptoms of inguinal lymphadenitis are:

Enlarged lymph nodes in the groin area. Enlarged lymph nodes are located in the inguinal ligament area and can reach several centimeters in diameter. Palpation characteristics do not differ from lymphadenitis in other areas.
Pain. Inguinal lymphadenitis is characterized by severe pain both in the source of inflammation and in the lower abdomen, in the upper part of the leg. The pain increases with walking, which may limit the patient's normal movement.
Skin changes. The skin above and around the site of inflammation is tense and swollen. If a purulent process has not developed, the color of the skin may be normal or pinkish.
Swelling of the legs on the affected side. Reason this symptom is both a direct disruption of the outflow of lymph through the inflamed lymph nodes, and a pronounced increase in their size, which can lead to compression of large vessels (including the femoral vein, passing directly behind the inguinal lymph nodes).
General condition of the body. Not changed if suppuration of the inflamed lymph node did not occur. In this case, there is an increase in body temperature to 38 - 40ºС, general weakness, pain in the muscles of the legs and abdomen, headaches, increased heart rate and other symptoms of intoxication of the body.

Diagnosis of lymphadenitis Diagnosing lymphadenitis, based on the symptoms listed above, is quite easy. It is much more difficult to identify the cause of the disease, which is a necessary condition for prescribing the correct treatment. In this case, a number of additional laboratory and instrumental studies are used.

In the diagnosis of lymphadenitis the following is used:

general blood analysis;
ultrasonography;
X-ray research methods;
lymph node biopsy.

Complete blood count (CBC) This is one of the first methods prescribed when an infectious process in the body is suspected. It allows you to identify signs and assess the severity of inflammatory processes, and in case of generalized infections, identify the pathogen and determine its sensitivity to various antimicrobial drugs.

Ultrasound examination (ultrasound) Simple and quick method research that does not require special training patient, is absolutely safe, has virtually no contraindications and can be performed directly in the doctor’s office.

Using ultrasound it is possible to determine:

Location, number, shape, size and structure of lymph nodes.
The relationship of the lymph node with surrounding tissues (fused or not).
The presence of inflammation in lymphatic vessels the area under study.
The presence of purulent complications of lymphadenitis (abscess, phlegmon).
The presence of a focus of infection in the internal organs.

X-ray research methods are used when there is a suspicion of damage to deep-lying groups of lymph nodes, which is typical for a number of systemic infectious diseases.

X-ray methods include:

Plain X-ray of the chest and abdomen. Allows you to identify groups of enlarged lymph nodes (bronchopulmonary, tracheal and others), determine damage to the bones of the extremities in osteomyelitis. With specific tuberculous lymphadenitis, it is possible to identify foci of tuberculosis in the lung tissue.
CT scan - a modern research method that allows you to more accurately determine the size, location and shape of inflamed lymph nodes, the presence of abscesses or adenophlegmon, the degree of spread of the purulent process in the affected area.

Lymph node biopsy An invasive research method (associated with a violation of the integrity of the skin), the essence of which is the removal and further examination of part of the inflamed lymph node. This method is associated with a number of complications, so its use for lymphadenitis is strictly limited.

Indications for performing a lymph node biopsy are:

suspicion of a tumor nature of an enlarged lymph node;
chronic lymphadenitis;
suspicion of specific lymphadenitis;
lack of effect from the treatment provided (for acute or chronic lymphadenitis).

Execution method The biopsy is performed in a sterile operating room under local or general anesthesia.

To take material from inflamed lymph nodes, the following is used:

Needle biopsy. In this case, a special hollow needle is inserted into the affected lymph node, and some of its tissue passes into the lumen of the needle.
Fine needle aspiration biopsy. A special thin needle is used, the internal diameter of which is less than 1 millimeter. The needle is connected to an empty syringe and inserted into the affected lymph node (often under ultrasound guidance), after which the lymph node tissue is aspirated into the syringe and further examined.

Research results The resulting material is sent to the laboratory, where it is stained with special dyes and examined under a microscope. This makes it possible to identify tumor cells in the lymph node (

if available

), as well as determine the severity and nature of the inflammatory process - the predominance of lymphocytes will indicate a viral infection of the lymph node, the predominance of neutrophils will indicate a bacterial infection.

The resulting material is also sown on special nutrient media designed for growing certain types of microorganisms. The nutrient medium with the test material is placed in a special thermostat, which creates optimal conditions for the growth and reproduction of bacteria. If an infectious agent is present in the lymph node punctate, it will begin to actively multiply, and after some time entire colonies of these microorganisms will appear on the nutrient medium. This allows you to accurately determine the type of pathogen, as well as determine its sensitivity to various antibacterial drugs, which will allow you to prescribe the most effective treatment.

Treatment of lymphadenitis

As mentioned earlier, lymphadenitis is a manifestation of the presence of infection in a specific area of the body. Therefore, to completely eliminate inflammation, it is necessary to eliminate its root cause - the primary infectious focus. At the same time, the inflammatory process itself should not be ignored, as it can progress, leading to the development of serious complications.

Which doctor should I contact?

If you experience painful enlargement of the lymph nodes in any part of the body, you should consult your family doctor as soon as possible. The doctor will carefully examine the affected area, examine all other groups of lymph nodes, prescribe laboratory tests, and, if necessary, refer you for consultation to other specialists.

Depending on the location and type of lymphadenitis, consultation with the following specialists may be necessary:

Otorhinolaryngologist (ENT) and/or dentist – with inflammation of the submandibular and cervical lymph nodes.
Urologist – with inflammation of the inguinal lymph nodes.
Therapist – with inflammation of the lymph nodes in the chest or abdominal cavity (identified using various instrumental diagnostic methods).
Dermatologist – for chronic infectious skin diseases.
Phthisiatrician – with tuberculous lymphadenitis.
Surgeon - if there are signs of a purulent process in the inflamed lymph nodes.

The main directions in the treatment of lymphadenitis are:

drug treatment;
physiotherapy;
traditional methods of treatment;
surgery.

Drug treatment The principles of drug treatment of lymphadenitis are etiotropic therapy aimed at eliminating the root cause of the disease (in this case, the primary foci of infection in the body), as well as symptomatic therapy, the purpose of which is to reduce the manifestations of the inflammatory process in the lymph nodes and improve the general well-being of the patient.

Drug treatment of lymphadenitis

Symptomatic therapy
Group of drugs	Representatives	Mechanism therapeutic effect	Directions for use and dosage
Nonsteroidal anti-inflammatory drugs	Ketorolac	In all tissues of the body, the activity of the enzyme cyclooxygenase, which is involved in the formation of prostaglandins - biologically active substances that play an important role in the development and maintenance of the inflammatory process, is inhibited. It has anti-inflammatory, analgesic and antipyretic effects.		Take orally, after meals, with a glass of warm water or milk. The recommended dose is 5 – 10 milligrams (mg) 3 – 4 times a day. Maximum daily dose– 40 mg. The course of treatment is no more than 5 days.
	Nimesulide (Nimesil)	A drug of the latest generation that selectively inhibits the activity of cyclooxygenase at the site of inflammation. It has virtually no effect on healthy tissues of the body, due to which it is free from many side effects characteristic of conventional anti-inflammatory drugs. It has a pronounced anti-inflammatory, analgesic and antipyretic effect.		It is taken orally in powder form. Dissolved in 100 ml of hot boiled water. The recommended dose is 100 mg (1 sachet) 2 times a day. The course of treatment is no more than 10 days.
Antihistamines	Cetirizine	Blocks H1-histamine receptors located on inner surface vessel walls and cell membranes of leukocytes (lymphocytes, basophils and neutrophils). The mechanism of action of cetirizine is due to: Constriction of blood vessels at the site of inflammation. Reducing the permeability of capillaries at the site of inflammation, which prevents the release of leukocytes and fluid from the vascular bed and the development of edema. Inhibition of chemotaxis (the process of migration of leukocytes to the site of inflammation). Inhibition of the release of biologically active substances (mainly histamine) from basophils and eosinophils, which reduces the activity of the inflammatory process.		Take orally with a glass of warm water. children under 6 years old – 2.5 mg 2 times a day; children over 6 years of age and adults – 5 mg 2 times a day.
Etiotropic therapy
Antibacterial drugs	Amoxiclav	A combination drug consisting of the antibiotic amoxicillin (a derivative of penicillin) and clavulanic acid. Amoxicillin blocks the formation of bacterial cell wall components, which leads to the death of microorganisms. Clavulanic acid protects amoxicillin from the action of beta-lactamases, special enzymes that destroy penicillins (produced by some pathogenic bacteria and reduce the effectiveness of penicillin antibiotics). Used to treat nonspecific lymphadenitis.		Take orally 15 minutes after meals. children from 1 to 2 years old – 60 mg 3 times a day; children from 2 to 7 years old – 125 mg 3 times a day; children from 7 to 12 years old – 250 mg 3 times a day; children over 12 years of age and adults - up to 300 - 500 mg 3 times a day. The course of treatment is at least 7 - 10 days.
	Ceftriaxone	Synthetic antibiotic wide range action, resistant to beta-lactamases. The mechanism of action is associated with disruption of the formation of cell membrane components and the death of bacteria. Used to treat nonspecific lymphadenitis.		It is administered intramuscularly (injections are very painful) or intravenously. children under 12 years old – 20 – 80 milligrams per 1 kilogram of body weight (mg/kg) 1 time per day; children over 12 years old and adults – 1 – 2 grams 1 time per day. The course of treatment is at least 1 week.
	Clindamycin	Binds to the 50S subunit of ribosomes (intracellular structures responsible for the synthesis of bacterial cell components). Inhibits the processes of division (reproduction) of bacteria.		Inside, after eating. children – 3 – 6 mg/kg 3 times a day; adults – 150 mg every 6 hours. The course of treatment is at least 10 days.
	Benzylpenicillin	A penicillin derivative used in the treatment of specific lymphadenitis in syphilis. The mechanism of action is associated with the suppression of the formation of bacterial cell wall components (including Treponema pallidum, the causative agent of syphilis), which leads to their death.		It is administered intravenously or intramuscularly. children – 25 – 100 thousand action units per kilogram of body weight (IU/kg) 2 – 4 times a day; adults – 1 – 1.5 million units 4 times a day.
Antiviral drugs	Acyclovir	It is integrated into viral DNA, disrupting the processes of virus reproduction. Does not affect the DNA of human cells. Prescribed for viral lymphadenitis caused by the herpes virus, Epstein-Bar, cytomegalovirus.		Orally, at a dose of 200–500 mg 4–5 times a day. The minimum course of treatment is 10 days.
	Rimantadine	Suppresses the processes of viral reproduction in the cells of the body, and also stimulates antiviral immunity. Prescribed for lymphadenitis caused by influenza and herpes viruses.		Inside, after eating, with a glass of warm water. children under 10 years old – 5 mg/kg 1 time per day; children over 10 years of age and adults – 100 mg 2 times a day.
Anti-tuberculosis drugs	Ethambutol	Inhibits the processes of RNA formation in actively growing Mycobacterium tuberculosis, leading to the cessation of reproduction and cell death.		Orally, 1 time per day, 30 minutes before meals, at a dose of 15 – 25 mg/kg. The duration of treatment is several months.
	Rifampicin	Suppresses the formation of various protein structures of bacterial cells (including Mycobacterium tuberculosis), which leads to their death.		Take orally, on an empty stomach, 30 minutes before meals. children – 10 – 20 mg/kg/day; adults – 450 – 600 mg per day. Courses of treatment range from several months to several years.
	Capreomycin	Suppresses the synthesis of protein molecules in Mycobacterium tuberculosis, providing a bacteriostatic effect (stops the processes of bacterial reproduction).		It is administered intramuscularly or intravenously at a dose of 15–20 mg/kg/day. The course of treatment is several years, during which the dosage and frequency of administration may vary.
Antifungal drugs	Fluconazole	It disrupts the formation of structural components and increases the permeability of fungal membranes, which disrupts the processes of their growth and reproduction.		Orally, at a dose of 200–400 mg 1 time per day. The duration of treatment depends on the type and location of the infection.
	Amphotericin B	It disrupts the permeability of fungal membranes, causing them structural components exit into the extracellular space, and the fungus dies.		Administer intravenously, drip, slowly. The recommended daily dose is 0.25 – 0.3 mg/kg.

Physiotherapy

It consists of influencing the body by various physical factors in order to obtain a therapeutic effect. The use of physiotherapy for lymphadenitis alleviates the patient’s general condition, reduces inflammation in the lymph nodes and promotes speedy recovery damaged tissues.

Physiotherapeutic methods in the treatment of lymphadenitis are used:

ultra-high frequency (UHF) therapy;
laser therapy;
galvanization.

UHF therapy This method involves influencing the human body with high-frequency electromagnetic field. This leads to an increase in temperature in the affected area, promotes vasodilation and migration of leukocytes to the site of inflammation, and the growth of connective tissue there. The described effects contribute to strengthening the local anti-infective immunity of tissues and a more rapid resolution of the inflammatory process.

UHF therapy is indicated in the presence of an acute inflammatory process in the lymph nodes. Absolute contraindications are suspicion of a tumor process, as well as specific tuberculous lymphadenitis. It is not recommended to use this method if there are symptoms of a general infectious process in the body (

increased body temperature, chills, rapid heartbeat, muscle pain, and so on

Laser therapy The essence of this method is the effect of light waves of a certain length on the tissues of the body. This leads to improved microcirculation in the inflamed lymph node, has an anti-inflammatory and analgesic effect, and also stimulates reparative (restorative) processes.

This method is prescribed for acute and chronic lymphadenitis. Contraindications are the same as for UHF therapy. In addition, laser exposure should be avoided to areas of the skin that contain benign tumors (

moles, age spots and others

Galvanization The essence of the method is the effect on the body of constant electric shock low power (up to 50 milliamps) and low voltage (30 - 80 volts), which passes through the tissues of the body, causing a number of complex physiological processes. It has a local analgesic effect, improves microcirculation in the area exposed to current, and promotes the restoration of damaged tissues and nerve fibers.

This method is used at the recovery stage of treatment after eliminating the cause of lymphadenitis and reducing the activity of the inflammatory process in the lymph nodes, as well as when chronic forms lymphadenitis.

Traditional methods of treatment

Folk remedies are used mainly to reduce the symptoms of inflammation in the lymph nodes, improve the general condition and speed up the healing process. It is worth noting that the use of methods

traditional medicine

only permissible in combination with antibacterial therapy and only after establishing the true cause of the enlarged lymph nodes. The greatest effect can be achieved by early stages nonspecific lymphadenitis, when inflammatory and destructive (

destructive

) processes are expressed insignificantly.

The most common folk methods for treating lymphadenitis are:

warming up the lymph nodes;
herbal preparations;
Echinacea tincture.

Warming up the lymph nodes It is a widespread folk method, effective in the initial stages of lymphadenitis, as well as in the recovery period. Before using this method, you must consult your doctor and determine the true nature of the enlarged lymph nodes.

Warming the lymph nodes is absolutely contraindicated:

in the presence of a tumor process in enlarged lymph nodes;
with specific tuberculous lymphadenitis;
with the development of adenophlegmon;
if there are signs of intoxication of the body (fever, muscle and headaches, rapid heartbeat).

It is necessary to warm up the inflamed lymph nodes with nonspecific lymphadenitis with dry heat. To do this, you can take sand or salt (coarse), heat it in a frying pan, place it in a fabric bag (or sock) and apply it to the site of inflammation for 15 - 20 minutes. After completing the procedure, the warming area must be wrapped in a warm scarf or scarf to prevent hypothermia. The procedure can be repeated 2 – 3 times a day. The recommended duration of treatment is no more than 5–7 days.

If there is a progressive enlargement of the lymph nodes after the start of treatment, an increase in body temperature or a deterioration in general health, warming should be stopped immediately and consult a specialist.

Herbal infusions Anti-inflammatory and antimicrobial properties various plants have been used in the treatment of lymphadenitis for many decades. They should be used in combination with other treatment methods.

Dandelion root infusion. Pour 10 g of crushed raw materials into a glass of boiling water. Leave for 4 hours, then strain and take 1 tablespoon 3-4 times a day.
Infusion of nettle flowers. 5 tablespoons of dried nettle flowers should be poured with 1 liter of boiling water. Leave for 2 hours, then strain and take 100 ml 2 times a day. This infusion has a certain anti-inflammatory effect and also helps remove toxins from the body.
Aloe juice. Aloe leaves must be washed, crushed and squeezed out the juice. Add 200 g of honey to 100 g of juice and leave for 1 day. Take 1 teaspoon 2 times a day. It has a certain anti-inflammatory and antimicrobial effect.

Echinacea tincture Echinacea is a herbal plant whose components are included in more than 200 various medications. Stimulates the general immunity of the body, increases resistance to the effects of pathogenic microorganisms (both bacteria and viruses, fungi).

The beneficial effects of Echinacea for lymphadenitis are due to:

increased migration of lymphocytes to the site of inflammation;
increased phagocytic activity of leukocytes;
facilitating the release of biologically active substances at the site of inflammation.

You can buy echinacea tincture at a pharmacy or prepare it yourself. To do this, you need to pour 100 grams of dry and crushed echinacea roots into 500 ml of 60% alcohol and place it in a place protected from light. Leave for 14 days, then strain through cheesecloth. Store the tincture in a place protected from light at a temperature not exceeding 20ºС.

Echinacea tincture can be used:

Externally. A compress with Echinacea tincture is usually used. To do this, you need to dilute 10 - 20 ml of the tincture with warm (not hot!) water in a ratio of 1:2, moisten a bandage or gauze in it and apply a compress to the source of inflammation overnight. It is not recommended to use this method for more than 5 - 7 days.
Inside. Adults take 20–40 drops of tincture dissolved in 100 ml of warm water, 1–2 times a day. Dose for children – 5 – 10 drops 1 – 2 times a day.

Surgical methods of treatment Surgical treatment is resorted to in the event of the development of purulent complications of lymphadenitis - abscess and adenophlegmon. Under local or general anesthesia, the purulent focus is opened, pus and destroyed tissue are removed. The prevalence of the purulent process and the degree of damage to nearby organs and tissues are determined. At the end of the operation, the source of suppuration is washed with antiseptic solutions (for example, furatsilin), the wound is sutured and drained - a special tube (drainage) is installed into the wound cavity, through which inflammatory fluid and pus flow out, and various antiseptic solutions can also be injected.

Cervical lymphadenitis is manifested by acute or chronic inflammation of the lymph nodes located in the neck. This disease immediately manifests itself typical symptoms, such localization is easy to diagnose, so treatment can be started on time to prevent complications. The cause of cervical lymphadenitis in young children and adults is often diseases of the oral cavity caused by viral and bacterial microorganisms. A distant purulent focus can also become a factor in the development of the disease.

Causes

Damage to regional lymph nodes is often preceded by a purulent process in the facial area. Among the most common causative agents of the disease are staphylococci and streptococci. Depending on the causative factor, lymphadenitis is classified into specific and nonspecific. In the first case, the cause will be a severe infection, diseases such as tuberculosis, diphtheria and many others. Nonspecific inflammation occurs when an infectious agent directly enters the lymph node through wounds in the neck without aggravating pathologies.

People at risk include people with a weakened defense mechanism, children with frequent infectious diseases, adults who work with animals, land and contaminated water. More often diagnosed in people over 18 years of age.

Risk factors:

infection in the oral cavity and nasopharynx;
pathologies of the endocrine system, especially the thyroid gland;
immunodeficiency, HIV;
complicated allergic reaction;
violation of metabolic processes;
alcohol abuse.

Cervical lymphadenitis is not a contagious disease; it is a secondary process and develops as a complication of an advanced bacterial or viral process.

The treatment of lymphadenitis is carried out by a surgeon, ENT specialist, pediatrician, infectious disease specialist and other specialists, depending on the consequences and associated disorders in the body.

Stages of inflammation

The inflammation is acute, then gradually progresses to chronic stage. Depending on the state of the immune system, clear signs may be absent at the initial stage of the pathology, then lymphadenitis is diagnosed already at the chronic stage.

Stages of acute cervical lymphadenitis:

Serous. Develops after the pathogen penetrates the lymph nodes. Accompanied by moderate symptoms without severe intoxication of the body. The temperature rarely rises to 38 degrees, the prognosis for treatment is favorable.
Purulent. Occurs when damaged by bacteria. Manifests itself with severe symptoms with an increase in temperature to 39 degrees. Immediate surgical treatment is required.
Complicated. Without surgery, the infection spreads to neighboring lymph nodes. Adenophlegmon appears, an inflammation of the deep layers of the skin.

The transition to the chronic stage is accompanied by a subsidence of clinical manifestations, pronounced symptoms disappear, but intoxication of the body continues, which is accompanied by constant weakness, lack of appetite, low-grade body temperature.

Forms of the disease

Depending on the pathogen, specific and nonspecific lymphadenitis are distinguished. According to the intensity and duration of the pathology, acute, chronic, complicated and recurrent pathology are noted.

Features of the course, depending on the etiology:

nonspecific inflammation occurs against the background of a fungal or viral infection entering the lymph node, is easier to treat, and less likely to lead to complications;
specific inflammation is a sign of severe pathology, including tuberculosis, syphilis, typhoid fever and the plague.

A complicated form of inflammation in a small child and adults can result in the spread of pathology to other lymph nodes, which will lead to a serious illness - generalized lymphadenitis. From less dangerous consequences One can distinguish adenophlegmon and exacerbation of existing diseases against the background of decreased immunity.

Symptoms

General signs of the disease:

in the acute form, the temperature rises;
weakness, poor sleep and lack of appetite;
neurological symptoms (migraine, apathy, dizziness);
intoxication.

At the initial stage of the disease, enlargement and thickening of regional lymph nodes can be observed. On palpation they are painful and adherent to the surrounding tissues. This is the serous stage of the disease, if you do not seek help, the symptoms increase, swelling of the lymph nodes persists for several weeks, and the process becomes chronic.

Symptoms of chronic lymphadenitis:

swelling of the lymph nodes;
temperature rise to 37.5-38 degrees;
malaise, drowsiness, loss of sleep;
mild pain during palpation.

At the chronic stage, the symptoms are poorly distinguishable, the body “gets used to it” and fewer resources are spent on fighting the disease. This leads to slow poisoning by decay products and areas of necrosis.

As purulent tissue damage occurs, external signs of inflammation increase and at one point the disease worsens. The transition to the purulent stage will be indicated by severe pain and pulsation during palpation, swelling of the lymph nodes, which are already fused with the surrounding tissues. Body temperature rises to 38 degrees and above, the condition becomes life-threatening.

In children, lymphadenitis is more active and moves faster from one stage to another. More often in a child one can observe inflammation of the submandibular nodes and the spread of the pathological process to the neck.

Diagnostics

During an external examination, the doctor pays attention to the affected lymph nodes and surrounding tissues to identify the causative factor. Clinical analysis blood will show an inflammatory process, an increase in the level of lymphocytes, and if lymphadenitis is not complicated by other disorders, treatment begins immediately. When the doctor sees changes in other organs, instrumental diagnostics and additional tests are prescribed.

A comprehensive examination includes:

clinical blood test;
puncture, histological examination of the node material;
chest x-ray if tuberculosis is suspected;
ultrasound examination of the abdominal cavity for unknown causes of inflammation;
computed tomography to visualize the focus of the disease and surrounding tissues;
analysis for HIV and hepatitis.

Visiting a doctor should not depend on the stage of the disease. A decrease in swelling and absence of pain does not indicate recovery. At any moment, lymphadenitis can worsen, in which case urgent surgical treatment will have to be performed. The best option would be to visit a doctor when the first symptoms appear: swelling and pain in the neck. In this case, it will be possible to plan a drug therapy regimen and prepare for surgery.

Treatment options

For purulent lymphadenitis, surgical treatment is indicated. The lesion is opened, the contents removed, treated and drained. Then symptomatic treatment is prescribed.

Drug therapy is carried out depending on etiological factor. Symptomatic medications for pain relief, anti-inflammatory and restorative drugs are prescribed. The doctor prescribes antibacterial drugs. During the period when symptoms subside, you can undergo physiotherapeutic procedures, including UHF therapy, galvanization and medicinal electrophoresis.

Prevention

For the primary prevention of cervical lymphadenitis, it is important to promptly treat inflammatory and purulent diseases in the face and chest. Considering the risk of the disease occurring against the background of oral diseases, it is necessary to regularly visit the dentist for professional hygiene and sanitation.

Pathogenic microflora accumulates in hard dental deposits, which can trigger inflammation of the gums and periodontium. Without treatment in case of weakened immunity, this threatens the spread of infection to regional lymph nodes and bone tissue.

Prevention includes:

taking vitamin complexes;
treatment of wounds and scratches on the skin;
treatment of boils, abscesses and other foci of purulent infection.

It is not allowed to treat cervical lymphadenitis at home without first being examined by a doctor. Warm compresses and many other traditional medicine methods can lead to the spread of infection and blood poisoning.

If the disease process progresses and develops periadenitis , then the described symptoms may worsen. Painful sensations become sharper, the skin over the lymph nodes becomes hyperemic , and when palpating the nodes the patient feels pain. Lymph nodes, which previously could be very clearly palpated, now merge with each other and with the surrounding tissues, and they also become immobile.

Inflammatory processes in the lymph nodes they are characterized by their productive nature. They turn into a purulent form in fairly rare cases. Among the manifestations of chronic nonspecific lymphadenitis, the following symptoms stand out: the lymph nodes enlarge and thicken, the pain in them is mild, they do not adhere to each other. The lymph nodes remain in this state for quite a long period of time, later the connective tissue grows inside and they become smaller.

At tuberculous lymphadenitis as general illness appears . Lymphadenitis in children can manifest itself just during the period of primary tuberculosis. Microbacterium tuberculosis can cause tuberculosis of peripheral lymph nodes. The infection can spread in different ways. Yes, she can penetrate through tonsils . Most often, the infection penetrates through the lymphohematogenous route, spreading from the affected lymph nodes.

If the disease begins acutely, the patient experiences a sharp rise in temperature and symptoms of tuberculosis appear. intoxication , the lymph nodes become larger and manifest inflammatory-necrotic changes . As a special sign of tuberculous lymphadenitis, which distinguishes it from other forms, the presence of periadenitis is noted. They appear very rarely. Most often, lesions appear on the cervical, submandibular and axillary nodes. Chronic lymphadenitis in children sometimes develops in parallel with -,. At the very beginning of development, lymphadenitis appears in children at the locations of the lymph nodes. When pressing on it, the child may feel pain. And after a few days, the inflammation spreads to nearby tissues. The lymph node becomes difficult to palpate, the tissues become denser. If you have such symptoms, you should immediately contact your pediatrician.

Diagnosis of lymphadenitis

To make an appropriate diagnosis, the doctor is guided by the clinical picture, taking into account the anamnestic information. Superficial lymphadenitis (inguinal , cervical lymphadenitis ) the doctor determines quite easily. It is more difficult to diagnose lymphadenitis, the complication of which is periadenitis , and the inflammatory process involves the adipose tissue between the muscles, the cellular spaces of the mediastinum and the retroperitoneal space.

To establish a differential diagnosis, it is important to know where the primary purulent-inflammatory focus is located. It is important to differentiate chronic nonspecific lymphadenitis with enlarged lymph nodes in other infectious and other diseases. In the process of recognizing chronic lymphadenitis, the doctor evaluates a whole range of symptoms of the disease. If diagnosis is difficult, then the lymph node should be removed or removed for subsequent histological examination. Such a study of the material means a lot in the process of differential diagnosis of chronic lymphadenitis and identification.

Diagnosis specific lymphadenitis» is established based on the results comprehensive examination patient. This takes into account the patient’s contact with patients. tuberculosis , his reaction to, the presence or absence of tuberculosis in the lungs and other organs.

You can also establish the correct diagnosis using puncture of the affected lymph node. X-rays can be used to determine formation in nodes calcifications , which are visible on an x-ray as dense shadows on the cervical soft tissues, under the jaw, in the armpits and groin area. It is important to differentiate tuberculous lymphadenitis from nonspecific purulent lymphadenitis, metastases of malignant tumors, lymphagranulomatosis .

If inguinal lymphadenitis is suspected, a thorough examination of the rectal area and genital organs should be performed to determine the condition of the pelvic and hip bones. It is important to establish the correct diagnosis, because in some cases inguinal lymphadenitis is defined as strangulated hernia .

Treatment of lymphadenitis

Treatment lymphadenitis of acute nonspecific form is prescribed depending on the stage at which it begins. If only available initial forms disease, then treatment of lymphadenitis is carried out using conservative methods. So, the affected organ should be at rest; treatment is UHF therapy , therapy of the source of infection (i.e. autopsy, autopsy purulent leaks ), is also carried out antibiotic therapy .

For purulent lymphadenitis, a surgical treatment method is used: abscesses are opened and removed. , held wound drainage . All subsequent measures are carried out the same as in the process of treating purulent wounds.

When treating lymphadenitis of a chronic nonspecific form, it is necessary first of all to eliminate the underlying disease, which became the source of this form of lymphadenitis. Treatment of specific lymphadenitis is carried out depending on the nature of the damage to the lymph nodes, as well as the presence of tuberculous changes in other organs. If the process is active, first-line drugs are used: Tubazid , in combination with or thrombophlebitis , the purulent process can spread to the cellular spaces, and the patient may also develop metastatic foci of purulent infection.

Prevention of lymphadenitis

To prevent lymphadenitis, it is necessary to avoid injuries and wounds, and to treat pyoinflammatory diseases rationally. In patients with axillary lymphadenitis, it may appear sepsis , subpectoral phlegmon .

List of sources

Dvoretsky L.I. Differential diagnosis for lymphadenopathy. // Directory of a polyclinic doctor. - Volume 03. - No. 2. - 2005.
Lymphadenopathy. Guide for doctors // Ed. Nikulicheva V.I. - Ufa: Bashkortostan. - 2001.
Melikyan A.L. Non-tumor lymphadenopathy: Dis. ...Dr. med. Sci. M., 2008