lymphadenitis

What is Lymphadenitis?

Lymphadenitis is an infection of the lymph nodes, also known as lymph glands. It is a complication of certain bacterial infections.

• Lymph nodes are small, bean-shaped structures that are part of the body's immune system.
• They help to filter out bacteria and other foreign substances from the blood.
• When a lymph node becomes infected, it can become inflamed and enlarged, leading to symptoms such as pain, swelling, and redness.

Causes of Lymphadenitis

Lymphadenitis is usually caused by an infection with certain types of bacteria. The most common causes include:

• Staphylococcus aureus (staph) infections
• Streptococcus pyogenes (group A strep) infections
• Other bacterial infections such as E. coli and Klebsiella

Symptoms of Lymphadenitis

The symptoms of lymphadenitis can vary depending on the severity of the infection, but common signs include:

• Infected lymph nodes that are enlarged and tender to the touch
• Pain or tenderness in the affected area
• Redness and swelling around the infected node
• Fever

References:

• [1] Lymphadenitis is an infection of the lymph nodes (also called lymph glands). It is a complication of certain bacterial infections. [3]
• Lymph nodes are small, ovoid nodules normally ranging in size from a few millimeters to several centimeters in diameter. [4]
• Infected lymph nodes enlarge and are usually tender and painful. Sometimes, the skin over the infected nodes is inflamed, looks red, and feels warm to the touch. [6]

Common Signs and Symptoms of Lymphadenitis

Lymphadenitis, an infection of the lymph nodes, can manifest in various ways. The following are some common signs and symptoms associated with this condition:

• Enlarged, sore lymph nodes: This is the primary symptom of lymphadenitis, where one or more lymph nodes become swollen, tender, and painful to touch.
• Fever: Many people experience a fever as their body tries to fight off the infection.
• Chills: Feeling cold or experiencing chills can be another symptom of lymphadenitis.
• Pain and tenderness: The affected lymph node(s) may be painful to the touch, and the surrounding area might feel tender.
• Redness on the skin: In some cases, the skin overlying the infected lymph node may become red, inflamed, or swollen.

Other Possible Symptoms

While not as common, other symptoms that may occur in some individuals with lymphadenitis include:

• Night sweats
• Runny nose and sore throat, which can be indicative of an upper respiratory infection
• Headaches and neck pain or discomfort

It's essential to note that these symptoms can vary from person to person, and not everyone will experience all of them. If you suspect you have lymphadenitis, it's crucial to consult a healthcare professional for proper diagnosis and treatment.

References:

[3] Lymphadenitis mainly causes enlarged, sore lymph nodes. A lymph node is considered enlarged if it is about 1/2 inch ...

[4] The main symptom of lymphadenitis is a swollen, very painful lymph node. Other symptoms include: fever; chills; feeling sick; redness on the ...

[6] Infected lymph nodes enlarge and are usually tender and painful. Sometimes, the skin over the infected nodes is inflamed, looks red, ...

[8] Symptoms may include: Red, tender skin over lymph node; Swollen, tender, or hard lymph nodes; Fever.

[9] Result: earache pain | swollen neck | neck lumps, masses, or tumors | headaches | neck pain, aches, soreness, or discomfort

Lymphadenitis, an inflammation of the lymph nodes, can be diagnosed through various diagnostic tests.

Imaging Studies

• An ultrasound of the stomach area is often used to diagnose mesenteric lymphadenitis [2].
• A CT scan of the stomach area also might be used to visualize the affected lymph nodes [2].

Laboratory Tests

• Blood tests are essential in diagnosing lymphadenitis, including:
  • Complete blood count (CBC) with a careful evaluation of the peripheral blood smear [4]
  • Lactate dehydrogenase (LDH) and uric acid levels [4]
  • Chest radiography to rule out any underlying conditions [4]
• Blood tests may also be used to check for signs of infection, such as:
  • White blood cell count
  • ESR (erythrocyte sedimentation rate)
  • C-reactive protein [6]

Biopsy and Other Tests

• A biopsy may be performed to obtain tissue samples from the affected lymph nodes [3].
• Blood tests may also be used to check for specific bacteria or viruses that may be causing the lymphadenitis [8].

Physical Examination

• A careful history and physical examination are mandatory for diagnosis, including:
  • Evaluation of signs of infection near the enlarged lymph nodes [9]
  • Assessment of any underlying conditions that may be contributing to the lymphadenitis [7]

These diagnostic tests can help healthcare providers determine the cause and extent of lymphadenitis, allowing for proper treatment and management.

Treatment Options for Lymphadenitis

Lymphadenitis, an inflammation of the lymph nodes, can be effectively treated with antibiotics in most cases. The choice of antibiotic depends on various factors such as the severity of the infection, patient's age and overall health, and the presence of any underlying medical conditions.

• Narrow-spectrum beta-lactam therapy: Uncomplicated lymphadenitis can be managed with narrow-spectrum beta-lactam therapy (such as flucloxacillin) with low rates of complications [6].
• Oral antibiotics: Many patients with lymphadenitis may respond to outpatient therapy with oral antibiotics. However, some patients may develop abscesses that require more aggressive treatment [5].
• Intravenous antibiotics: Treatment with intravenous antibiotics (given into a vein) is usually only needed for more severe cases of lymphadenitis or when the infection does not respond to oral antibiotics [9].

Commonly Used Antibiotics

Some commonly used antibiotics for treating lymphadenitis include:

• Amoxicillin
• Cephalosporins
• Doxycycline
• Erythromycin
• Penicillin G
• Ceftriaxone
• Vancocin (vancomycin)
• Zithromax (azithromycin) [2]

Empirical Treatment

In cases where the diagnosis is uncertain, empirical treatment with antibiotics such as amoxicillin or cephalexin may be initiated. If initial non-operative management is chosen, a narrow spectrum regimen (i.e., without vancomycin) is encouraged to facilitate transition to oral therapy [4].

Prognosis and Recovery

Prompt treatment with antibiotics usually leads to a complete recovery from lymphadenitis. However, it may take weeks or even months for the infection to fully resolve [7].

Differential Diagnoses of Lymphadenitis

Lymphadenitis, an inflammation of the lymph nodes, can be caused by various factors, making its differential diagnosis crucial for proper treatment. Here are some possible causes:

• Systemic conditions: In patients with generalized lymphadenitis, systemic conditions such as infections (e.g., tuberculosis), autoimmune disorders (e.g., rheumatoid arthritis), and malignancies (e.g., lymphoma) should be considered [1].
• Malignancy: Lymphadenopathy can be a sign of underlying malignancy, including cancers like lymphoma, leukemia, or metastatic disease [3][5].
• Infections: Infections such as bacterial (e.g., cat-scratch disease), viral (e.g., HIV), and fungal (e.g., histoplasmosis) can cause lymphadenitis [2][4][6].
• Autoimmune disorders: Conditions like sarcoidosis, lupus, or rheumatoid arthritis can lead to lymphadenopathy [3][5].
• Medications and iatrogenic causes: Certain medications or medical procedures can cause lymphadenopathy as a side effect [1][3].

Key Factors in Differential Diagnosis

To narrow down the differential diagnosis of lymphadenitis, it's essential to consider:

• A thorough clinical history
• Physical examination findings
• Laboratory studies (e.g., blood tests, imaging)
• Imaging results (e.g., ultrasound, CT scans)

By considering these factors and possible causes, healthcare professionals can arrive at a more accurate differential diagnosis for patients with lymphadenitis.

References: [1] Apr 4, 2024 — Generalized lymphadenitis. In a patient with generalized lymphadenitis, the differential includes systemic conditions. Associated medication ... [2] by R FERRER · 1998 · Cited by 425 — Distinguishing between localized and generalized lymphadenopathy is important in formulating a differential diagnosis. [3] by HL GADDEY · 2016 · Cited by 260 — Etiologies include malignancy, infection, and autoimmune disorders, as well as medications and iatrogenic causes. The history and physical ... [4] Mar 21, 2024 — Differential Diagnoses · Acute Complications of Sarcoidosis · Acute Lymphoblastic Leukemia (ALL) · Brucellosis · Coccidioidomycosis and Valley ... [5] Etiologies of lymphadenopathy can include malignancies, infections, autoimmune disorders, miscellaneous/unusual conditions, and iatrogenic causes.​​​ While the ... [6] Aug 1, 2024 — A broad differential diagnosis can be narrowed with a thorough clinical history, physical examination, laboratory studies, and imaging. [7] by MRCH Portal — Further examination should be guided by history and differential diagnosis. Differential diagnosis. Acute cervical lymphadenopathy. Cervical lymphadenitis ... [8] by HL Gaddey · 2016 · Cited by 260 — Lymphadenopathy is benign and self-limited in most patients. Etiologies include malignancy, infection, and autoimmune disorders, ...