Reactive lymphadenitis with macrofocal hemorrhage. Lymphadenitis - causes, symptoms, treatment of acute and chronic forms of lymphadenitis. Cervical lymphadenitis in children and adults

When the body is fighting an infection or injury, lymph nodes sometimes swell. Doctors call this reactive lymph node hyperplasia ( reactive lymphadenitis), which is usually not dangerous.

What is the function of the lymph nodes?

Lymph nodes contain B and T lymphocytes, which are the main types of white blood cells. These cells help the body fight bacteria and viruses. Lymph nodes also carry lymph fluid and connect through lymphatic vessels. Together, the lymph nodes and lymph vessels make up the lymphatic system, which is an integral part of the immune system.

When something goes wrong in the body, the lymphatic system produces cells to fight bacteria, viruses, and other causes of illness. Then the lymph nodes begin to swell. Lymph nodes can also enlarge in response to injury, and sometimes they enlarge due to cancer.

Lymph nodes usually enlarge near the injury site. For example, lymph nodes near the pinna may swell when a person develops an ear infection, while lymph nodes in the neck may swell in response to strep throat.

Symptoms of reactive lymphadenitis

The main symptom of a reactive lymph node is swelling. Sometimes the area around the lymph node also swells up. The body contains hundreds of lymph nodes, and they are most often crowned on the neck and around the face, in the groin and armpits. When lymph nodes become enlarged due to infection or injury, they:

• less than 1.5 centimeters in diameter;
• soft;
• mobile.

Swelling is usually only seen in a specific lymph node or group of lymph nodes. A person who has many enlarged lymph nodes throughout the body may have a severe systemic infection or certain types of cancer.

Reactive lymph nodes often accompany an infection or injury, and a person may notice other symptoms of an infection, such as:

• fever;
• pain near the injury
• disease symptoms;
• signs of infection near the injury, such as redness or swelling;
• nausea.

An enlarged lymph node does not necessarily mean that the infection is serious. In some people, swollen lymph nodes do not cause other symptoms.

The reasons

The most common causes of swollen lymph nodes are:

• infections such as skin, ear or sinus infections;
• exposure to allergens;
• skin injury or irritation;
• dental health problems such as cavities or stomatitis
• exposure to bacteria or viruses;
• mononucleosis, a highly contagious virus that can cause various lymph nodes to swell;
• skin irritation, such as from acne or rashes.

Sometimes immune diseases cause swollen lymph nodes. Less common causes of a reactive lymph node condition include:

• metastases from cancer that spreads from the main location to neighboring lymph nodes;
• lymphoma - cancer of the lymph nodes;
• sepsis, which is a type of systemic infection that can become life-threatening.

When a person has cancer or a severe infection, they may have many swollen lymph nodes. Swelling in one lymph node is less likely to be a sign of a serious problem.

Reactive lymphadenitis - treatment

Proper treatment for swollen lymph nodes depends on the cause. When a person has no symptoms of an infection, the swelling often goes away on its own. When infections cause lymph node reactivity, a person may need antibiotics. More severe infections may require antibiotics to be given intravenously. People with weak immune systems may need to be hospitalized for even relatively minor infections.

Treatment is available for many forms of cancer, especially if a doctor diagnoses them early. Depending on the type of cancer, a doctor may recommend removal of lymph nodes, chemotherapy, or radiation.

When to See a Doctor

Enlarged lymph nodes can be worrisome, especially if the cause is unclear. However, in most cases, swollen lymph nodes are a sign that the body's immune system is working well. A person with HIV or AIDS who is taking drugs that suppress the immune system, or if the person has a weak immune system, should see a doctor if their lymph nodes are swollen.

Most people can wait 1-2 weeks to see if symptoms go away. You should see your doctor within a day or two if:

• enlarged lymph nodes appear after a skin injury;
• enlarged lymph nodes in a newborn or infant;
• swollen lymph nodes are accompanied by fever.

You can wait about 2 weeks to see if the swelling goes down. If the swelling persists, or if the lymph node becomes hard or larger than 1.5 cm in diameter, see your doctor.

Forecast

Lymph nodes enlarge for many reasons, most of which are relatively harmless. However, a doctor can determine if a person has a serious infection that needs treatment, as well as evaluate other potential causes of reactive lymph nodes.

Sometimes the lymph nodes remain enlarged long after the infection has gone. If the lymph node does not change or become hard, this is usually not a cause for concern.

Regarding the reactive node in the armpit, this means that the lymph node has increased as a result of a reaction to any intervention or infection. In any case, you should be guided by the opinion of the attending physician.

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Reactive lymphadenitis

Reactive lymphadenitis (inflammation of the lymph glands) is a dependent disease. This pathological process is a concomitant symptom of various diseases, both bacterial and viral etiology.

Reactive lymphadenitis characterizes the initial phase (reactive) of disorders, in the form of a primary reaction to the focus of infection in the human body.

The treatment of lymphadenitis itself will not be effective without determining the exact cause that caused the pathological condition.

What is reactive lymphadenitis

Reactive lymphadenitis is part of a general chain of painful changes that are almost asymptomatic. Accordingly, a reactive change in the lymph nodes is the initial manifestation of the disease, the first sign of the body's fight against infection.

For example, with a latent form of tuberculosis (latent), the pathogen (Koch's wand) can remain in an inactive phase for a long time. It can be completely neutralized by the body's defenses without causing any harm to a person.

However, often as a result of a number of negative influences, a dormant infection can become active. Then, with a high probability, the lymph nodes, as an integral part of the immune system, will be the first to take the hit.

The following factors can provoke the appearance of reactive lymphadenitis:

• Chronic inflammation.
• Low immunity.
• Frequent colds.
• Hypothermia.
• Long stay in a stuffy, unventilated room.
• Lack of sunlight.
• Chronic emotional overstrain, severe stress, can trigger the mechanisms of a dormant infection, for example, Koch's bacillus in tuberculosis.
• Malnutrition, mono-diets.
• Frequent fatigue.
• Sedentary lifestyle.
• Bad habits (alcohol abuse, smoking).
• Avitaminosis.
• Often, reactive lymphadenitis occurs in children under 6 years of age due to immature immunity, as a reaction to any focus of inflammation in the child's body. It can be rhinitis, otitis and acute respiratory viral infections.

Clinical manifestations of reactive lymphadenitis

Reactive inflammation in the lymph nodes is a concomitant symptom of a disease.

Often the zone of inflamed lymph nodes indicates a local pathological process in the same area, that is, it is nearby, near the focus of inflammation.

The initial sign of reactive lymphadenitis is reactive lymphadenopathy, as the very first reaction of the body in response to infection.

It can manifest itself by an increase in a different number of lymph nodes and their mild soreness.

Left unattended, this pathological process is aggravated by lymphadenitis, which can be recognized by the following signs:

• Enlargement, swelling of the lymph nodes.
• Lymph glands are painful on palpation and pressure.
• Swelling and redness of the skin over the affected lymph nodes.
• The glands are not soldered to the skin and to each other, dense to the touch.

Depending on the factors that triggered the development of reactive lymphadenitis, it may be accompanied by the following manifestations:

• General weakness.
• Elevated or subfebrile (37 ° C) body temperature.
• Headache.
• Sleep disturbance.
• Cough.
• Rhinitis.

Important! If there is severe pain in the area of ​​​​one lymph node or a whole group of them, an increase in body temperature of more than 38.5 ° C, rapid breathing and heartbeat (signs of purulent lymphadenitis), it is necessary to urgently consult a doctor

The fact is that with reactive lymphadenopathy after treatment of the underlying disease, the lymph nodes almost always return to normal on their own.

However, if the primary pathology is left without appropriate therapy or the treatment is insufficient, the process may be complicated by painful changes in the lymph glands themselves.

In this case, there may be a proliferation of lymphoid tissue, with the development of reactive hyperplasia in the lymph nodes, with a violation of their function.

This can cause their suppuration or the spread of infection to nearby tissues and the entire human body.

What diseases and conditions can be accompanied by reactive inflammation of the lymph glands

Reactive lymphadenitis may accompany diseases such as:

• Tuberculosis. Parotid and axillary nodes often become inflamed. Lymphadenopathy of the cervical lymph nodes may also occur.
• Angina.
• Tonsillitis.
• Pathological process in the oral cavity (caries, stomatitis).
• Acute mastitis caused by staphylococcus and streptococcus bacteria.
• AIDS.
• Syphilis.
• Diseases of the female and male genitourinary system. For example, hyperplastic (tissue growth). Abnormal changes in the mucous membrane of the uterus (polyps, endometrial hyperplasia). A woman often manifests an increase in inguinal lymph nodes.
• Enterocolitis.
• Flu.
• Otitis.
• Sinusitis.
• Teething in infants.
• Adenoiditis in children.
• Bubonic plague.

Which specialist should be contacted if the lymph nodes are enlarged or inflamed for no apparent reason

Reactive hyperplasia of the lymph nodes is dangerous because it can go unnoticed by the patient.

With general weakness, increased fatigue, subfebrile body temperature, sweating, as well as with any ailment, it is necessary to pay attention to the lymph nodes.

With their increase, pain during palpation, first of all, you need to consult a general practitioner.

After the examination, the doctor can give a referral to such specialists as:

What research can a doctor prescribe

If reactive lymphadenitis is detected, in order to understand the cause of the disease and determine the state of the lymph glands themselves, the doctor may prescribe the following tests:

• General analysis of urine and blood (with formula).
• Blood for syphilis, HIV, viral hepatitis.
• Bacteriological examination of blood, urine. To identify pathogens, to sensitivity to antibiotics.
• Tumor markers.
• Blood for hormones.
• Biochemistry.
• Cytological and bacteriological analysis of discharge from the vagina, urethra.
• Bacteriological culture of sputum.
• Puncture of the lymph node with subsequent cytological examination.

Also, a doctor may recommend a patient with reactive lymphadenitis to undergo such instrumental diagnostics as:

• X-ray (fluorography, mammography, urography).
• Computed tomogram (CT).
• Magnetic resonance imaging (MRI).
• Gastroduodenoscopy.
• Sigmoidoscopy.
• Bronchoscopy.

Treatment

Reactive lymphadenitis can be the initial symptom of many diseases. Accordingly, his treatment will be based on the elimination of the source of infection itself.

If the bacterial flora acts as an infectious agent of the pathological process, then antibiotic therapy is used first of all.

A fungal infection is treated, for example, with drugs such as:

To combat a viral infection, the following antiviral agents will be effective:

Important! You can not self-medicate reactive lymphadenitis. This pathology can be a manifestation of various diseases, which can only be determined by a doctor. All of the above drugs are prescribed exclusively by a doctor.

Prevention

Preventive measures for reactive lymphadenitis include the following:

• For any symptoms of malaise (subfebrile body temperature, sweating, chills, fatigue) that last more than 5 days, consult a doctor.
• Women visit a mammologist and gynecologist once a year. After forty years, undergo a mammogram every 12 months, visit a gynecologist every six months.
• Men undergo preventive examinations by a urologist once a year.
• In case of prolonged weakness, prolonged cough, consult a doctor.
• In wet slushy weather, during epidemics, to increase immunity, you need to take decoctions and tinctures of herbs that strengthen the body's defenses. For example, such as:
  • Tinctures of echinacea, eleutherococcus can be purchased at the pharmacy. Take after consultation with the doctor in accordance with the attached instructions.
  • Rosehip decoction. This drink can be prepared using a thermos in the following way:

1. Rinse a thermos with boiling water.
2. Place in it 2 tablespoons of rose hips washed with running water.
3. Pour in a liter of freshly boiled water.
4. Insist 8 hours.
5. Then strain through 4 layers of gauze into a liter glass container.
6. Fill in the missing volume with boiled water.

The berries left in the thermos do not need to be thrown away. They can be poured a second time with boiling water and used according to the above scheme.

Also, for the normal functioning of the immune system, the prevention of various diseases, it is necessary to lead a healthy lifestyle. It is necessary to avoid physical and emotional overstrain, engage in feasible physical education, eat well, do not neglect rest, sleep, and be outdoors as often as possible.

Snoring is always an unpleasant, annoying sound.

Peculiarities of inflammatory diseases of children.

The human lymphatic system is directly connected with.

Despite the rapid development of medicine, many

HIV infection is one of the most dangerous diseases.

The information on the site is provided for informational purposes only, does not claim to be reference and medical accuracy, and is not a guide to action. Do not self-medicate. Consult with your physician.

Ultrasound of the lymph nodes. Reactive lymphadenitis

Very often, the lymph nodes increase due to a non-specific inflammatory process - reactive lymphadenitis (non-tumor nature) occurs, and ultrasound data of the lymph nodes are very important as a differential diagnosis in this case.

For the convenience of diagnosis, all nonspecific reactive lymphadenitis is divided as follows:

1. According to the course of the disease: 1) acute; 2) subacute; 3) chronic lymphadenitis.
2. By localization of the process: 1) isolated; 2) regional; 3) widespread; 4) generalized lymphadenitis.

Those reactive changes that occur in response to various pathological processes in the body (such as an inflammatory process or vaccination), contribute to the appearance of such ultrasound signs as: an increase in the size of the lymph node, tension of its capsule, increased vascular pattern of the lymph node, expansion its cortical and pericortical zones, edema and rupture of the capsule, expansion of the sinuses is determined, as well as single anechoic structures of a “cystic” nature can be found in the lymph node, and their abscess formation can occur in the future. It should also be taken into account that changes in the lymph nodes that are located next to the tumor, with ultrasound of the lymph nodes, can also manifest themselves as a non-specific inflammatory reaction.

Hyperplastic nodes according to ultrasound of the lymph nodes are more often oval, their echostructure is hyperechoic, with a thin hypoechoic rim, which occupies about 1/3 of the node; if we talk about the size of the affected lymph nodes, then the size of the lymph nodes in the inguinal regions, as a rule, is not more than 3.5x1.5 cm, in other anatomical areas - 2.5x1 cm. The ratio of the thickness to the length of the lymph nodes with hyperplasia does not exceed 1: 2. The contours of such lymph nodes are clear, even. With the development of reactive lymphadenitis, the anatomical architecture of the node is preserved. If there are hypoechoic nodes of oval or round shape, with even clear contours, small sizes, sometimes with a hyperechoic center, which occupies less than 2/3 of the node, such lymph nodes can be both hyperplastic and metastatic.

The vessels in the inflamed lymph node are more dilated compared to the vessels of the metastatic lymph node, which, on the contrary, are usually compressed by tumor cells.

In both normal and reactively altered lymph nodes during an inflamed process, visible vessels are more often located in the region of the gate of the lymph node or are not detected at all. In a large hyperplastic lymph node, the vascular pattern in its peripheral parts is always ordered, blood vessels are determined along the capsule, and are also located radially from the gate to the periphery.

With node hyperplasia, if adequate treatment of lymph nodes with a positive effect was carried out, they become less contrasting, and there is also a decrease in their size. In chronic lymphadenitis, a thickening of the capsule of the lymph nodes is often noted, signs of soldering it with the tissues surrounding the node.

Hyperplasia of the lymph nodes

Lymph node hyperplasia is a serious problem in clinical medicine.

In fact, hyperplasia (Greek - over education) is a pathological process associated with an increase in the intensity of reproduction (proliferation) of tissue cells of any kind and localization. This process can start anywhere and results in an increase in tissue volume. And, in fact, such hypertrophied cell division leads to the formation of tumors.

However, it should be noted that lymph node hyperplasia is not a disease, but a clinical symptom. And many experts attribute it to lymphadenopathy - an increased formation of lymphoid tissue, which causes their increase. And the lymph nodes are known to enlarge in response to any infection and inflammation.

ICD-10 code

Causes of lymph node hyperplasia

When characterizing the causes of lymph node hyperplasia, it is necessary to clarify that lymphoid or lymphatic tissue (consisting of reticuloendothelial cells, T-lymphocytes, B-lymphocytes, lymphatic follicles, macrophages, dendrites, lymphoblasts, mast cells, etc.) is located not only in the parenchyma of the organs of the lymphatic system : regional lymph nodes, spleen, thymus, pharyngeal tonsils. This tissue is also present in the bone marrow, in the mucous membranes of the respiratory, gastrointestinal and urinary tracts. And if there is a focus of chronic inflammation in any organ, clusters of lymphoid tissue cells appear there too - to protect the body from an attacking infection.

But we are interested in the regional lymph nodes, which provide the production of lymphocytes and antibodies, lymph filtration and regulation of its currents from the organs. Today, the causes of lymph node hyperplasia are considered as the reasons for their increase, which is an immune response to any pathological process that changes both the dynamics of tissue metabolism of the lymph node and the ratio of certain cells. For example, when a lymph node reacts to genetically distinct cells (antigens), the production of lymphocytes and mononuclear phagocytes (macrophages) increases; when bacteria and microbes enter the lymph nodes, their metabolic products and neutralized toxins accumulate. And in the case of oncology, hyperplasia of the lymph nodes can involve any of their cells in the pathological process of proliferation. This causes an increase in size, a change in the shape and structure of the fibrous capsule of the lymph node. Moreover, the tissues of the lymph nodes can grow outside the capsule, and in the case of metastases from other organs, they can be displaced by their malignant cells.

Based on this, lymph node hyperplasia can be of infectious, reactive or malignant origin.

Hyperplasia of lymph nodes of infectious etiology

Hyperplasia of the lymph nodes (in the sense of an increase in their size) is a response to infection in diseases such as strepto- or staphylococcal lymphadenitis, rubella, chicken pox, infectious hepatitis, felinosis (cat scratch disease); tuberculosis, HIV, infectious mononucleosis, cytomegaly, tularemia, brucellosis, chlamydia, syphilis, actinomycosis, leptospirosis, toxoplasmosis.

With nonspecific lymphadenitis - depending on the localization - there is hyperplasia of the lymph nodes in the neck, lower jaw or axillary lymph nodes. An increase in axillary lymph nodes was noted with mastitis, inflammation of the joints and muscle tissues of the upper limbs, brucellosis, felinosis, etc.

For inflammatory processes in the oral cavity and nasopharynx (with actinomycosis, caries, chronic tonsillitis, pharyngitis, bronchitis, etc.), hyperplasia of the submandibular lymph nodes, behind the ear, preglottis and pharynx is characteristic. And with infectious mononucleosis, only the cervical lymph nodes increase.

In the case of rubella, toxoplasmosis, tuberculosis, as well as syphilis, doctors ascertain hyperplasia of the cervical lymph nodes. In addition, in the symptoms of tuberculosis, hyperplasia of the intrathoracic and mediastinal lymph nodes is noted. At the same time, in the lymph nodes, there is a gradual displacement of healthy cells of the lymphoid tissue by necrotic masses of a caseous nature.

Characteristic of tuberculosis and hyperplasia of the mesenteric lymph nodes. In addition, a significant increase in the lymph nodes of the mesenteric part of the small intestine occurs due to the defeat of the gram-negative bacterium Francisella tularensis, which causes tularemia, an acute infectious disease transmitted by rodents and arthropods.

Hyperplasia of the inguinal lymph nodes is noted by doctors with infectious mononucleosis, and toxoplasmosis, brucellosis and actinomycosis, as well as with all infections of the genital area and HIV.

Symptoms of lymph node hyperplasia

Hyperplasia of the lymph nodes, as mentioned above, is a symptom of a wide range of diseases. The most important task is to identify the symptoms of lymph node hyperplasia, confirming or refuting the malignant pathogenesis of increased cell division.

If the lymph node increases rapidly (up to 2 cm or a little more), if pain occurs during palpation, and the consistency of the node is quite soft and elastic, then there is every reason to say that this lymph node hyperplasia has arisen due to an infectious lesion or inflammatory process. This is confirmed by reddening of the skin in the area of ​​the lymph node.

When the lymph node enlarges slowly, there is no pain on palpation, and the node itself is very dense - it is likely that the process is malignant. And with metastases, an enlarged lymph node literally grows into the tissues surrounding it and can form “colonies”.

Localization of the hypertrophied lymph node is also important. Hyperplasia of the submandibular, cervical and axillary lymph nodes speaks in favor of its good quality. What can not be said about hyperplasia of the supraclavicular, lymph nodes of the mediastinum, retroperitoneal and lymph nodes in the abdominal cavity.

Where does it hurt?

What worries?

Reactive lymph node hyperplasia

Reactive hyperplasia of the lymph nodes occurs as a response of the immune system to pathologies of the same immune nature. These pathologies include:

• autoimmune collagenoses (rheumatoid arthritis and polyarthritis, periarteritis nodosa, systemic lupus erythematosus, scleroderma, Hamman-Rich syndrome, Wegener's granulomatosis); - Wagner's disease or dermatomyositis (systemic disease of skeletal and smooth muscles and skin)
• storage diseases (eosinophilic granuloma, Gaucher disease, Niemann-Pick disease, Letherer-Zive disease, Hand-Schüller-Christian disease).

In addition, the reactive form may be associated with serum sickness (allergies to the use of immune serum preparations of animal origin), hemolytic anemia (hereditary or acquired), megaloblastic anemia or Addison-Birmer disease (which occurs when there is a deficiency of vitamins B9 and B12) and chemotherapy and radiation therapy. oncological diseases.

Among autoimmune diseases of the endocrine system, lymph node hyperplasia is characteristic of hyperthyroidism (Graves' disease), the cause of which lies in the increased production of thyroid hormones by the thyroid gland. With this pathology, hyperplasia of the lymph nodes is generalized with increased mitosis of the lymph follicles.

Experts emphasize that reactive lymph node hyperplasia is characterized by significant proliferative activity and, as a rule, affects the lymph nodes in the neck and lower jaw.

From the point of view of cytomorphology, the reactive form has three types, the most common of which is the follicular form.

Follicular hyperplasia of the lymph nodes

Histological studies have shown that a feature of follicular hyperplasia of the lymph nodes is the size and number of secondary follicles that form antibodies, as well as the expansion of their reproduction centers (the so-called light centers), which are significantly higher than the norm of lymphoproliferation. These processes occur in the cortex of the lymph nodes. At the same time, secondary follicles behave quite aggressively, displacing other cells, including lymphocytes.

Follicular hyperplasia of the lymph nodes in the neck is diagnosed as a characteristic symptom of angiofollicular lymphoid hyperplasia or Castleman's disease. With a localized form of this disease, only one lymph node is enlarged, but this is manifested by periodic pain in the chest or in the abdomen, weakness, weight loss, and fever attacks. Researchers attribute the cause of Castleman's disease to the presence of the herpes virus HHV-8 in the body.

Malignant hyperplasia of the lymph nodes

Hyperplasia of the lymph nodes of malignant etiology can affect regional nodes throughout the body. The primary ones are lymphomas.

Prolonged enlargement of the supraclavicular lymph nodes may indicate an oncological disease of the esophagus, stomach, duodenum, intestines, kidneys, ovaries, testicles.

Hyperplasia of the cervical lymph nodes is observed with tumors of the maxillofacial localization, with melanoma in the head and neck. In patients with tumors of the lungs or mammary glands, oncopathology will necessarily manifest itself as hyperplasia of the axillary lymph nodes. In addition, it happens with blood cancer.

Hyperplasia of the cervical and lymph nodes of the mediastinum are characteristic of sarcoidosis (with the formation of epithelioid cell granulomas and their subsequent fibrosis).

With leukemia, with malignant neoplasms in the pelvic organs, metastases of cancer of the prostate, uterus, ovaries, rectum, both hyperplasia of the lymph nodes in the abdominal cavity and inguinal lymph nodes are usually noted.

With Hodgkin's lymphoma, as a rule, there is a persistent increase in the cervical and supraclavicular nodes, as well as hyperplasia of the retroperitoneal and lymph nodes of the abdominal cavity. The significant size of the latter cause violations of the functions of the intestines and pelvic organs. In the case of non-Hodgkin's lymphoma against the background of anemia, neutrophilic leukocytosis and lymphopenia, hyperplasia of the cervical and intrathoracic lymph nodes (near the diaphragm), as well as nodes in the elbow and popliteal folds, is found.

Diagnosis of hyperplasia of the lymph nodes

Diagnosis of lymph node hyperplasia should take into account and correctly evaluate all the factors that led to the occurrence of this syndrome. Therefore, a comprehensive examination is necessary, which includes:

• general blood analysis,
• biochemical blood test (including for toxoplasmosis and antibodies),
• blood immunogram,
• tumor marker analysis,
• general urine analysis,
• a swab from the throat for the presence of pathogenic flora,
• serological tests for syphilis and HIV,
• Pirquet and Mantoux test for tuberculosis,
• Kveim test for sarcoidosis
• x-ray (or fluorography) of the chest,
• ultrasound examination (ultrasound) of the lymph nodes,
• lymphoscintigraphy;
• biopsy (puncture) of the lymph node and histological examination of the biopsy.

In half of the cases, an accurate diagnosis is possible only with the help of a histological examination after taking a sample of the tissues of the lymph node.

What needs to be examined?

How to investigate?

Who to contact?

Treatment of lymph node hyperplasia

Treatment of lymph node hyperplasia depends on the cause of its occurrence, and therefore there is no single therapeutic regimen and cannot be. But, according to doctors, in any case, complex therapy is necessary.

If the enlargement of the lymph node is caused by an inflammatory process, but it is necessary to fight the infection that led to the inflammation. For example, in the treatment of acute lymphadenitis in the early stages of the disease, compresses are used, but with purulent inflammation they are strictly prohibited. Doctors prescribe antibiotics to such patients, taking into account the resistance of specific pathogenic microorganisms to them. Thus, most staphylococci are resistant to drugs of the penicillin group, neutralizing the effect of the drug with the help of the beta-lactamase enzyme. It is also recommended to take vitamins and take a course of UHF therapy.

In the treatment associated with tuberculosis or other specific infection, treatment is prescribed according to the schemes developed for each specific disease.

In the case of a diagnosed autoimmune disease that led to the occurrence of hyperplasia of the lymph nodes, or the malignant nature of the reproduction of lymph node cells, no compresses and antibiotics will help. Keep in mind that in the case of lymph nodes and pathological proliferation of their tissues, self-treatment is absolutely unacceptable!

Prevention of hyperplasia of the lymph nodes - timely examination and treatment, and in case of incurable pathologies - the implementation of all the recommendations of experienced and knowledgeable doctors. Then it is possible not to bring the disease to extremes, when hypertrophied tissues turn into a malignant neoplasm.

Prognosis of lymph node hyperplasia

Any prognosis of lymph node hyperplasia - with such a diverse "range" of its pathogenesis - rests on the root cause. With nonspecific infection, the prognosis is the most positive. However, there are some nuances here: any “elementary” and enlargement and inflammation of the lymph nodes - in the absence of proper diagnosis and adequate treatment - has every chance of leading either to sepsis or to an appointment with an oncologist with lymphoma ...

Medical Expert Editor

Portnov Alexey Alexandrovich

Education: Kyiv National Medical University. A.A. Bogomolets, specialty - "Medicine"

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Reactive lymphadenitis - an inflammatory reaction

Reactive lymphadenitis is an inflammation of the lymph nodes, which is a reaction to any infectious diseases. Lymph nodes are a very important part of the immune system; they are among the first to take a hit when any pathogens enter the body.

As a rule, inflammation of the lymph nodes begins in the area that was affected by the infection, for example, with respiratory diseases, the cervical lymph nodes usually become inflamed. Sometimes the symptoms of reactive lymphadenitis are mistaken for signs of lymphoma, although this disease is much less common than reactive lymphadenitis.

What are the symptoms of reactive lymphadenitis?

The main symptom of reactive lymphadenitis (which, strictly speaking, is itself a sign of certain diseases) is an increase in a lymph node or several lymph nodes. Enlarged lymph node Lymph nodes - what our immunity rests on, as a rule, can be palpated, and touching or pressing on it can cause pain. In some cases, however, inflammation of the lymph nodes Inflammation of the lymph nodes - when the infection comes, it is not accompanied by painful sensations. Sometimes there is redness and increased sensitivity of the skin over the inflamed lymph node.

Depending on what caused reactive lymphadenitis, it may be accompanied by symptoms such as fever, chills, general malaise, headaches, weakness, drowsiness, runny nose, cough. In rare cases, when there are symptoms such as severe pain in an enlarged lymph node Enlarged lymph nodes - a reason to see a doctor, difficulty or rapid breathing, high fever (body temperature above 38.5 C), increased heart rate, you should immediately seek medical help .

Causes of reactive lymphadenitis

By the way, one of the most striking examples of reactive lymphadenitis was observed in patients with bubonic plague. Bubonic plague is the least contagious - they had a very strong increase in lymph nodes in the elbow joints. Large swellings on the skin of patients are called buboes, which gave the name to this disease.

Often, by exactly where the signs of reactive lymphadenitis appeared, it is possible to establish its cause - usually inflammation begins at the source of infection. For example, with infections that affect the scalp, the lymph nodes located on the back of the neck can become inflamed and enlarged, and with infections of the mouth and teeth, the lymph nodes that are in the jaw area become inflamed, and so on.

If signs of reactive lymphadenitis appeared simultaneously with symptoms characteristic of acute respiratory infections or influenza, the doctor may limit himself to a simple examination and not prescribe additional diagnostic procedures. In such cases, the symptoms of infection become less pronounced after a few days, and one or two weeks later the patient recovers, and the symptoms of reactive lymphadenitis disappear. If a bacterial infection and some other diseases are suspected, a blood test may be required. Finally, in rare cases, when doctors have reason to believe that inflammation and enlargement of the lymph nodes may be associated with the formation of a tumor, an examination can be carried out using the following methods:

• Ultrasound procedure;
• CT scan;
• Magnetic resonance imaging;
• Biopsy of the lymph node. This diagnostic method consists in the fact that the doctor uses a special tool to take a sample of lymph node tissue, which is then studied in the laboratory. Biopsy for reactive lymphadenitis is very rare.

Since reactive lymphadenitis is not an independent disease, in order to cure inflammation of the lymph nodes, its cause must be eliminated. For this, various home remedies (for example, for influenza and other viral infections), as well as antiviral drugs, antibiotics, antifungal drugs, and so on can be used. If symptoms of reactive lymphadenitis persist within days of starting treatment, or if inflammation worsens, see a doctor - a misdiagnosis may have been made and inappropriate treatment prescribed.

Lymphadenitis is called inflammation of the nodes of the lymphatic system, caused by the defeat of pathogenic microorganisms. Signs of the disease are enlargement and soreness of the lymph nodes. Lymphadenitis rarely acts as a primary disease, more often appears as a result of any infectious disease in the body. The inflammatory process in the lymph node begins due to the ingress of harmful microbes from the primary inflammatory focus into it with the flow of lymph: suppuration, furuncle, etc.

Types and stages of development

Classifying inflammation of the lymph nodes, doctors take into account the causes, localization, as well as the duration and characteristics of the course of the disease.

On the basis of what infection became the cause, specific and non-specific are divided.

Nonspecific lymphadenitis is caused by:

• viruses;
• bacteria;
• fungal flora.

The specific form is a response to the penetration of special microorganisms into the lymph nodes, including:

• actiminocet or radiant fungus;
• pale treponema;
• brucella;
• tuberculosis bacillus;
• tularemia bacterium;
• plague stick.

The penetration of Koch's sticks into the lymph nodes causes tuberculous lymphadenitis. This form of the disease most often affects the cervical and submandibular lymph nodes, as pathogens enter the body through the oral cavity and nasopharynx. Tuberculous lymphadenitis is able to infect the symmetrical nodes of the lymphatic system.

The duration of the disease underlies the division into chronic and acute forms.

Acute lymphadenitis characterized by a rapid course of the disease. This form occurs when the body is affected by a general disease, or when the pathogen enters the lymph node directly. Provokes acute lymphadenitis infection with a high degree of contagiousness.

Chronic lymphadenitis is the result of a long illness. Also, chronic lymphadenitis may be associated with the development of oncology or the presence of a chronic disease.

Based on the nature of the inflammation, serous lymphadenitis is distinguished (the primary stage, when symptoms do not manifest themselves significantly) and purulent lymphadenitis (a dangerous form of the disease with vivid symptoms that requires mandatory professional treatment).

In accordance with where the inflammation of the lymph node occurred in the body, types are distinguished:

• parotid;
• mesenteric lymphadenitis.

The development of the disease goes through three stages:

1. Simple or catarrhal- initial.
2. hyperplastic- a later stage with an increase in the number of lymphocytes in the inflamed node.
3. Purulent - the last phase. Purulent lymphadenitis is characterized by the destruction of the lymph node.

Causes

The cause of lymphadenitis can be diseases of the internal organs. Cases where pathogenic microorganisms enter directly into the lymph nodes (with skin damage) occur less frequently. When local disturbances become the cause, it is called reactive lymphadenitis.

Both one lymph node and several adjacent ones can become inflamed. This form is called regional lymphadenitis.

Lymphadenitis in adults indicates a decrease in immunity. This disease affects the children's body mainly at preschool age, when the immune system has not yet fully formed.

In addition to the above general causes, they can be characteristic only of the part of the body where lymphadenitis has occurred.

Cervical

Lymph nodes in the neck become inflamed under the influence of ENT diseases, allergies, metabolic disorders, connective tissue diseases, suppuration in the neck. Also provocateurs of inflammation are cancer and HIV.

The danger of this form lies in its proximity to the throat and nose. With a serious course of the disease, problems with breathing and eating are not excluded, especially in children.

Submandibular

This is the most common form. Inflammation of the lymph nodes occurs against the background of diseases of the skin of the face, salivary glands, and oral cavity. May be due to acute tonsillitis.

Inguinal

Problems in the genital area can provoke an inguinal type: inflammation, tumors, STDs, as well as inflammatory processes in muscle tissues and on the skin, purulent wounds in the perineum.

Axillary

Inflammation in the armpit, like other forms, occurs due to suppuration of the skin or damage by pathogenic microbes: HIV, various cocci, etc. Another reason for it is hypothermia, which is especially common in summer. In the heat, it is more difficult to protect sweaty armpits from drafts. In women, the axillary form can be triggered by mastitis, which often occurs during breastfeeding.

Rarer forms

One of the rare forms is parotid lymphadenitis. The cause of inflammation behind the ears can be contamination of the earlobe puncture, purulent diseases and skin injuries in this area. Lymphadenitis behind the ear is especially dangerous, as it can cause a disease such as inflammation of the brain. More information in the review

The cause of mesenteric (also sometimes called mesenteric) lymphadenitis are diseases of the upper respiratory tract and tonsils. Children are mostly susceptible to mesadenitis, in adults this form is less common.

The main symptoms of inflammation of the lymph nodes, taking into account localization

Common manifestations of the disease include fever, swelling of the lymph node and redness of the skin at the site of the lesion. The patient is feverish. The number of leukocytes in the blood increases.

Along with this, there are several local symptoms of lymphadenitis. So, the cervical type is characterized by pain when turning the head, eating, talking. The submandibular view is distinguished by pain when moving the jaw. With inflammation of the lymph node in the groin, the thigh swells on the affected side. A distinctive feature of the axillary form of the disease is swelling and difficulty in moving the hand.

Diagnostic Rules

The International Classification of Diseases of the Tenth Revision assigns the code L04 to acute lymphadenitis. According to this classification, nonspecific lymphadenitis has code I 88. Chronic (except mesenteric) lymphadenitis according to ICD-10 has code I88.1.

It is necessary to distinguish between lymphangitis and lymphadenitis. With lymphangitis, the lymphatic vessels become inflamed, not the nodes.

Diagnosis of inflammation of the lymph nodes should be carried out by the attending physician. It determines the symptoms and treatment. First of all, the doctor palpates the lymph nodes for inflammation, identifies the signs and prescribes how to treat lymphadenitis. To identify at what stage the disease is and what caused the disease, the following methods may be required:

• blood test (general, for HIV, STIs);
• x-ray/CT;
• biopsy of an inflamed lymph node.

More information about the biopsy procedure in the overview

Therapeutic methods

Treatment of lymphadenitis is always carried out in a complex. It should be aimed both at eliminating the inflammation itself and at the primary disease that caused it.

Medical therapy

To relieve inflammation of the lymph nodes and cure the root cause of the disease, the doctor prescribes antibiotics, anti-inflammatory and painkillers, as well as immunomodulators. Antifungal and anti-tuberculosis agents may also be prescribed.

Physiotherapy procedures

Physiotherapy helps to improve the patient's well-being, reduce the inflammatory process and restore the affected tissues. To treat this disease of the lymph nodes, the doctor prescribes the following physiotherapy: UHF, laser and galvanization.

Surgical treatment

Surgical treatment is required when inflammation increases. Purulent contents and dead tissue are surgically removed. The intervention is performed under local anesthesia. Drainage is installed for a week.

Treatment of lymph nodes at home

Home remedies can only be used in conjunction with therapy prescribed by a specialist. They are used to boost immunity, relieve swelling and inflammation, provided that this is allowed by the doctor.

Decoctions

Blueberries are good for immunity. Its berries are poured with water in a ratio of 1 to 4 and left for an hour. Drink 4 teaspoons twice a day.

Nettle flowers can help relieve inflammation. 5 tablespoons of dried flowers are poured with a liter of boiling water and infused for 2 hours. Strained infusion drink half a cup in the morning and evening.

Due to its healing properties, dandelion is widely used in folk medicine. With inflammation of the lymph nodes, a decoction of its leaves is used. Take 1 part of dandelion leaves for 4 parts of water. Take 50 ml half an hour before meals three times a day.

Tinctures

Echinacea tincture is used to boost immunity. Half a glass of water is from 20 to 40 drops of tincture. Take orally 1-2 times a day.

Echinacea also has disinfecting properties, so its tincture is also useful for compresses. It is bred in a ratio of one to two. The compress is applied all night.

rinses

Useful properties of tea from chamomile, calendula and mint. It is taken both as a drink and as a gargle 3-4 times a day.

You can also gargle with a solution of soda and salt. Dissolve half a teaspoon of each remedy in a glass of hot water. Let cool and use several times a day.

Compresses

If there is no purulent inflammation, then compresses with dimexide can be used. It is diluted in half with water. The compress is used twice a day for 15 minutes.

Common compress from celandine. The leaves are poured over with boiling water and applied to the affected area. Hold for half an hour. Repeat 3 times a day.

Ointments

Due to its antiseptic properties, ichthyol ointment can be used in the treatment of inflammation of the lymph nodes. The ointment is applied to the inflamed area several times a day.

Can it be cured forever?

Only a doctor should determine. A significant role is played by what caused this disease, and its type. It must be remembered that an acute form that has not been fully cured can transform into chronic lymphadenitis. Therefore, it is important to consult a doctor and follow the prescribed treatment in order to get rid of this disease forever.

In the chronic form of the disease, special attention should be paid to prevention: to maintain and restore immunity.

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The inflammatory process in the lymph nodes, often of a purulent nature, is called lymphadenitis. A common disease among children and adult patients, more often detected in the axillary, submandibular, inguinal zone or in the neck.

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

• with the formation of pus and non-purulent;
• acute and chronic type;
• single and multiple foci (by the number of affected lymph nodes);
• specific and non-specific form.

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

A specific pathology is caused by "cat-scratch disease", tuberculosis, syphilis, etc. In this case, lymphadenitis provocateurs are specific infectious agents: Candida fungi, Koch's bacillus, actinomycetes, and so on.

Lymphadenitis: ICD-10 code

The international classification of diseases of the 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 causative agent of infection, use additional identification with the code B95-B97.

In turn, acute lymphadenitis μb is subdivided:

• L04.0 - pathological foci are located in the face, neck, on the head;
• L04.1 - lymph nodes of the body are inflamed;
• L04.2 - the disease is found on the upper limbs (shoulders, armpits);
• L04.3 - detection of affected nodes (the pathology is acute) on the lower extremities (pelvic region);
• L04.8 - localization in other zones;
• L04.9 Acute lymphadenitis, type unspecified

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 - 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 with pathogens, as a primary and independent disease develops extremely rarely. Bacteria provocateurs of pathology are: streptococcus, staphylococcus, Pseudomonas aeruginosa, E. coli, pneumococcus. The lymph node increases as a result of the accumulation of cells in the zone of inflammation. The entry of microorganisms into the lymph node is also possible through lymphatic flow from the original lesion. For example, as a result of caries, purulent rash on the skin, boils, etc.

Often the causes of lymphadenitis lie in diseases of the internal organs. The presence of inflammatory bowel processes, infections in the ovaries, various liver diseases is dangerous by the hematogenous spread of disease-causing particles (through the bloodstream) that settle in the lymphatic system and cause inflammation of the lymph node.

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

Nonspecific infection is the most common cause of compaction, growth and inflammatory response from the lymph nodes. Caused by conditionally pathogenic microorganisms, lymphadenitis is typical for: submandibular, cervical, elbow, inguinal, axillary, femoral, popliteal zones. Favorable conditions for the reproduction of pathogenic microorganisms will be injury, hypothermia, a stressful or painful condition, 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 weakening of the immune system due to various factors - an elderly or vice versa young, not strong organism, mental or physical overwork, previous illnesses, etc.

An increase in lymph nodes and an inflammatory process in their tissues should not be confused. The growth of the lymph node is due to the production of more lymphocytes, in which antibodies are produced to fight the potential threat, which in itself indicates the fulfillment of the lymphatic system's protective function and does not apply to pathology.

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How long does lymphadenitis last?

Remembering the types and features of the course of lymphadenitis, you 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 a chronic type is a sluggish, latent pathology without clear 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 more often due to a sharp deterioration in the general condition characteristic of the acute course of the disease. The purulent process requires sanitation and cleansing of the affected tissues. When the lymph node is melted after opening the abscess, the cavity is drained. The rate 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 reach one and a half years.

Symptoms of lymphadenitis

The symptomatology of the disease largely depends on the type of lymphadenitis and helps the specialist to make the correct diagnosis, as well as to choose the right treatment tactics. Common signs are: edema, local reddening of the skin, temperature, limitation of limb mobility, chills, the quantitative content of leukocytes in the blood increases.

The following symptoms of lymphadenitis are distinguished:

• nonspecific chronic inflammation is a sluggish, latent process that does not manifest itself for a long time. It is characterized by a slight swelling of the skin adjacent to the affected lymph node, and subfebrile temperature (37 o C);
• acute lymphadenitis - has a pronounced symptomatology, namely: sharp pain and an increase in nodes that limit motor ability. Often the condition is aggravated by a dull or aching headache, general weakness, fever;
• the state of the purulent process is determined by a jerking, sharp pain syndrome. On palpation, the patient feels pain. Skin is red. As the disease progresses, the affected lymph nodes grow together with each other and with adjacent tissues, forming fixed seals;
• pathology of the serous type - dull pain syndrome is localized in the region 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 tissue of the lymph node and accumulation of purulent contents, necrotic areas appear;
• adenophlegmon - the stage into which purulent inflammation passes without proper therapy. The skin with signs of hyperemia, puffiness has blurred boundaries with softening foci. Among the obvious signs of pathology are high fever, palpitations, 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 a pathological condition, so it is important to seek advice in a timely manner.

Cervical lymphadenitis

An increase in cervical lymph nodes occurs as a result of infectious and inflammatory processes of the upper respiratory tract (tonsillitis, pharyngitis, purulent otitis media, etc.). Cervical lymphadenitis occurs mainly in children, as a result of influenza, SARS, pneumonia. In adulthood, it can 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, gum disease 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, a purulent wound or a scratch, contributes to the entry of bacteria into the lymphatic channel. Lymph brings pathogenic flora to the lymph nodes, which become inflamed. This is how acute lymphadenitis occurs, manifesting itself as a sharp, increasing soreness, fever and deterioration in the general condition.

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Subacute lymphadenitis

A very rare disease - subacute lymphadenitis in clinical manifestations in many ways resembles an acute inflammatory process in the lymph nodes. This pathology is differentiated by the primary immune response. The subacute variety is characterized by a more intense red color of the skin in the area of ​​​​the infected lymph node, which has a dense texture than in the acute course of lymphadenitis. Visual examination is not enough to confirm the diagnosis, therefore, cytological and histological examination is used.

By cytology, macrophages with a large number of cell particles and leukocytes are detected, 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 allows you to determine the sharp outline of the lymphatic follicles, an increase in blood vessels filled with blood.

In the subacute form, a significant increase in body temperature is possible if pus is formed. In other cases, the temperature is close to subfebrile.

Chronic lymphadenitis

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

Generalized lymphadenitis

Simultaneous inflammation of several lymph nodes or their sequential defeat is a generalized lymphadenitis. A rather rare disease is the result of a primary infectious process, for example, generalized tuberculosis. Quite often the illness is shown and proceeds brightly with the expressed intoxication, and also quickly progresses. In this case, all groups of lymph nodes are significantly enlarged, inflammation rapidly covers nearby tissues, spreading to internal organs. The generalized form can acquire a chronic course, 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.;
• accumulation diseases - Niemann-Pick and Gaucher diseases;
• reactions to medicines and chemical compounds - hay fever, allergic manifestations to drugs.

Hemorrhagic lymphadenitis

Hemorrhagic lymphadenitis is a special form of inflammation of the lymph nodes, in which dysfunction of capillary permeability entails saturation of the lymph node with blood. Similar is observed with the defeat of anthrax or plague.

Anthrax inflammation is characterized by lymphangitis and regional lymphadenitis, but the enlargement of the lymph nodes occurs painlessly. The inflammatory process has a long course. Initially, nodes that are 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 method (PCR).

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

Specific lymphadenitis

Such serious diseases as: tuberculosis, syphilis, HIV, plague and others cause infection of the lymphatic system, which is manifested by an increase in lymph nodes. Moreover, the underlying disease may still be at the stage of inception, and the lymph nodes in a timely manner “signal” about a hidden problem.

Specific lymphadenitis is classified into:

• viral;
• tuberculosis;
• actinomycotic;
• fungal;
• syphilitic;
• vaccinal, etc.

A specific form of inflammation of the lymph nodes has a wide range of clinical manifestations. The defeat of the cervical nodes often indicates tuberculous lymphadenitis, an increase in nodes in the inguinal zone indicates specific peritonitis. Supraclavicular nodes react if the primary infection is localized at the pulmonary apex. Pathology of regional lymph nodes is observed after vaccination. The tumor is found on one or both sides. "Children's pruritus" or scrofula also causes generalized growth of nodes.

Specific lymphadenitis often has a chronic form with characteristic periods of exacerbation. The symptoms of the disease vary depending on the type of infection. The causative agent is identified on the basis of a blood test.

Tuberculous lymphadenitis

The penetration of the tubercle bacillus into the lymphatic system causes an increase in the nodes of the neck and submandibular zone. Over time, the lymph nodes soften, the pathological process covers nearby cells, and when the capsule of the lymph node is opened, a gray, purulent mass of a crumbly consistency is found. Often, tuberculous lymphadenitis, which develops 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 on the neck, non-specific type of lymphadenitis, metastasis of malignant tumors, lymphosarcoma. Microscopic analysis of intracapsular pus helps to establish an accurate diagnosis.

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

Caseous lymphadenitis

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

• the occurrence of a primary lesion in the lung;
• lymphangitis - the spread of infection to the efferent lymphatic vessels;
• lymphadenitis - defeat of regional nodes.

In the area of ​​inflammation, tissue necrosis is observed, serous edema gradually develops, leading to pneumonia of the caseous type. The size of the primary tuberculous area depends on the affected area (alveolitis, lobe, acinus, or segment). Specific inflammation pretty soon covers the lymphatic vessels adjacent to the primary focus. Formed to the root of the lung, lymphostasis and characteristic swelling with tubercles in the peribronchial and perivascular tissue make the root nodes accessible to infection. This is how the second stage begins - lymphangitis, which spreads to 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 focus of inflammation is a festering scratch or wound, erysipelas, boils, skin ulcers, etc. Pathogenic microorganisms infect the lymph nodes, spreading with the flow of lymph, blood, or directly when the node is injured.

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

• acute - more often, as a serous form. Perhaps an increase in 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. The development of the disease from the serous form to the purulent stage causes an increase in temperature, weakness, and malaise. The next signs of the 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. Lymph nodes remain enlarged for a long time, practically painless and not soldered to surrounding tissues. Sometimes the spread of connective tissue in the lymph node is fraught with problems of lymph circulation, swelling, lymphostasis, elephantiasis.

Reactive lymphadenitis

Reactive lymphadenitis is a stage of inflammation of the lymph nodes, which is 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, in 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 often the reactive phase accompanies the acute course of inflammation. However, it also occurs in a chronic disease of an exacerbation period, which is characterized by an active reaction from the body.

Reactive lymphadenitis is manifested as a result of the failure of the immune forces of children or because of a prepared organism that already knows the microorganism and has antibodies to suppress it. Recall, a mantoux test, showing the body's response to a tubercle bacillus. The presence of a skin globule indicates the recognition of an infection. A similar mechanism of immune response is displayed by the lymph nodes.

The reactive course of inflammation is always a rapid process, meaning the fight against the source of infection, when the rest of the body's defense system has not yet had time to “join in the confrontation”. The reactive phase changes rather quickly. So recovery can occur if the infectious agent was suppressed in time by the immune forces of the body.

Lymphadenitis behind the ear

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

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

The growth of behind-the-ear nodes in size sometimes causes lymphoma, various cancers of the lymph nodes. Active hair loss on the head, annoying itching and the presence of peeling of the skin often indicate a fungal infection. In any case, you should not independently establish a diagnosis and prescribe treatment for yourself. A timely appeal to a specialist will save you from mistakes that provoke irreparable complications.

Behind the ear lymphadenitis

The growth of lymph nodes behind the ears signals the need to undergo an 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, some allergic manifestations cause the spread of pathogenic flora with lymph flow. A large amount of pathogens that settle in the lymph nodes often provoke behind-the-ear lymphadenitis. The inflammatory process can be a harbinger of serious diseases, such as cancerous tumors.

Lymphadenitis has a direct relationship with the primary lesion of a viral, fungal or viral nature. So, 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 presence of the primary and secondary focus in the immediate vicinity of the brain poses a danger to the patient in the form of complications, severe disease and long-term recovery. Only timely seeking medical help will avoid all negative consequences and restore health in a short time.

Lymphadenitis of the face and neck

The face is the site of localization of the buccal, 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 are chains of superficial and deep (pharyngeal) lymph nodes. The pharyngeal nodes receive lymph from the posterior parts of the nasal cavity, partly from the palate. In the lymph nodes of the cheeks, lower and submandibular, chin lymph flows from: the oral cavity, paranasal sinuses, teeth, mucous membranes, jaws, salivary glands. 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, chin and cervical zones can be odontogenic or non-odontogenic in nature. Odontogenic processes are characterized by a pathological relationship with the dentition, often develop against the background of periostitis of the period of exacerbation, chronic periodontitis, acute pericoronitis. Inflammation of the lymph nodes of the non-odontogenic type includes otogenic, rhinogenic and stomatogenic (formed as a result of stomatitis, otitis media, glossitis, gingivitis, etc.).

Throat lymphadenitis

Viruses that provoke various diseases of the upper respiratory tract (tonsillitis, 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 zone. As a secondary pathological process, throat lymphadenitis often disappears when the underlying cause is treated. For example, cervical lymph nodes return to normal with appropriate therapy for angina.

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

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

The defeat of the lymph nodes of the throat area is possible without a 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 increase in the lymph nodes, during the examination and when swallowing, there may be a slight soreness. The patient's body is usually weakened by frequent colds.

Occipital lymphadenitis

Identification of the reasons why occipital lymphadenitis develops helps to eliminate the primary disease in the shortest possible time 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.

Viruses of a generalized type serve as an important diagnostic factor in occipital lymphadenitis that accompanies measles rubella. With this pathology, inflammation of the posterior cervical nodes is also possible, sometimes a generalized type of lymphadenopathy is formed. Symptoms of a secondary pathological process appear earlier than skin rashes differentiate. In the case of occipital lymphadenitis, the nodes are slightly enlarged, have a soft-elastic consistency, are easily displaced by probing, without pain.

Chicken pox is one of the diseases that cause the growth of the occipital lymph nodes. Characteristic manifestations of the disease will be fever, skin rash, disorders of the upper respiratory tract. Specific infections of syphilis and tuberculosis rarely affect the cervical and occipital lymph nodes.

Posterior cervical lymphadenitis

Lymphadenitis of the neck 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 occurrence in rubella. In addition to enlarged lymph nodes, patients complain of limited neck movement due to severe pain. In parallel, there is inflammation of the nodes near the ears, as well as the occipital region. An interesting fact is that the pathological growth of lymph nodes occurs earlier than the appearance of a characteristic red rash.

In most cases, it is difficult to identify the causes of the inflammatory process and the growth of the volume of lymph nodes located on the back of the neck. This is due to the fact that not only an infectious disease can act as a provocateur of inflammation, but also more serious illnesses, such as tuberculosis. In the process of differential diagnosis, it is necessary to provide for the ability of the formation of lymphoma, the development of lymph node metastases due to malignant neoplasms of the neck and head.

Mesenteric lymphadenitis

The disease of the lymph nodes of the mesentery of the intestine develops more often in children, occurs with signs of intoxication and characteristic pain in the abdomen. 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 a large number of lymph nodes are located in the abdominal cavity, therefore, mesenteric lymphadenitis can occur when any pathogens of a viral or bacterial nature enter them from the primary focus of inflammation.

The disease begins with an acute pain syndrome to the right of the navel, but the general condition of the patient remains stable. As the inflammation progresses, nausea, vomiting, which does not bring relief, the patient has a fever. The clinical picture is complemented by a violation of the chair. These symptoms last for several days and require immediate medical attention, as 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;
• pseudotuberculous/tuberculous.

by flow type:

• chronic/acute.

Inflammation of the lymph nodes of the peritoneal zone occurs hematogenously (through blood flow), 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 of the digestive tract. When making a diagnosis using the differential diagnosis method, it is necessary to exclude:

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

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

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

Lymphangitis and lymphadenitis

The secondary inflammatory process in the capillaries and trunks of the lymphatic channel 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-, staphylococci, but in clinical practice there are such pathogens as: Proteus, Escherichia and tubercle bacillus and other microorganisms.

Quite often, lymphangitis and lymphadenitis of the regional type are simultaneously detected, accompanied by swelling, hyperemia along the lymphatic vessels, pain, fever, chills and general weakness. Manifestations of superficial lymphangitis outwardly resemble erysipelas, along the vascular bed, seals in the form of a cord or rosary are palpated. The defeat of 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, ultrasonic 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. Often the body temperature rises, the appetite and general condition of the patient worsens. In the case of the formation of pus, the face is able to acquire asymmetry due to the accumulated infiltrate. The cover of the skin becomes swollen with a red tint. Palpation causes discomfort. An acute purulent process covers nearby tissues, symptoms of intoxication appear.

The cause of the pathology is dental disease. Infection of the oral cavity penetrates not only into the maxillary nodes, but also into the parotid, buccal, chin, superficial and deep cervical lymph nodes. Pain in the area of ​​the affected nodes increases with head movement. Difficulty opening the mouth is observed only if the purulent process extends to the masticatory muscles.

A complication of odontogenic lymphadenitis is an abscess or adenophlegmon.

Lymphadenitis of the cervical lymph nodes

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

• the affected lymph nodes are soldered together, but do not involve nearby tissues in the pathological process;
• often proceeds without pain, which is confirmed by palpation;
• inflammation in most cases is asymmetrical.

Tuberculous lymphadenitis of the cervical lymph nodes most often acquires a chronic course. And 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 respond to traditional therapy, so often the lymph nodes have to be excised.

The presence of a primary syphiloma on the head (as a rule, this is the region 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 mobile. During the 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. A feature 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 located. Lymph from the abdominal region, genital area and gluteal zone enters the inguinal nodes, so the presence of infection in these organs provokes their inflammation. Viruses and bacteria that cause a pathological focus 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 an increase in lymph nodes, pain when pressed. Purulent lymphadenitis of the lower extremities causes an increase in temperature, swelling of the affected area. The spread of pus on nearby tissues is dangerous by 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 the femoral and inguinal lymph nodes is observed in the bubonic form of the 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 axillary and ulnar lymph nodes are more commonly inflamed. If the pathological process is started, then fluctuation with purulent softening of the nodes is revealed.

The popliteal lymph nodes receive lymph from the feet, so wounds, abrasions should be treated on them in a timely manner, abscesses and other purulent formations should be opened.

Inguinal lymph nodes become inflamed due to chlamydia, infections of the genital area (venereal disease, syphilis, AIDS, Nicolas-Favre disease) cause pathology. Moreover, a group of nodes soldered to each other and to the surrounding tissues is often involved in the lesion.

The cause of femoral lymphadenitis is carbuncles, boils, 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.

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Abdominal lymphadenitis

Infectious practice indicates the widespread nonspecific mesenteric lymphadenitis, which is most common in childhood, but 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, and also as a result of the presence of bacteria that provoke mononucleosis and tuberculosis. The peritoneal zone 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 lymph nodes of the mesentery.

The first signs of pathology are easily confused with the usual indigestion or symptoms of intoxication. The pain is localized near the navel on the right, more down the abdomen. The pain syndrome intensifies as inflammation develops, acquiring a aching, cramping character of varying intensity. The condition is supplemented by fever, nausea, vomiting, 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 well-being.

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

Lymphadenitis of the lungs

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

Lymphadenitis of the lungs 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 in whooping cough, especially tormenting the patient at night;
• the development of a dry, unproductive cough into a wet one with sputum;
• noisy breathing;
• irritability;
• night chills;
• feverish state;
• chest pain;
• signs of intoxication;
• weakness.

Clinical practice knows cases of an asymptomatic course of the disease, when pulmonary lymphadenitis is diagnosed only during a routine examination. Help in differentiating the pathology is provided by an increase in superficial nodes.

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

Lymphadenitis of the mammary gland

The mammary gland is conditionally 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 is understood as a local lesion of the lymph nodes. Symptoms of the disease begin with a pathological process in the nodes of the armpit, the region of the mammary glands, sub- and supraclavicular lymph nodes. Lymphadenitis of the mammary gland is most often provoked by strepto- and staphylococci, less often by gono- and pneumococci. The infection enters from the primary foci of inflammation located directly on the chest (purulent wounds, skin diseases), or by the lymphogenous / hematogenous route from other affected organs and systems.

The clinical picture includes: enlargement and soreness of the lymph nodes, the skin over the affected node is hyperemic and tense. The patient's condition worsens with the formation of purulent discharge in the focus 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, more often in the armpits and groin. Active growth of lymph nodes in size and sharp pain indicates the development of a pathological focus.

A complication after BCG vaccination is considered tuberculous inflammation of the lymphatic system, which affects babies. The cause of the disease are:

• a decrease in the body's resistance forces as a result of frequent colds, with severe diathesis, rickets, etc .;
• vaccination of premature babies;
• administration of an excessive amount of 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 in the oral cavity provoke unilateral inflammation of the lymph nodes of the lower jaw. The defeat of the cervical nodes on the left or right is observed due to the infectious and inflammatory process in the body (tonsillitis, influenza, 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. Attacks proceed in an acute form, resembling inflammation of the appendix with severe symptoms of intoxication.

An increase in the submandibular lymph nodes on the right side causes pathologies of the oral cavity of the same part of the face (untreated caries, gum disease, various chronic diseases).

The only sign of mononucleosis of an infectious nature is inflammation of the cervical lymph nodes on one side or symmetrically. With odontogenic lymphadenitis, the patient's face becomes skewed to 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 with nearby nodes (the area of ​​​​the main collector), in the future, signs of the disease are detected along the course of the lymph flow or spread through the bloodstream.

Bilateral lymphadenitis

Pronounced bilateral lymphadenitis is formed as a result of:

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

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

A disease such as rubella provokes an increase in behind-the-ear, posterior-cervical and occipital nodes more often on both sides. Growth of lymph nodes is noted in the absence of a characteristic red rash. Complaints of patients are reduced to pain when turning the neck.

The 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, the inflammation is more often unilateral, but there is also a bilateral lesion due to a decrease in the body's defenses.

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Supraclavicular lymphadenitis

When the supraclavicular lymph nodes become inflamed, lymphoma, infectious and tumor processes of the chest organs, infections and tumor neoplasms of the peritoneal organs should be excluded. Tumors of the gastrointestinal tract often cause an increase in lymph nodes above the collarbone, mainly on the left. Neoplasms of the genital area, mammary glands, and lungs can also give metastases to the region of the supraclavicular lymph nodes.

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

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

• the patient is in a sitting position with arms down, the gaze is 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 body of an adult is able to resist various viruses and bacteria. This is made possible by the lymphatic system, which provides protective and drainage functions. An increase in lymph nodes indicates the presence of an infection in the body and that the immune system has reacted by providing the production of antibodies to pathogens.

Lymphadenitis in adults is often asymptomatic or against the background of a slight deterioration in well-being. First of all, the cervical, submandibular, axillary and inguinal nodes become inflamed. The cause of the pathology is purulent processes of various organs (furuncle, erysipelas, etc.), serious diseases (tuberculosis, plague, etc.). Factors provocateurs of lymphadenitis in adult patients are: stress, hypothermia, lowering of protective forces. As a primary disease, inflammation of the lymph nodes is extremely rare with direct infection of the node when damaged (trauma).

Lymph nodes in the groin area become inflamed more often in adulthood and indicate problems with the organs of the genital area, 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, an otolaryngologist.

Lymphadenitis in children

Inflammation of the lymph nodes in childhood is much brighter and more intense than in adult patients. Lymphadenitis in children is provoked by various infections, most often of the upper respiratory tract. Diseases such as: tonsillitis, SARS, tonsillitis, caries, etc. contribute to an increase in submandibular lymph nodes. In clinical practice, cases of damage to the cervical, popliteal, axillary nodes are much less common. Inguinal lymphadenitis in babies is an even rarer phenomenon, differentiated as a result of infringement of the inguinal hernia.

Lymphadenitis in pregnant women

Inflammation of the lymph nodes during the bearing of the baby occurs due to infectious and inflammatory processes and a decrease in immunity. Lymphadenitis in pregnant women mainly occurs in a catarrhal and purulent form.

Purulent inflammation is dangerous for its consequences:

• lymphangitis - the disease spreads to the walls of the lymphatic vessels;
• thrombophlebitis - damage to the circulatory system;
• violation in the work of the organs or systems of the body of the expectant mother.

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

Detection of lymphadenitis after the onset of pregnancy requires immediate contact with a specialist. Therapy is carried out with the help of antibiotics, more 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. Lymphadenitis of an advanced stage without proper treatment provokes irreversible processes: tissue necrosis, abscess formation, ichorous destruction of the lymph nodes, sepsis (blood poisoning).

Simple inflammation does not extend beyond the lymphatic capsule. Pathology with destructive manifestations covers nearby tissues, increasing the affected area at times. It is common for a nonspecific form of the disease to develop into thrombophlebitis with the formation of metastatic foci of infection (septicopyemia, lymphatic fistula).

A chronic inflammatory process is dangerous because in most cases it proceeds hidden, without severe symptoms, indicating a decrease in the body's defenses and threatening degeneration of the lymph nodes. Characteristic complications of chronic non-specific lymphadenitis are: swelling, elephantiasis (overgrowth of connective tissue), lymphostasis, dysfunction of lymph circulation.

Consequences of lymphadenitis

Lymphadenitis is terrible with the possibility of spreading infection, cancer cells 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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The initial diagnosis of lymphadenitis includes palpation of the inflamed nodes, after which instrumental and laboratory techniques are prescribed:

• study of the composition of the blood;
• histological analysis (taking a tissue sample from the affected node);
• with lymphadenitis of a specific type, focus on the possibility of contact with a carrier of tuberculosis and make skin tests with laboratory tests (blood, sputum), as well as x-rays;
• purulent inflammation requires surgical opening of the capsule of the lymph node, 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 suspicions of Quincke's edema, tumor formations of the cervical zone and the exclusion of congenital cysts;
• often used - ultrasound, consultation with an ENT doctor, computed tomography, HIV analysis.
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Blood test for lymphadenitis

Quantitative and qualitative characteristics of the composition allows you to identify a blood test for lymphadenitis. In addition to the general analysis, the leukoformula and the level of LDH (lactate dehydrogenase), characteristic of leukemia and lymphoma, are counted. An excess of ESR indicates inflammatory and tumor processes. A mandatory study of a peripheral blood smear is required to determine infectious mononucleosis.

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

Lymphadenitis on ultrasound

An ultrasound study helps to track the effectiveness of antibiotic therapy. For this purpose, the size of the affected node is recorded before and at the end of treatment.

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

Lymphadenitis on ultrasound is noted by a number of features:

• nodes are enlarged;
• the capsule of the lymph node is tense;
• the vascular pattern is strengthened;
• the cortical and near-cortical zones are significantly expanded;
• puffiness is determined;
• anechoic areas may be present;
• hyperplastic and spliced ​​nodes are observed;
• sometimes metastatic changes are detected.

Which doctor treats lymphadenitis?

Inflammation of the lymph nodes is the reason for contacting a therapist who refers an endocrinologist, surgeon or oncologist for a consultation. The choice of a specialist largely depends on the nature of the course of lymphadenitis and the severity of the initial lesion. Often, an examination by an infectious disease specialist, hematologist or rheumatologist is 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 is the timely treatment of primary diseases: tonsillitis, tonsillitis, purulent skin lesions, osteomyelitis, rhinitis, gingivitis, boils, carbuncles and various infectious diseases (influenza, SARS, etc.). Prevention of lymphadenitis also includes anti-caries measures: a systematic visit to the dentist in order to treat caries, stomatitis and other pathological foci of the oral cavity.

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

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

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

Prognosis of lymphadenitis

Nonspecific acute lymphadenitis at the beginning of development, with the provision of high-quality treatment, most often has a favorable prognosis. The destructive course of the inflammatory process ends with the destruction of the lymph node, followed by scarring. The progression of acute forms of lymphadenitis of the extremities provokes a violation of lymphatic drainage, the formation of lymphostasis, and subsequently to 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, lymphatic fistulas.

The prognosis of chronic lymphadenitis is favorable when establishing the root cause of inflammation and timely therapy. Negative consequences can be scarring, swelling of the tissue over the affected node. As a result of wrinkling and compaction of the lymph node, there is a proliferation of connective cells, impaired lymph circulation.

Lymphadenitis is able to go away on its own in case of timely and effective treatment of the underlying purulent-inflammatory disease. Therefore, at the first symptoms of inflammation of the lymph nodes, it is necessary to visit a doctor and strictly follow his instructions.

Lymphadenitis is an inflammation of the lymph nodes resulting from the ingestion of various microorganisms and their toxins. It is characterized by an increase in lymph nodes in size and a sharp pain in the affected area. Only in rare cases, lymphadenitis is an independent disease. Most often, this is nothing more than a symptom that signals some kind of malfunction in the body.

What kind of disease is this, what are its first signs, causes, why is lymphadenitis dangerous for a person, if not treated - we will consider further.

What is lymphadenitis?

Lymphadenitis is an inflammatory disease of the 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, as well as through the hematogenous route.

Usually, lymphadenitis occurs as a complication of the primary inflammation of any localization. Infectious pathogens (microorganisms and their toxins) penetrate into the regional lymph nodes with a flow of lymph that 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 the infection directly enters the lymphatic network through damaged skin or mucous membranes.

Symptoms appear more frequently on the neck, as well as in the armpit and in the groin. Enlarged lymph nodes can be single or observed simultaneously in different parts of the body.

General signs are represented by local and general fever, severe pain, flushing of the skin, chills and itching. Lymphadenitis is a pathology that can develop in any person, regardless of gender and age.

More than 80% of people have painless enlargement of the submandibular lymph nodes, which is considered normal. No other groups of lymph nodes are normally palpable.

Classification

According to the duration of the course of the disease, lymphadenitis, like many other diseases, is acute and chronic, according to the type of infectious agents - specific and nonspecific, according to the progression - purulent and non-purulent.

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

Acute lymphadenitis

The beginning of the development of the pathological process is acute. The main reasons for the progression of the pathology: infection of the wound, 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. With a purulent form, the lymph nodes melt and the disease affects neighboring tissues.

Around the lymph node there is redness and swelling, the contours of the node are blurred, the lymph node is soldered to the surrounding tissues, movements in this area bring pain. As pus accumulates and tissues melt, the movement of pus inside the node is noted. If there is no surgical treatment, an abscess in the area of ​​​​the node can break out or into the depths of the tissues.

Chronic lymphadenitis

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

In chronic nonspecific lymphadenitis, inflammation in the lymph nodes is protracted. Such inflammation is productive. Its transition to a purulent form practically does not occur.

Symptoms of chronic non-specific lymphadenitis are noticed an increase in lymph nodes, they are dense, slightly painful on palpation, not soldered together. Lymph nodes remain enlarged for a long time, but gradually they decrease. In rare cases, the growth of connective tissue can lead to a disorder of the lymphatic circulation, edema.

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, vasodilation in the node area),
• hyperplastic (with an increase in the size of the node, soaking it with plasma)
• purulent (formation inside the node of the purulent cavity).

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

The reasons

Lymphadenitis in adults develops against the background of harmful work and with advanced forms of disease. Both men and women tend to neglect their own health when they are sick. Often attempts are made to self-medicate infectious diseases. This approach provokes suppuration of the lymphatic tissues, the transition of the disease into a chronic form.

As a rule, lymphadenitis is a consequence of primary septic inflammation. Pathogenic (pyogenic) microflora - streptococci and, and the toxins produced by them migrate from the focus by the lymphogenous route, or with the bloodstream. It is also possible to introduce infectious agents 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,. Lymph nodes can increase with childhood infections -, or.

Among the commonly encountered non-infectious causes of lymphadenitis, the following can be distinguished:

• oncology of the lymph nodes ();
• 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 it is impossible not to notice the symptoms of acute lymphadenitis, then the so-called simple lymphadenitis in general often proceeds painlessly and for the time being does not cause concern.

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 the body with toxins that release causative agents of inflammation.
• Suppuration in the region of the lymph node - if there is a formation of pus, then we are talking about the development of an abscess, sometimes purulent fusion of the lymph node occurs.
• The development of tachycardia - when the process is running, inflammation increases and gives a complication to the cardiovascular system.
• Gas crepitus - on palpation of the affected lymph node, a slight crunch is felt.
• Violation of the functional features of the site of localization of inflammation - due to a pronounced pain syndrome, a person cannot move his arm or leg, neck, depending on the area in which the lymph node has become 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. As symptoms may appear:

• pain in the area of ​​regional lymph nodes.
• At the same time, there is an increase in lymph nodes, their soreness during palpation.

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

• Painful sensations become sharp, the skin over the lymph nodes becomes hyperemic, and when the nodes are palpated, the patient feels pain.
• Lymph nodes, which previously could be very clearly palpated, now merge with each other and with the tissues surrounding them, and besides, they become motionless.

Signs of a chronic form

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

• lymph nodes are firm and painless on palpation,
• do not have adhesions.

Often, their own cells are replaced by connective tissue, which leads to impaired lymphatic circulation, lymphostasis and extensive edema.

Increased sizes can last for a long time, but then the nodes decrease due to the growth 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 tuberculous 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 proceeds as a unilateral process. Lymph nodes resemble a "chain". When palpated, they are free, not soldered and rarely with pus.

Lymphadenitis	Symptoms
Cervical	Pressing on the formed seals of the lymph nodes causes pain. In addition to inflammation in cervical lymphadenitis: the general well-being of the patient worsens, he has a headache and a fever. In an acute form, strong suppurations form in the area of ​​​​lymph nodes.
Submandibular	Enlarged submandibular lymph nodes. Pain. Increases as the disease progresses. Changes in the skin over the lymph nodes: redness swelling local increase in temperature by 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: discomfort in the lower abdomen sharp soreness. Associated symptoms include: high temperature, weakness and chills. Complicated inguinal lymphadenitis: localized edema skin hyperemia.
Axillary form	Symptoms of the axillary form of pathology: enlarged lymph nodes and their suppuration; increase in body temperature; sharp soreness of the nodes; phenomena of general intoxication; swelling of surrounding tissues; it is possible to break the abscess outward (with the formation of fistulas in the armpit) and inward (the formation of adenophlegmon).

Individual symptoms of lymphadenitis indicate the development of serious conditions that are potentially life-threatening. If they are available, it is necessary to seek qualified help as soon as possible, sometimes the bill goes literally for hours and minutes. These are signs such as:

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

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

Complications

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

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

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

Diagnostics

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

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

Examinations in the diagnosis of lymphadenitis:

• clinical blood test;
• analysis for HIV infection;
• allergic skin tests;
• CT scan;
• x-ray examination;
• node biopsy.

When examining children, it is necessary to exclude or confirm angioedema, congenital tumors and cystic neoplasms in the neck. When examining patients with inguinal form of lymphadenitis, it is required to exclude the presence of inguinal hernia and venereal 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 (, etc.). Of course, in such cases, the diagnosis requires clarification. Only after examination and testing, the patient is diagnosed.

Treatment of lymphadenitis

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

• creation of 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 prescribe antibiotic therapy, taking into account the sensitivity of the pathogenic flora, as well as vitamin therapy and UHF therapy.

In chronic nonspecific lymphadenitis, the elimination of the underlying disease that supports 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 the treatment of 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,;
• Anti-tuberculosis drugs: Ethambutol, Rifampicin, Capreomycin;
• Antifungals: Fluconazole, Amphotericin B.

Operation

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

Operation steps:

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

Prevention

Prevention of lymphadenitis implies:

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

Lymphadenitis as a disease of the 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 disease that contributed to lymphadenitis.