Lymphadenitis

Swollen lymph nodes usually occur as a result of infection from bacteria or viruses. Rarely, swollen lymph nodes are caused by cancer. Your lymph nodes, also called lymph glands, play a vital role in your body's ability to fight off infections. They function as filters, trapping viruses, bacteria and other causes of illnesses before they can infect other parts of your body. Common areas where you might notice swollen lymph nodes include your neck, under your chin, in your armpits and in your groin.
In some cases, the passage of time .Hard, swollen or tender lymph nodes
Itchy skin, Lump, or mass that can be felt beneath the skin, Rash
Redness, warmth or selling immune system disorders
Lupus — a chronic inflammatory disease that targets your joints, skin, kidneys, blood cells, heart and lungs
Rheumatoid arthritis — a chronic inflammatory disease targeting the tissue that lines your joints (synovium)
Cancers
Lymphoma — cancer that originates in your lymphatic system
Leukemia — cancer of your body's blood-forming tissue, including your bone marrow and lymphatic system
Other cancers that have spread (metastasized) to lymph nodes

1. LYMPHADENITIS PRESENTED BY R.PRIYA

2. INTRODUCTION Lymphadenitis is a condition in which your lymph nodes become inflamed. When the condition affects the lymph nodes in the membrane that connects your bowel to the abdominal wall (mesentery), it's called mesenteric lymphadenitis ( mez -un-TER- ik lim -fad-uh-NIE-tis). A viral intestinal infection is the usual cause of mesenteric lymphadenitis, also known as mesenteric adenitis. It mainly affects children and teens.

3. DEFINITION Lymphadenitis is the medical term for enlargement in one or more lymph nodes, usually due to infection. Lymph nodes are filled with white blood cells that help your body fight infections. When lymph nodes become infected, it's usually because an infection started somewhere else in your body. Rarely, lymph nodes can enlarge due to cancer.

4. TYPES Lymphadenitis can be one of two types: Localized lymphadenitis.  This is the most common type. Localized lymphadenitis involves one or just a few nodes that are close to the area where the infection started. For example, nodes enlarged because of a tonsil infection may be felt in the neck area. Generalized lymphadenitis.  This type of lymph node infection occurs in two or more lymph node groups and may be caused by an infection that spreads through the bloodstream or another illness that affects the whole body.

5. CAUSES Bacterial and viral infections are among the common causes of lymphadenitis. Examples include: Fungal or parasitic infections HIV Infectious mononucleosis ( Epstein-Barr virus ) Other bacterial or viral infections Staphylococcus (staph) Streptococcus (strep) Tuberculosis (serious infection affecting the lungs and other organs) Upper respiratory viral infections Noninfectious causes of lymphadenitis Noninfectious causes of lymphadenitis include: Inflammation in response to a foreign body Lymphoma (cancer of the lymph nodes) Secondary (metastatic) cancers that spread from other regions of the body tuberculosis or  cat scratch disease  (bartonella).

6. PATHOPHYSIOLOGY

7. SIGNS AND SYMPTOMS Hard, swollen or tender lymph nodes Itchy skin Lump  or mass that can be felt beneath the skin Rash Redness, warmth or swelling Erythemia have any of these life-threatening symptoms including: Difficulty breathing or rapid breathing High  fever  (higher than 101 degrees Fahrenheit) Rapid heart rate (tachycardia) Severe  pain , redness, warmth or swelling

8. SIGNS AND SYMPTOMS Local signs of infection depending on location of lymph node Cervical URI  symptoms Conjunctivitis Mouth sores, dental infection Axillary Breast infections Upper-limb infections Mesenteric Abdominal pain ,  nausea/vomiting Inguinal GU infections Lower-limb infections

9. DIAGNOSTIC EVAUATION If associated exudative pharyngitis, consider Rapid GAS testing If severe symptoms (ill-appearing, high fever), consider: Basic labs (CBC, BMP) Blood cultures ESR/CRP may be helpful for monitoring course of infection/response to treatment Ultrasound to evaluate for associate abscess or deep locations If subacute/chronic, consider: CBC, BMP, ESR/CRP Uric acid, LDH Tuberculin skin test

10. DIAGNOSTIC EVAUATION Medical history.  Your doctor will want to know when and how your swollen lymph nodes developed and if you have any other signs or symptoms. A physical exam.  Your doctor will also want to check lymph nodes near the surface of your skin for size, tenderness, warmth and texture. The site of your swollen lymph nodes and your other signs and symptoms will offer clues to the underlying cause. Blood tests.  Certain blood tests may help confirm or exclude any suspected underlying conditions. The specific tests will depend on the suspected cause, but most likely will include a complete blood count (CBC). This test helps evaluate your overall health and detect a range of disorders, including infections and leukemia. Imaging studies.  A chest X-ray or computerized tomography (CT) scan of the affected area may help determine potential sources of infection or find tumors. Lymph node biopsy.  Your doctor may have you undergo a biopsy to secure the diagnosis. He or she will remove a sample from a lymph node or even an entire lymph node for microscopic examination. More Information Chest X-rays The sample from your needle biopsy may help your doctor determine what's causing: A mass or lump.  A needle biopsy may reveal whether a mass or lump is a cyst, an infection, a benign tumor or cancer. An infection.  Analysis from a needle biopsy can help doctors determine what germs are causing an infection so that your doctor can choose the most effective medications. Inflammation.  A needle biopsy sample may reveal what's causing inflammation, and what types of cells are involved.

11. MANAGEMENT Medication to treat your lymphadenitis including : Analgesic drugs (painkillers) to control pain Antibiotic  drugs to treat underlying infection Anti-inflammatory drugs to reduce swelling and inflammation Other drugs, depending upon the specific cause of lymphadenitis Nonmedication treatment for lymphadenitis Your health care provider may recommend nonmedication treatment to address some of the symptoms of lymphadenitis including: Cool, moist compress to reduce inflammation Surgery to drain an abscess if necessary

12. MANAGEMENT Mild symptoms (well appearing, absent/low-grade fever, minimal tenderness) Serial exams, PMD follow-up PO Antibiotic treatment if associated GAS pharyngitis found Moderate symptoms (fever, tenderness without fluctuance) Empiric PO Antibiotic therapy that covers S. Aureus and GAS Cephalexin  500 mg PO QID x 10 days Amoxicillin-Clavulanate  875 mg PO BID x 10 days Clindamycin  300-450 mg PO TID x 10 days Consider anaerobic coverage if found to have poor dentition or evidence of periodontal disease Severe symptoms (ill-appearing, fever, fluctuance or overlying cellulitis) Incision & Drainage or Needle Aspiration IV Antibiotics Disposition

13. COMPLICATION Spread of  cancer Spread of infection

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