Lymphadenitis - Causes, symptoms and treatment. MF.

Lymphadenitis is an inflammation of the nodes of the lymphatic system.

Lymph nodes are peripheral organs of the lymphatic system, which contain cells that provide a protective function, connected to the circulatory system. These nodes are specific protective filters that prevent the penetration of harmful substances and their spread throughout the body. Lymphadenitis belongs to the group of acute purulent infections. In rare cases, lymphadenitis is a direct primary disease, more often as a complication of another pathology that has arisen, it can be a nonspecific process: furuncle, panaritium, carbuncle, thrombophlebitis, or any other purulent wound. In more rare cases, the formation of lymphadenitis can be the result of specific more serious diseases, such as plague, tuberculosis, actinomycosis and others. The most frequent place of localization of processes: axillary cavity, inguinal region, cervical and submandibular lymph nodes.

Possible causes of lymphadenitis

Lymphadenitis develops due to infection of the lymph node with various microorganisms, the most frequent pathogen is staphylococcus, streptococcus, various types of diplococci( pneumococcus), Pseudomonas aeruginosa and E. coli. A direct increase in the lymph node is due to the accumulation of cells of the inflammatory reaction in the zone where the microorganism is detected. In most cases, these microorganisms enter the lymph node through lymphatic vessels with a current of lymph from the infected area of ​​the body, the so-called primary focus of infection. It can be a purulent wound, localized on the surface of the skin, purulent-necrotic inflammation of the hair follicle or furuncle.

The hematogenous pathway of infection( with blood flow) occurs as often as lymphogenous and is a consequence of a foci of infection in internal organs( inflammatory diseases of the liver, ovaries, intestines, tonsillitis and others).

The contact pathway of transmission of the pathogen is more rarely encountered directly when the infectious material and tissue of the lymph node come into contact. Possible penetration of microbes directly into the lymph node when it is injured. In such cases, lymphadenitis acts as a primary disease.

Getting into the lymph node, the microorganism begins to send the products of its vital activity surrounding tissue, causing inflammation, and further purulent tissue meltdown. In this case, changes in the surrounding tissues can be limited to serous inflammation or go into a purulent with the formation of adenophlegmons.

Possible symptoms of lymphadenitis

Acute lymphadenitis begins quite brightly, with a sharp pain and enlargement of the lymph node, which rarely leads to a restriction of the mobility of that part of the body next to which lymphadenitis was formed. A person starts to worry about a constant, dull or aching headache, there is general weakness, possibly malaise, fever.

The initial stage of lymphadenitis, cervical lymph nodes.

The serous nature of of lymphadenitis gives a slight disruption to the general condition of the patient. Appears dull pain in the region of regional lymph nodes;the latter can be enlarged, sufficiently dense in comparison with healthy and slightly painful when palpating, the skin over the affected lymph nodes is not changed. With further progression of the inflammatory reaction in the lymph node, destruction of the lymphatic tissue occurs with the development of purulent fusion and the formation of necrotic tissue.

With purulent lymphadenitis the pain is sharp, sometimes jerking. The skin over the inflamed lymph node is hyperemic( it has a bright red color, indicative of inflammation), with sensation reveals soreness. If in the initial stages, even with serous lymphadenitis, the lymph nodes did not merge, then they merge with each other and surrounding tissues, become immobile.

Chronic nonspecific lymphadenitis is the result of a prolonged chronic untreated infection. Chronic lymphadenitis can take place without significant symptoms, or in general not manifest itself at all. Usually there is a small subfebrile temperature of about 37 degrees C, which a person eventually gets used to and does not notice, a small swelling in the area of ​​the affected lymph nodes.

With adenoflegmon , which is formed due to untreated purulent lymphadenitis, diffuse hyperemia of the skin is determined, tight, without clear boundaries, edema with foci of softening. Body temperature rises to high figures, there is a chill, a marked increase in heart rate, headache, severe weakness. To this state, this disease should not be brought, because it can lead to serious complications.

Purulent fusion of the supraclavicular lymph node.

If the first symptoms of lymphadenitis, such as tenderness of the lymph node, swelling, or fever, should be immediately consulted by a physician or surgeon. These specialists will help to determine the cause of lymphadenitis directly and prescribe the right treatment or further diagnosis. Under the mask of lymphadenitis, various diseases can hide, such as plague, tuberculosis, various tumor processes. In tumorous processes, as a rule, a group of lymph nodes increases, they are very dense to the touch, they are not mobile and often painless. With plague, tuberculosis and tularemia, in addition to the inflammatory process as with lymphadenitis, there will be other specific manifestations of these diseases. It is difficult to distinguish inflammatory lymphadenitis from a specific one, so self-diagnosis can lead to sad consequences.

Diagnosis of lymphadenitis

The lymph nodes in a healthy person are soft, not enlarged, dislocated relative to adjacent tissue, painless. Very often, people with normal physique can not feel the lymph nodes. They are well found in children and adolescents of lean physique. When diagnosed, the doctor will first examine the lymph nodes and establish all of the above signs. Further guided by the received data, the question on laboratory and instrumental methods of diagnostics will be solved. Possible variants:

• General blood test, which will allow to determine qualitative and quantitative composition changes. If there is a suspicion of tumor blood, a node biopsy( puncture of the lymph node tissue) may be performed for histological examination.
• In the surgical pathology, a diagnostic and therapeutic operation will be performed to open and drain the formed cavity. Inspection of the nearest organs for the presence of abscesses and other purulent wounds.
• For specific lymphadenitis, contact with tuberculosis patients is taken into account and a number of diagnostic tests are performed: skin and allergic tests and microscopic examinations( blood, sputum), X-ray examination for suspected tuberculosis.
• In children, the doctor, when examined, should rule out Quincke's edema as one of the varieties of an allergic reaction that can endanger life;tumors in the neck, as well as congenital cysts that look like enlarged knots.
• If the patient discovers an extremely swollen lymph node in the groin, the doctor must exclude a hernia in the groin to avoid further progression of the hernia and prevent it from being infringed. Hernias occur in 1% of the population, 85% of patients with a hernia of a man.
• In some cases, depending on the concomitant symptomatology, it will be necessary to perform more targeted diagnostic methods such as: ultrasound of all peripheral lymph nodes and abdominal organs in particular the spleen and liver;analysis for HIV infection;ENT-doctor examination and computed tomography.

It must be remembered that only a person with a higher medical education can make an accurate diagnosis, which will evaluate the whole picture as a whole, taking into account the data in aggregate.

Treatment of lymphadenitis

Treatment of the initial forms of lymphadenitis is to create rest for the affected area where the lymph node is located, physiotherapy( galvanization, drug electrophoresis, ultrasound therapy), anti-inflammatory ointments is widely used. At any stage of the disease, it is necessary to use antibiotics for the proven infectious cause of the disease. The group of antibiotics is determined by the spectrum of sensitivity of the pathogen. With nonspecific infectious lymphadenitis I use antibiotics penicillin series, cephalosporins 2 generations( Cefuroxime).With a confirmed tuberculosis infection, treatment is carried out strictly in a stationary setting with specific anti-tuberculosis therapy.

With suppuration of lymphadenitis, drainage of the festering cavity is urgently needed. This procedure must be performed under sterile conditions in order to avoid the attachment of a secondary infection. After draining, a permanent dressing and wound treatment is necessary.

If after a puncture biopsy a benign or malignant tumor process is confirmed, complex chemotherapy and irradiation may be required.

Folk methods of treatment are possible only at the initial stages of lymphadenitis and only in combination with drug treatment. To remove the inflammatory reaction and reduce further progression, you can use an extract from AloeVera leaves for compresses to the affected area.

Complications of lymphadenitis

This disease can be complicated by the following conditions: cutaneous abscess, osteomyelitis, meningitis, encephalitis, septic arthritis and sepsis. The last listed conditions with ineffective or incorrect treatment can lead to disability and death of the patient.

Prevention of lymphadenitis

In order to avoid the possibility of formation of lymphadenitis, it is necessary: ​​timely treatment of any skin wounds and chronic infection, observance of precautions to avoid injury. Maintain immunity at the proper level and contact the doctor in a timely manner. As for nutrition, you should not eat some foods that can exacerbate the inflammatory reaction. This meat is fatty and coarse-fiber( especially lamb and pork) hot, salty and smoked;dairy. Promotes the recovery of foods rich in vitamin C.

Physician therapist Zhumagaziev EN