Acute lymphadenitis

Acute lymphadenitis is an acute inflammatory process in the tissues of the lymph nodes, often purulent. As a rule, acute lymphadenitis is secondary in nature, when pathogenic microorganisms are found outside the local pathological focus and penetrate the lymph nodes.

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Causes of acute lymphadenitis

Acute lymphadenitis is usually provoked by pyogenic microorganisms that penetrate the lymph nodes through the lymphatic vessels from purulent acute or chronic foci (furuncles, scratches, felon, phlegmon wounds, etc.). Pyogenic microorganisms include:

• Staphylococci and streptococci most often contribute to the inflammatory process in the lymph nodes.
• gonococci.
• meningococci and many others.

Acute lymphadenitis can also be caused by diseases such as:

• tuberculosis (causative agent – Mycobacterium tuberculosis or Koch's bacillus).
• syphilis (causative agent – white treponema).
• cancerous lesion of internal organs.

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Clinical symptoms of acute lymphadenitis

Acute lymphadenitis manifests itself with both general and local symptoms.

General symptoms of acute inflammation in the lymph nodes:

• increase in temperature to high levels (up to 39 - 40°C).
• the appearance of tremors (chills).
• Severe headache is possible.
• the presence of severe weakness.
• muscle soreness.
• sleep disturbance.

Local manifestations of acute lymphadenitis are characterized by an increase in the size of the lymph nodes and all the signs of inflammation - there are five of them:

• redness of the skin over the area of the lymph nodes.
• the appearance of swelling or edema of the skin in the projection of the lymph nodes.
• painfulness of the lymph nodes - both at rest and when palpating them.
• increase in local temperature, skin is hot to the touch.
• the function of the area where the lymph nodes are affected is impaired (for example, it is painful to move a leg or arm, turn the neck, etc.).

The clinical symptoms of acute lymphadenitis are quite clear and will not be difficult to diagnose by an experienced specialist.

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Acute lymphadenitis in children

Acute inflammation of the lymph nodes in childhood has some peculiarities. In children, all inflammatory processes occur faster and with more pronounced symptoms. Therefore, if a painful lymph node is detected in a child, you should immediately contact a specialist (pediatrician, pediatric surgeon), undergo all necessary examinations and begin treatment.

To prevent acute lymphadenitis in your child, you need to promptly treat carious teeth, inflammatory processes in the oral cavity, runny nose, protect from injuries, and if any, treat with antiseptics (brilliant green, iodine, etc.).

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Classification of acute lymphadenitis

1. Acute lymphadenitis can be purulent and serous (non-purulent).

Serous and purulent acute lymphadenitis are stages of a single process. At first, the inflammation begins as serous, it can end on its own or after appropriate treatment, or it can transform into purulent.

2. A distinction is made between non-specific and specific acute lymphadenitis, everything depends on the type of pathogen that provoked it.
3. Depending on which groups of lymph nodes are affected, the following types of acute lymphadenitis are classified:
   • lymphadenitis of the face and neck.
   • cervical.
   • submandibular.
   • odontogenic.
   • mesenteric.
   • inguinal.

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Acute serous lymphadenitis

In acute serous lymphadenitis, general well-being suffers little. There may be no temperature, or it may rise to 38°C. At this stage, painful sensations arise in the lymph nodes, they increase in size. When palpating them, they are slightly dense and mobile. With timely detection and treatment of the primary focus, these lymph nodes decrease in size, their soreness passes, general well-being is normalized. Otherwise, serous inflammation turns into purulent.

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Acute purulent lymphadenitis

With purulent inflammation in the lymph nodes, their pronounced pain is noted, an increase in temperature above 38 ° C. Sleep is disturbed, headaches and weakness appear, i.e. general well-being suffers greatly. Over time, an abscess forms at the site of the lymph node, which will need to be removed surgically in a hospital setting, it will not go away on its own. Not treating purulent acute lymphadenitis is very dangerous to health and life, since it is fraught with the development of lymphadenophlegmon and sepsis (blood poisoning).

Acute lymphadenitis of the face and neck

As a rule, the cause of acute lymphadenitis of the face and neck are microorganisms circulating in the oral cavity - coccal flora - staphylococci. That is, such lymphadenitis occurs as a result of odontogenic infection. Therefore, timely treatment of carious teeth is important. Most often, the infection penetrates the following groups of lymph nodes and occurs:

• acute submandibular lymphadenitis.
• buccal.
• acute cervical lymphadenitis.
• parotid.
• supramaxillary and mandibular.

In the prevention of the above-mentioned acute lymphadenitis, personal hand hygiene is important, and special care should be taken when removing acne and pimples in the face and neck area.

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Acute mesenteric lymphadenitis (mesadenitis)

Acute mesenteric lymphadenitis is an inflammation of the lymph nodes of the intestinal mesentery. Such acute lymphadenitis occurs after operations on the abdominal organs (removal of appendicitis, for example), after diseases of the upper respiratory tract, tuberculosis and many other diseases. Such lymphadenitis is more common in school-age children. It occurs suddenly, there is acute cramping pain in the abdomen, not associated with food intake, dyspeptic disorders (nausea, possibly vomiting), an increase in temperature to high numbers. In such a situation, it is necessary to carefully collect anamnestic data, study the clinical picture in detail, undergo the necessary instrumental and laboratory tests prescribed by a specialist.

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Acute inguinal lymphadenitis

Acute inguinal lymphadenitis is characterized by enlarged and hardened lymph nodes in the groin area. There is pain in the lower abdomen and groin area, especially during movement and physical activity, and the temperature increases. The causes of inflammation of the lymph nodes in the groin area can be: syphilis, metastases of cancer of the genitals, rectum, fungal diseases and wounds on the lower extremities. If enlarged inguinal lymph nodes are detected, you should immediately seek help from a doctor (therapist, surgeon, if it is a child - a pediatrician).

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Diagnostics of acute lymphadenitis

• Superficial acute non-specific lymphadenitis is not difficult to diagnose. For this, clinical symptoms together with anamnesis data (medical history) will be sufficient. The main thing is to determine the primary purulent inflammation, where its focus is located.
• Acute specific lymphadenitis is determined using clinical and laboratory data.
• If tuberculosis is suspected, Mantoux and Pirquet tuberculin tests are performed, chest X-rays are taken, sputum is examined, and a puncture of the corresponding lymph node is prescribed if necessary.
• If syphilis is suspected, a puncture of the affected lymph node is performed, where pale treponema is found in the puncture.

In addition, in case of specific lymphadenitis, consultation with specialized specialists is necessary: venereologists, infectious disease specialists, phthisiologists.

• If necessary, additional methods of examining the lymph nodes may be prescribed: ultrasound diagnostics, computed tomography and magnetic resonance imaging of the affected areas, X-ray contrast lymphography, lymphoscintigraphy.

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Treatment of acute lymphadenitis

Treatment of acute lymphadenitis is carried out depending on the form of the inflammatory process.

Therapy of acute serous lymphadenitis.

1. Treatment of the underlying disease, due to which the infection entered the lymph nodes (treatment of caries, if there are wounds, treating them with an antiseptic - iodine, brilliant green and applying a sterile bandage, etc.).
2. Symptomatic therapy:

• if the temperature rises – antipyretics (paracetamol, ibuprofen)
• an excellent addition to therapy at this stage would be the use of the drug lymphomyosot, it very well relieves inflammation and pain in the lymph nodes
• multivitamins as a general strengthening therapy (multifort, vitrum, multitabs)
• antiallergic drugs will help to additionally relieve swelling at the site of the pathological focus (erius, fenkarol, fenistil)
• if severe pain is observed, for example, as in the case of mesenteric lymphadenitis, painkillers are prescribed (analgin, ketalong, dicloberl)
• In case of progression of acute serous lymphadenitis, even after elimination of the underlying disease, antibacterial drugs (ceftriaxone, cefotaxime, augmentin) are prescribed.

Treatment of acute purulent lymphadenitis:

1. Hospitalization of the patient in the surgical department.
2. Surgical intervention - the purulent focus is opened, dead tissue is removed, the purulent cavity is washed with antiseptic solutions and the wound is tamponaded, and an aseptic dressing is applied.
3. Prescribing antibacterial drugs.
   • In case of non-specific acute lymphadenitis, antibacterial drugs are prescribed, taking into account the sensitivity of microorganisms to the antibiotic (as a rule, broad-spectrum antibiotics are prescribed - cefotaxime, augmentin, azithromycin, sumamed).
   • In case of specific acute lymphadenitis, antibiotics are prescribed depending on the identified underlying disease: if it is syphilis, then penicillin, macropen, sumamed are prescribed; if it is tuberculosis, then streptomycin, rifampicin are prescribed.
4. The use of multivitamin complexes as general tonics and to improve the functioning of the immune system (Multifort, Vitrum).
5. Antihistamines are prescribed to reduce the risk of allergic reactions from the use of antibiotics and to additionally reduce swelling in the area of the pathological focus (fenkarol, erius, cetrin).
6. In the postoperative period, if necessary, painkillers are prescribed (dicloberl, ketalong).
7. Proper care of the patient (regular aseptic dressings of the postoperative area).
8. Compliance with sanitary and hygienic regulations (personal hygiene, ventilation of the premises, air humidification and regular cleaning of the premises).
9. A rational diet with limited fatty, fried and salty foods. It is necessary to avoid fast food. Eat more plant, dairy and protein products (lean meats, fish).
10. Physiotherapy in the postoperative period - UHF therapy - reduces inflammation, accelerates the healing and recovery of wounds. In addition, it helps reduce the sensitivity of nerve receptors, which leads to a decrease in pain.

Prevention of acute lymphadenitis

The best prevention of acute lymphadenitis is timely and adequate therapy of the underlying disease that may cause lymphadenitis. Timely diagnosis and therapy are necessary:

• foci of infection in the body: treatment of dental caries, tonsillitis, opening of boils, carbuncles, panaritium, etc.
• diseases such as tuberculosis and syphilis.

Sometimes minor scratches, calluses or wounds, which many people do not pay attention to, can cause acute lymphadenitis. Based on this, in any unclear cases of enlarged lymph nodes, accompanied by high temperature and pain, it is necessary to seek help from specialists. Self-medication in such cases is dangerous.

Prognosis of acute lymphadenitis

Most often, the prognosis for acute lymphadenitis is favorable and ends in recovery, especially in its initial stages and with timely treatment.

In advanced forms of lymphadenitis (destructive), the death of lymph nodes is observed, and scar tissue subsequently forms in their place. When such a process occurs on the extremities, a violation of the lymph outflow and the formation of lymphostasis are observed, with the subsequent development of elephantiasis.

Also, do not forget that acute lymphadenitis is a sign of generalization, the spread of infection in the body and carries a great danger of developing lymphadenophlegmon, and later - sepsis, especially if treatment is not started in a timely manner.