Axillary lymphadenitis

Purulent inflammation of the lymph nodes, localized directly in the axillary region and causes axillary lymphadenitis. A characteristic feature of the disease is that axillary lymphadenitis is a typical complication of all kinds of purulent-inflammatory diseases, and does not develop as a pathology on its own.

In rare cases, when the lymph node is infected, for example due to injury or trauma, the disease can be considered primary. Literally from ancient Greek axillary lymphadenitis has such a value: lymph - fluid, aden - iron, itis - inflammatory process. Thus, axillary lymphadenitis is the inflamed lymph nodes in the armpit. Possible localization of inflamed lymph nodes in the groin area.

According to the structure of the disease, axillary lymphadenitis is divided into two subspecies: catarrhal or serous and purulent. The development of nonspecific lymphadenitis is possible during the course of various inflammatory processes. The course of inflammatory processes is determined by the characteristic changes in the lymph nodes, namely, the increase in size, painful sensations when touching, mild mobility, plastic consistency, isolated state of the lymph nodes.

As a rule, serous inflammation of the lymph nodes is accompanied by their increase, their sensitivity and soreness increases, in spite of the fact that the general condition of the diseased by external signs practically does not change. Skin integument does not change and is not welded to the joints. In the case when the disease lasts a long time, there is a probability of finding the patient's inflamed lymph nodes, in the form of "packages".

The purulent form of axillary lymphadenitis is characterized by pronounced pain sensations in the armpit region, the color of its skin changes, redness and swelling appear, as well as hyperthermia is possible. Lymph nodes have a blurring of outlines and adhesions to the surrounding tissue, as well as to each other. The general condition of the patient significantly worsens, against a background of general malaise there is tachycardia, fever, severe headache, chills, fatigue. Untimely treatment, in most cases, entails the development of neglected form of the disease, possible complications, for example, thrombophlebitis, abscess, adenophlegmon, in more severe cases of generalized infection - sepsis.

[1], [2], [3],

Causes of axillary lymphadenitis

Most often, the causes of axillary lymphadenitis involve the infection of lymph nodes with all kinds of infectious microorganisms. These include intestinal and pseudomonas aeruginosa, staphylococci, streptococci, all kinds of pneumococci and diplococci. The increase in lymph nodes occurs depending on the magnitude of the inflammatory process and the size of the site of the dislocation of the infectious microorganism.

There are three ways of infection of lymph nodes: lymphatic, hematogenous, contact. All three methods involve the infection of lymph nodes by the infiltration of infectious microorganisms. Regardless of the method of infection, the symptomatology of axillary lymphadenitis remains unchanged, the only difference is the time necessary for infection.

The main pathogens provoking axillary lymphadenitis can be called strepto- and staphylococci penetrating into the lymph nodes with a lymph flow directly from the focus of acute or chronic purulent inflammation or by direct contact through broken skin, as a result of injuries and injuries. According to the state of inflammatory foci, specialists distinguish axillary lymphadenitis of non-purulent and purulent axillary lymphadenitis. Depending on the duration of the inflammatory process, axillary lymphadenitis may be acute or chronic in degree of flow. In some cases, lesions are possible with purulent-inflammatory processes of one or several adjacent lymph nodes. Such extensive purulent-inflammatory foci of suppuration of soft tissues are transformed into adenophlegmons.

The root causes of axillary lymphadenitis, as already described above, are all kinds of infectious foci in the human body. This includes infected open wounds, inflammation and scuffing of the skin, various phlegmon, for example trophic ulcer, erysipelas, all kinds of osteomyelitis, furunculosis. Very often inflammation of the lymph node is a consequence of inflammation of the lymphatic vessels or the words of specialists - lymphangitis. In more cases, axillary lymphadenitis is provoked by: proteins, various kinds of Escherichia coli, staphylo-, entero-streptococci, or, as a consequence of their vital activity, toxic products of the disintegration of the tissue of primary inflammatory foci. The form and nature of purulent processes determine the features of the clinical picture of axillary lymphadenitis. Depending on the type of bacterium, the axillary lymphadenitis is divided into specific and non-specific. Specific diseases caused by viruses, bacteria, fungi, as well as tumors, both benign and malignant, form a specific axillary lymphadenitis. To the diseases provoking occurrence of axillary lymphadenitis it is possible to carry: tuberculosis, infectious mononucleosis, brucellosis, sarcoidosis, actinomycosis, AIDS.

Typically, infection of the lymph node occurs by the penetration of harmful microorganisms through the lymph vessels along with the flow of lymph from the infected part of the body or primary infectious focus. This method of spreading infection is called lymphogenous. The primary infected hearth may well be any damage to the skin in the armpit, for example, cuts with an inaccurate shaving of the armpits, all kinds of wounds or scrapes from tight clothing. Also, the primary infected focus can be purulent necrotic inflammation of the hair follicle and even a furuncle. In addition to this method of infection of the lymph nodes, there is a hematogenic way of infection - involving the spread of infection along with the flow of blood from the infectious foci of internal organs, inflammatory diseases of the intestine, ovaries, liver.

Hematogenous way of infection of lymph nodes occurs quite often, as well as lymphogenous way of infection. Less common is the contact method of infection of the lymph node, involving direct contact or contact of the infected surface and tissues of the lymph nodes.

Contact method is possible, for example, when fitting clothes. A high probability of penetration of infectious microorganisms is with all possible injuries of the lymph nodes, when infection occurs by direct contact of microbes and injuries. In this case, the causes of axillary lymphadenitis are quite obvious and the disease is classified as primary. Regardless of the way in which infectious microorganisms penetrated the lymph nodes, the poisoning of these microorganisms by the products of their vital activity is a consequence of this penetration. This explains the occurrence of inflammation, purulent tissue melting. Then there are serous inflammations with the further development of purulent formations. So, let's sum up.

It should be noted that the causes of axillary lymphadenitis can be associated with a number of diseases. For example, tuberculosis, malignant lesions of the neck and head, brucellosis, melanoma, rubella, lymphoma, nonspecific infectious lesions, cat scratch disease. The presence of women in silicone glands of silicone implants specialists also do not exclude from the cause of axillary lymphadenitis. In any of the cases listed above, when the size of the lymph node exceeds 1 cm in diameter, the pain in the armpits signals the need to investigate the possible cause of axillary lymphadenitis.

[4], [5], [6], [7], [8], [9]

Lymphadenitis in the armpit

Lymphadenitis in the armpit arises from the spread of infectious microorganisms through the lymphatic or blood vessels, as there is a possibility of contact penetration of the infection through cuts, injuries and other violations of the integrity of the skin of the axillary region. The defeat of the lymphatic system occurs, as a rule, at a secondary level of infection with a local purulent infection, a common disease and possible intoxication that occurs against the background of regional tissue damage. You can absolutely confidently say that the lymph glands reflect the general state of the body's structure and body tissues, both external and internal. And if the pathological process begins in the body, the first reaction will be changes in the lymphatic system. Lymphadenitis in the armpit in most cases indicates the onset of such processes and, accordingly, requires immediate treatment.

Lymphadenitis of the axillary region

Lymphadenitis of the axillary region is characterized by inflammatory processes of supraclavicular and subclavian lymph nodes. Thus in the axillary region, lymph is concentrated from a number of located organs of the neck, thorax, and shoulder girdle. The course of simple forms of lymphadenitis of the axillary region is localized in the inflamed capsule and the confined focus of the inflammatory process. A more complex form of the lymphadenitis of the axillary region is accompanied by the development of destruction of the inflammatory process and spreading to the tissues located side by side. The likelihood of developing dense infiltrates - adenophlegmons, with softening foci is also great. Untimely treatment or ineffective forms of treatment lead to the onset of a wide spread of inflammatory processes with mediastinal tissue damage, the development of thrombophlebitis and septicopyemia. The formation of lymphatic fistulas is not excluded, as a result of purulent breakthroughs. Often acute lymphadenitis of the axillary region progresses and becomes purulent. In such cases, inflammation of the lymph nodes with reddening of the skin around. The lymph nodes become not mobile and gradually weld together between themselves and the nearby tissues.

Symptoms of axillary lymphadenitis

Patients with a diagnosis of lymphadenitis tend to have similar symptoms of axillary lymphadenitis, namely, severe pulling pain in the axillary region. The sensations are so painful that it becomes necessary to keep the limbs in a forced-comfortable position. Painful sensations are accompanied by an increase in body temperature, the appearance of swelling. With lymphadenitis located on the surface of the skin, often there is hyperemia and a local increase in temperature. The later stage of the disease is characterized by the appearance of chills, fluctuations, and leukocytosis. At this moment, the state of the primary infectious focus is of no special significance anymore.

Acute nonspecific form according to external signs has such symptoms of axillary lymphadenitis - characteristic sudden painful sensations in the area of enlarged lymph nodes, accompanied by general weakness, malaise, headaches, fever. Non-nasal lymphadenitis, usually, does not affect the general condition of the patient, and externally proceeds without significant symptoms.

Symptoms of axillary lymphadenitis without purulent formations or non-purulent lymphadenitis are characterized by such external signs - an increase in lymph nodes that are dense to the touch, palpable painful, moveable, the skin over the nodes does not change externally. The purulent form of axillary lymphadenitis is characterized by intense painful sensations, a constant, pulsating nature. Lymph nodes knit together with surrounding tissues and among themselves, become practically not mobile and dense to the touch. In cases of adenophlegmons, very often the skin above the focus of inflammation has noticeable redness. As a consequence of this reddening, a tumor appears that is dense in consistence with blurred boundaries and inflammation.

Secondary symptoms of axillary lymphadenitis with purulent formations have a characteristic increase in body temperature up to 39 ° C, accompanied by severe chills, palpitations, a pronounced general weakness. Putrid phlegmon, when you feel the inflamed focus, creates a sound similar to the "crunch of snow". In the absence of timely medical treatment, the probability of the purulent axillary lymphadenitis spreading to larger areas is very high and may subsequently provoke sepsis.

Axillary lymphadenitis in children

Undeveloped skin of a child in the axillary region is susceptible to all kinds of friction and irritation, which may well be a source of infection, along with purulent inflammatory foci of individual organs. Axillary lymphadenitis in children occurs mainly as a complication due to childhood infectious diseases, such as measles, scarlet fever, tonsillitis, diphtheria. Usually, axillary lymphadenitis is seen in older children. As pediatric practice shows, infection of the lymph nodes initiates staphylococci, but it is also possible to infect by any pyogenic microorganisms.

Development of axillary lymphadenitis in children occurs quickly and actively, which is why transformation into acute or chronic forms of the disease does not take much time.

Symptoms of axillary lymphadenitis in children have characteristic features, for example, headaches, loss or loss of appetite, poor sleep, severe pain in the armpit. The initial phase of development of axillary lymphadenitis in children is manifested by a tumor of the lymph nodes. At palpation of lymphonoduses the child feels a pain. To the touch, the lymph nodes become firm. In a few days the inflammatory processes spread to the tissues that are near the lymph nodes, and the knot itself is almost impossible to probe. The lymph node and the tissues surrounding it become denser and increase in size. It is very important not to miss the moment and begin timely treatment of axillary lymphadenitis, which will avoid the spread of inflammatory processes and complications.

When the acute form of the disease develops, there is a significant temperature increase, a general malaise, which is caused by the exposure of the child's organism to microbial toxins. With the development of purulent lymphadenitis, the axillary region of the inflammatory processes usually turns red. Lymph nodes become dense in consistency, with palpation painful sensations occur.

Diagnosis of axillary lymphadenitis in children is not particularly difficult for a specialist, doubts may arise in determining the etiology of the disease.

[10], [11], [12], [13]

Right-sided axillary lymphadenitis

Right-sided axillary lymphadenitis has a number of characteristic features in primary symptomatology and diagnosis. Its main, characteristic feature lies in the immediate proximity to the heart. And as a rule, this moment demands the utmost attention from the specialists in the part of the correctness of the diagnosis and the choice of the method of treatment of the disease. The possibility of the transition of right-sided axillary lymphadenitis into a purulent infectious form is accompanied by temporary remissions and exacerbations, the disease has a persistent course. This form of the disease manifests itself in the initial stages of a special pulling pain in the right-side axillary region, accompanied by general weakness, rapid fatigue, sluggish state. The first few days of the disease, the lymph nodes are sufficiently mobile, there are no painful sensations, no adhesions to the tissues are detected. And only after three or four days begins the rapid development of tissue infiltration, there is a spike of the lymph nodes. In appearance, the lymph nodes are like a bunch of grapes, fill the entire right-sided axilla.

Depending on the degree of development of the inflammatory focus, conservative or surgical treatment is used. If the patient has addressed at a stage of the expressed inflammatory process with disturbances of the general condition, then it is expedient to designate a therapeutic complex that suppresses the inflammatory process. Such a complex, as a rule, consists of local treatment, physiotherapy, antibiotic therapy.

Timely and qualitative treatment leads to positive dynamics, the lymph nodes take the same size, the overall well-being of the patient is significantly improved. Quite often, after the application of the therapeutic complex, the process of recovery does not begin or goes very slowly, then it makes sense to conduct an operation, in order to remove the focus of infectious inflammation and the adjacent tissues of the right-sided axilla. Complications with such surgical interventions practically does not happen, but exceptions are possible. Postoperative recovery of the patient with right-sided axillary lymphadenitis occurs without distinctive features and quickly enough.

Diagnosis of axillary lymphadenitis

Diagnosis of axillary lymphadenitis for a specialist is not particularly difficult. To establish the correct diagnosis, it is necessary to take into account all clinical indications and anamnesis. It is slightly more difficult to establish a diagnosis for complicated forms of axillary lymphadenitis. For all variants, it is necessary to determine the localization of primary purulent foci of inflammation. As a rule, the diagnosis of axillary lymphadenitis is carried out using a puncture biopsy of the lymph nodes, if necessary, the lymph node is excised by histological analysis. Such a procedure is necessary for the determination of chronic forms of axillary lymphadenitis and diagnosis of such diseases as leukemia, metastatic damage of lymph nodes, and lymphogranulomatosis. Diagnosis of axillary lymphadenitis provides for a whole complex of clinical laboratory studies - computer tomography of lymph nodes, lymphoscintigraphy, radiopaque lymphography.

If necessary, it is possible to attract specialists from other medical profiles, for example, venereologists, infectious disease specialists. Preliminary diagnosis of axillary lymphadenitis provides an external examination of the patient's body, with detailed palpation of the sites of the lymph nodes. In the case of detection of primary signs of the disease, ultrasound is assigned. With the aim of eliminating the primary symptoms of an organism intoxication, there is an abundant drink.

[14]

Treatment of axillary lymphadenitis

The treatment of axillary lymphadenitis depends, first of all, on the phase of development of the inflammatory process and the state of the lymph nodes. In the early stages of axillary lymphadenitis treatment is conservative and is aimed at eliminating the primary infectious inflammatory focus. For this, if necessary, open abscesses, phlegmon, drain abscesses, open purulent fines. Antibiotic therapy is also mandatory, but the sensitivity of the microbial flora of the primary inflammatory focus must be considered.

If necessary, the treatment of axillary lymphadenitis is carried out by an operative method. Opening of abscesses, removal of purulent masses, drainage of wounds is usually practiced in acute purulent forms of axillary lymphadenitis. In those cases where axillary lymphadenitis is secondary, treatment must begin with the localization of the main source of the infectious focus. Treatment of axillary lymphadenitis of a specific form is determined by the state of the lymph nodes and the degree of their defeat.

In active inflammatory processes, first-line drugs are used, for example, tubazid, ethambutol, streptomycin, protionamide, ethionamide. Directly on the inflamed lymph node impose streptomycin bandages, treated with tybonic or tubazidovoy ointments, as is the practice of local lymph node swabbing streptomycin. If purulent-inflammatory processes have a pronounced character, it is advisable to prescribe antibiotics for a wide range of uses. In some cases, treatment of axillary lymphadenitis can last up to six months. The methods of treatment of axillary lymphadenitis in children practically do not have any significant differences from the methods of treatment of adults. Purulent inflammation of lymph nodes is much less in children, and enlarged lymph nodes are a symptom of many infectious diseases. Because of this, the course of treatment is carried out in the case of painful sensations of lymph nodes or the characteristic signs of infectious diseases were not manifested before the inflammatory processes of the lymph nodes. Less often, experts diagnose chronic axillary lymphadenitis in children, as a rule, there is no need for a special course of treatment. But this gives an occasion for finding the main infectious focus. In such cases it is advisable to take appropriate measures to strengthen the immune system of the child.

Prevention of axillary lymphadenitis

Prevention of axillary lymphadenitis is fairly simple and accessible to everyone. First of all, you need maximum protection against possible infection by any means. Any inflammatory processes in the body should be timely and effectively localized. Particular attention should be paid to all kinds of wounds, injuries, scratches of the axillary region. It is necessary to minimize the possibility of such injuries and when they appear, timely and high-quality treatment with antiseptic agents is necessary in order to prevent the spread of infection. Any infectious disease must be treated medically, under the supervision of a specialist, if necessary, you need to undergo general antibiotic therapy. Do not forget that untimely treatment or lack of treatment of axillary lymphadenitis provokes the development of inflammatory processes and the formation of purulent foci, the treatment of which subsequently takes a long period of time. Prevention of axillary lymphadenitis involves strengthening the human immune system in general, a balanced diet rich in vitamins, compliance with personal hygiene.

Forecast of axillary lymphadenitis

The prognosis of axillary lymphadenitis in most cases with the initial form of the disease and timely started effective treatment is favorable, although in some cases, long-term therapy is possible. The destructive form of axillary lymphadenitis entails the death of the tissues of the lymph nodes with the further restoration of their scar tissues. The localization of lymphadenitis on the limbs provokes the lymph drainage and develops lymphostasis and subsequently attracts the appearance of elephantiasis. The forecast of axillary lymphadenitis of acute specific and nonspecific forms is favorable in many cases. The result of an effective course of treatment is scarring of lymph nodes, restoration of their functions. The duration of the course of treatment directly depends on the degree of development of the infectious focus and the timely diagnosis of the disease in each specific case and can last up to one year or more.

[15], [16], [17], [18], [19], [20]