Enlargement of lymph nodes in the groin: causes, treatment

In a healthy person, lymph nodes are no more than pea-sized or not palpable at all. These organs of the immune system are filters that populate the lymphatic fluid, trap pathogenic microorganisms, preventing them from entering the blood. When in contact with strangers, the lymph nodes intensively produce T, B and NK lymphocytes to normalize the body. If it is not possible to quickly cope with foreign elements, painful changes in the lymph nodes lead to their growth, inflammatory (lymphadenitis) and non-inflammatory genesis (lymphadenopathy).

First of all, the reaction occurs in the group of lymph nodes closest to the affected organ. Hyperplasia of the inguinal nodes signals the presence of trouble in the buttock zone, lateral sections of the trunk, intestine, reproductive organs and lower limbs.

[1], [2], [3], [4]

Epidemiology

Medical statistics show that more than 90% of cases of inguinal lymphadenopathy occur after trauma to the perineum and genital organs. Of the thousands who applied for medical help, two or three people are being treated for increased lymph nodes of any location, about 60% of them are male patients and about 40% are female. Most patients with lymphadenopathy (60-80%) are over forty years old.

[5], [6], [7]

Causes of the enlarged lymph nodes in the groin

The vast majority of cases of lymphadenopathy of this localization is caused by pelvic floor injuries and reproductive organs. As the most likely risk factors for hyperplasia of lymph nodes in this zone, the venereal, viral ( genital herpes, HIV ), parasitic and bacterial diseases of the pelvic organs, tumor formations such as lymphoma, diseases of the blood and connective tissue, dermatoses, lower limb injuries and unusual high physical stress on them. The beginning or abolition of hormonal / chemotherapy can be accompanied by an increase in lymph nodes as well in the groin. Taking medications (sulfonamides, penicillins, cephalosporins, preparations of gold, finlepsin, captopril and some others), vaccination can cause lymphadenopathy.

Lymphadenopathy is divided into nonspecific, the causative agent of which are in most cases staphylococci, somewhat less often - streptococci and other pyogenic bacteria, sometimes in combination with anaerobes, and specific, accompanying rubella, venereal diseases, actinomycosis, tuberculosis. The pathogenesis of hyperplasia is based on the ingress of a pathogen from the primary source of infection or the invasion of cancer cells into the lymph node, where the B-lymphocytes recognize the antigen and begin to produce antibodies to it. Also in the lymph node an active synthesis of whey proteins, immunocytes (T-killers, T-helpers, NK-lymphocytes), which try to destroy foreign microorganisms, begins. If the pathogenic microflora is not completely suppressed, then the lymph node becomes the focus of chronic infectious pathology. Its relapse ( acute lymphadenitis ) can develop as a result of a decrease in immunity due to endogenous or exogenous factors (nervous overexertion, freezing, exacerbation of autoimmune disease, etc.).

The enlarged lymph nodes in the inguinal zone are a sign of a progressive pathology of the organs, from which the lymph flow is directed. Upper nodes of this group increase with infection of buttocks, sides and pelvic organs, middle - intestines, lower - legs.

Forms

Types of acute lymphadenitis by the nature of the inflammatory process:

• simple or serous (catarrhal) - mild hyperplasia of the lymph nodes, they are soft, not hyperemic, mobile and not soldered, there is no edema, there may be slight pain when pressing;
• purulent - infiltrate from inflamed lymph nodes, severe pain syndrome, hyperemia and swelling of surrounding tissues, accompanied by a sharp rise in temperature (38-39 ° C), a significant increase in lymph nodes that prevent walking, the abscess can break through with the formation of a fistula or move to the next stage;
• adenophlegmon - the inflammation spreads to the surrounding capsule of the cell site, the patient is in a febrile state, which is accompanied by chills, tachycardia, headache, shortness of breath, hypotension (requires surgical intervention).

These types of diseases demonstrate the stages of development of one process. Timely appeal for medical care at the stage of serous inflammation with the help of conservative methods of treatment leads to complete recovery.

[8], [9]

Complications and consequences

The enlargement of the lymph nodes in the groin, lasting more than two weeks, even if it does not cause serious discomfort should not be left without attention. You can skip the development of such serious diseases as tuberculosis, oncopathology and others. It is necessary to consult a doctor and find out what caused it. This condition can be a symptom of serious health problems, and the earlier the diagnosis is made and the treatment is started, the better the chances of recovering health.

Acute lymphadenitis usually causes serious discomfort, and people try to get rid of it. However, not always immediately go to the doctor, and try to be treated by alternative methods, which can lead to purulent inflammation. Complications of purulent lymphadenitis can be an abscess or adenophlegmon, which require surgical intervention.

The response of the body to a local inflammatory process can be getting the infection into the systemic circulation, the appearance of purulent foci in the distant organs and sepsis.

Untimely treatment of acute lymphadenitis is fraught with the development of purulent inflammation of the veins, the consequence of which can be phlebothrombosis or pathology of the lymph drainage and the development of elephantiasis (elephantiasis). Thrombophlebitis of the lower limbs can result in a clogging of the pulmonary vessels and death of the patient.

Chronic sluggish inflammation of the lymph nodes, which does not cause any special troubles and is ignored by the patient, can lead to hypoplasia of the lymph nodes, their scarring and degeneration. In the affected lymph nodes connective tissue grows, drainage of the lymphatic fluid is broken, chronic edema appears, in severe cases - lymphostasis (elephant leg, scrotum).

[10], [11], [12], [13], [14]

Diagnostics of the enlarged lymph nodes in the groin

The accumulation of lymph nodes in this zone is the largest in the body. Hyperplasia of one or more nodes can signal the existence of a serious pathology of vital organs. How to determine the increase in lymph nodes in the groin? With their normal size, palpating the nodes is itself problematic. The enlarged superficial lymph nodes are noticeable visually, since their size can reach 50-60 mm. They are painful, especially when walking. An exact conclusion about the presence of pathological changes in the nodes of the inguinal group can be obtained by ultrasound, and in order to determine the cause of their increase, a number of diagnostic measures need to be performed.

The first and very important step in determining the etiology of lymph node hyperplasia is a careful collection of anamnestic information, infectious, professional, migratory. The organs and tissues are examined, the lymph drainage of which leads to enlarged lymph nodes. Nodes in other clusters are monitored. The magnitude, intensity of pain sensations, individual nodes or associated with each other and surrounding tissues, density and elasticity are taken into account.

The patient is assigned laboratory tests - blood (clinical), biochemistry, rheumatic, serological tests, urine and others, depending on the alleged diagnosis of the underlying disease. Sometimes, to establish an accurate diagnosis, a puncture biopsy of the lymph node's contents is assigned, excising it for histological examination.

Instrumental diagnosis - ultrasound, radiography, computer and magnetic resonance imaging.

[15], [16], [17]

Differential diagnosis

Differential diagnosis is carried out in order to distinguish specific lymphadenopathy in tuberculosis, syphilis, toxoplasmosis, and other infections. Malignant and metastatic neoplasms, blood diseases are excluded. Local hyperplasia should be differentiated from generalized, nonspecific lymphadenitis - from phlegmon and osteomyelitis.

Treatment of the enlarged lymph nodes in the groin

The size of the lymph nodes can increase under the influence of many factors, so first determine the cause of hyperplasia, depending on which treatment is prescribed. Independent therapy of enlarged lymph nodes is absent.

With non-inflammatory lymphadenopathy, which occur with lymphogranulomatosis, leukemia, metastasis, the underlying disease is treated, as with specific lymphadenitis. Depending on the underlying disease, the recommended treatment regimens for tuberculosis, venereal diseases, infectious mononucleosis, childhood infections are used.

Conservative treatment of enlarged lymph nodes in the groin is performed with nonspecific chronic lymphadenitis, acute catarrhal and at the initial stages of purulent process. With chronic disease, the main goal of therapy is to identify and eliminate the source of prolonged infection of the lymph nodes. It is not always possible to identify the cause of chronic inflammation of inguinal lymph nodes. In such cases, treatment is prescribed, aimed at eliminating inflammation in the lymph nodes and increasing the body's defenses.

Antibacterial preparations of the penicillin series are prescribed, for example,  Augmentin, whose spectrum of action is broadened by the presence of clavulanic acid in its composition. The antagonist of almost all bacterial pathogens that infect the genitourinary tract, skin, bones, soft tissues, intestines, is active against the causative agents of gonorrhea and syphilis. Produced in forms for oral administration and intravenous injection, dosed individually, taking into account the severity and localization of the infectious and inflammatory process. It is used at any age, the exception is the first trimester of pregnancy and the lactation period. May cause allergic reactions, since antibacterial drugs of this series cause them most often. In patients with renal failure, dose adjustment is required, with hepatic - prescribe with caution, especially intravenously.

Alternative choice can be stopped on cephalosporins of the second generation. For example,  Cefuroxime aksetil,  showing activity to the main infectious agents, provoking inflammation of the lymph nodes, staphylococci and streptococci. It is used for infections of the urinary and genital organs, bones, joints, skin and soft tissues. Produced for oral administration, as well as for intramuscular and intravenous injections. Dosage individually, applied from the first days of life, during pregnancy and lactation, reception is undesirable, its effect is not investigated. When the kidneys are disturbed, the dosages are corrected. Causes allergic reactions, special care should be given to people with an established allergy to penicillin drugs.

In the treatment of acute lymphadenitis, antibiotic therapy is also used, when choosing a drug, sensitivity of the infectious agent of the primary focus is taken into account. Simultaneously with the treatment of inflamed lymph nodes, the primary infection is eliminated. After its removal, the catarrhal inflammation usually passes. Purulent - requires a longer treatment. The patient must comply with bed rest, except for antibacterial anesthetic and restorative therapy. In addition to antibiotics, stimulants for the production of leukocytes are prescribed, for example,  Methyluracil. Activates the processes of hematopoiesis, especially leukopoiesis, promotes the renewal and recovery of cells, increases cellular and humoral immunity, relieves inflammation. Contraindicated in leukemia, lymphogranulomatosis, bone marrow cancer. Occasionally, when applying suppositories, there is a slight burning sensation, there may be skin and vegetative-vascular allergic disorders.

Oral administration is performed during or after a meal. The recommended dose at the age of 3-8 years is 250 mg, more than eight 250-500 mg, the number of receptions per day is three. Adult patients are dosed at 500 mg four times per day, the maximum allowed to increase the daily number of receptions to six. In the treatment of inflammation of the large intestine, suppositories are prescribed - from one to four units per day. Long-lasting non-healing skin surfaces are treated with 10% ointment simultaneously with oral administration.

Likopid  - a powerful immunostimulant, is used in severe cases in the treatment of purulent lesions for the prevention of sepsis. It has bactericidal and cytostatic properties, activates resorption of tumor formations. Pregnant and lactating women are not prescribed, children aged 3-15 years are dosed 1 mg / day for not more than ten days. May cause mild hyperemia that does not require its withdrawal, is not prescribed in case of aggravation of autoimmune processes, at febrile temperature in the patient, lactose intolerance. Tablets are taken orally dissolved before full dissolution under the tongue for half an hour before meals. Dosage and therapeutic scheme is developed by the attending physician individually, taking into account the features of the disease and the interaction with other prescribed medications.

In cases of primary infection in the form of pressure sores and other long-term recurrent wound lesions, the focus of infection is treated  with Vishnevsky ointment. It is used in conjunction with other activities, destroying pathogenic microorganisms in the primary focus and promoting its healing.

Ihtiol ointment is used in the initial stage of acute nonspecific lymphadenitis  . It does not have a pronounced antiseptic effect, but it strongly resists inflammation, soothes and heals the wound surface. These are old enough safe and tested means, the use of which contributes to the sanitation and healing of the primary focus of infection, and, accordingly, to the reduction of lymph nodes.

In the complex that strengthens the immune system and the general condition of the body, vitamin therapy is used. Appointments are made on the basis of diagnostic findings and medications used in treatment regimens. Vitamins C, E, A, group B, vitamin-mineral complexes accelerate the process of destruction of infection and recovery of the patient.

When treating enlarged lymph nodes in the groin, physiotherapy is widely used: drug electrophotography, phonophoresis, galvanization, UHF and laser therapy. In the initial stages of catarrhal inflammation, physiotherapy can lead to recovery. However, the use of physiotherapeutic procedures is contraindicated until the exact origin of the enlargement of the lymph nodes is determined.

If a primary purulent focus of infection is detected, in almost all cases, it is performed by opening, sanitation and drainage by an operative route.

With advanced forms of the disease, when drug therapy and physical therapy were not effective, surgical treatment is necessary. It consists in the opening of suppuration, sanitation and drainage of the wound. With necrotic changes in the lymph nodes, it may be necessary to remove the node itself. However, this operation is performed in extreme cases, since subsequently the patient develops lymphostasis and elephantism of the lower part of the body.

Alternative treatment

With the increase of lymph nodes in therapeutic regimens, alternative means may well be successfully applied. However, they can not be used independently, without a diagnostic examination and consultation with a doctor.

In the initial stages with serous lymphadenitis, it is advisable to use compresses, which is strictly not necessary for suppuration.

For compresses, the following formulations can be used:

1. The easiest way is to buy a tincture of echinacea in the pharmacy, dilute one part of the tincture in two parts of warm water, moisten the natural tissue or cotton wool in solution, attach it to the enlarged knots, fasten, wrap it on top with a woolen scarf, leave it overnight.
2. Bake one large turnip onion, peel and stir until smooth with a tablespoon of tar (pharmacy). Mix the mixture on a piece of natural tissue or a cotton pad, attach it to sore spots, fasten and wrap it on top with a woolen scarf, leave it overnight.
3. A mixture of crushed dry herbs (according to a teaspoon each): yarrow, St. John's wort, walnut leaves and mistletoe put on the bottom of the pan, pour water (200ml), boil and boil on a weak flame for three to five minutes. Moisten wadded disks or pieces of cotton cloth in a warmed decoction and apply, fixing and tying to sick places for the night.

Compresses are applied to inflamed lymph nodes until a noticeable decrease occurs.

It is recommended to drink infusions of herbs that help purify the lymph and relieve inflammation in both the primary and lymph nodes. Infusions can be drunk in all cases of nonspecific lymphadenitis.

1. The same tincture of Echinacea - drink twice or thrice a day a solution of 25-40 drops in 100ml of water. Contraindicated apply for autoimmune diseases. If the drug regimen has a medicamentous immunomodulator, be sure to consult a doctor.
2. Make a mixture of dried and chopped leaves and hazel bark (1/4 cup), pour in a thermos ½ liter of boiling water, insist about an hour, mix, strain. Drink before each meal, shaking the infusion every time and measuring ¼ cup to the reception. Take two to three weeks, then you can repeat with an interval of one week.
3. To prepare raw materials - soft young shoots of a pine in the crushed kind on volume should occupy two-liter utensils. Fold them in a saucepan, pour three liters of water, boil and, reducing the fire, cook for 90-120 minutes, closing the lid. Then strain the resulting broth in another container, add a glass of sugar and cook for another two hours. Ready to cool the broth and take after eating one tablespoon once or twice a day. The duration of treatment for a month and a half, after a two-week break can be repeated.

To prepare broth from herbs, it is necessary to use dishes made of refractory glass or enameled with white enamel. Keep the decoctions after percolation preferably in a glass container.

To reduce the size of the lymph nodes use herbal medicine. It is good to cleanse the lymph nodes with the infusion of St. John's wort: a tablespoon of herb is poured ½ liter of boiling water, the infusion is filtered after 20 minutes. He is drunk on half a glass three times a day and after half an hour they eat.

Infusion of birch buds, cooked as follows in the same proportions and filtered after cooling, taken three times a day on a tablespoon for 4-5 days before eating for a third of an hour, then increase the dose to ¼ cup and take another week or two. This remedy is contraindicated in case of gastric ulcer.

Just prepare and infusion of rose hips, which must be crushed before cooking. This infusion is taken three times a day before meals for 20 minutes. Drink it better through a straw, since the dogrose adversely affects the enamel of the teeth. You can immediately rinse your mouth after use.

[18], [19]

Homeopathy

In the treatment regimen, homeopathic remedies can be included as a means of enhancing the defenses of the body. Moreover, they usually do not cause side effects and do not interact with medications.

For example,  Anaferon, which is a combination of homeopathic dilutions of affinity-purified antibodies to human γ-interferon. Effective in viral and bacterial infections of the urogenital organs, in the case of immunodeficiency of various genesis. Contraindicated in case of allergy to components, during pregnancy and lactation.

Receipt sublugvalny one tablet from three to six pieces during the day, after relief of acute symptoms take one piece for eight or ten days.

For children, Anaferon is produced:

At the age of 6 months-3 years, one tablet is dissolved in pure water (15 ml) and given once a day. Take a week.

Lymphomyosot is a  homeopathic preparation containing 16 components. Strengthens the lymph drainage, removes intoxication and inflammation, reduces exudation, activating cellular and humoral immunity. Issued in drops and solution for injection. Pregnant and lactating women only take the doctor's prescription. Contraindicated in case of hypersensitivity to ingredients. With pathologies of the thyroid gland, exercise caution. In rare cases, skin allergic reactions can be observed.

The drops are dissolved in water (10ml) and retained in the mouth for absorption as long as possible, the administration is performed three times a day before meals for half an hour or an hour after. Patients 12 years and older drop 10 drops, infants - one or two, from one to three years - three, from three to six - five, from six to 12 - seven.

For the relief of acute conditions, a single dose is taken every quarter of an hour, however, no more than 10 times. Then they switch to the usual reception.

With increased function of the thyroid gland take half the dosage corresponding to age, increasing it daily by one drop and bringing it to the age norm.

In severe cases, a solution for injection is prescribed. Single dose is one ampoule and is used from the age of six. Injections are done two or three times within a week by intramuscular sub- and intradermal, intravenously and acupuncture points.

Oral administration of the solution from the ampoule is also possible, for this purpose, its contents are diluted in ¼ cup of water and drunk throughout the day at regular intervals, retaining the liquid in the mouth.

Homeopathic pharmacies in large cities usually have complex drugs used for lymphadenitis. They usually include Aurum metallicum, Calcium fluoricum, Silicea, Bromum, Tuberculinum, other substances can be contained.

Calcium fluoricum (calcium fluoride) is used at very dense sites, Barium jodatum (barium iodide) is also often prescribed with enlarged lymph nodes as, however, other drugs. In this case, the homeopathic doctor will take into account a lot of other symptoms and modalities in a particular patient. Therefore, if you want to be treated with homeopathy, you need to consult a doctor of the appropriate profile.

Prevention

To prevent diseases that provoke an increase in the lymph nodes in the groin, it is worth sticking to simple rules:

• for the prevention of sexual infections it is necessary to observe elementary norms of hygiene of sexual life;
• to avoid infection of internal organs with pathogenic microorganisms - sanitary and hygienic standards;
• Rationally eat, including a daily menu of more fruits and vegetables, fresh juices;
• move more, walk in the fresh air;
• avoid stress, contact with poisonous substances, harmful radiation;
• Do not get involved in medicines;
• try to avoid injuries, and in case of its receipt, try not to allow purulent complications;
• do not start inflammatory diseases, timely referring to a doctor.

[20], [21], [22], [23], [24]

Forecast

With timely access to a doctor, lymphadenopathy, in most cases, does not pose a threat to life. More often than not, the increase in inguinal nodules has an infectious cause and is susceptible to conservative treatment. The prognosis and prospects of each patient directly depend on the establishment of the main diagnosis.

[25], [26]