Acute lymphadenitis

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

[1], [2],

Causes of acute lymphadenitis

Provoke the development of acute lymphadenitis usually pyogenous microorganisms, which through the lymphatic vessels penetrate into the lymph nodes from purulent acute or chronic foci (furuncles, scratches, panaritium, phlegmon wounds, etc.). To pyogenic microorganisms are: 

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

The causes of acute lymphadenitis can be and such diseases as: 

• tuberculosis (pathogen - tuberculosis mycobacterium or Koch's stick).
• syphilis (pathogen - white treponema).
• cancerous lesions of internal organs.

[3], [4], [5], [6], [7], [8]

Clinical symptoms of acute lymphadenitis

Acute lymphadenitis manifests itself as a general and local symptomatology.

The general symptomatology of acute inflammation in the lymph nodes: 

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

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

• redness of the skin above the area of the lymph nodes.
• the appearance of swelling or swelling of the skin in the projection of the lymph nodes.
• tenderness of lymph nodes - both at rest and when feeling them.
• increase in local temperature, skin is hot when touched.
• the function of the area where the lymph nodes are affected (for example, it hurts to move the leg or arm, turn the neck, etc.) is broken.

The clinical symptoms of acute lymphadenitis are fairly clear and will not be difficult when diagnosed by an experienced specialist.

[9]

Acute lymphadenitis in children

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

To prevent acute lymphadenitis in your child, you need to treat carious teeth in time, inflammation in the mouth, runny nose, protect from injuries, and if they are available, treat with antiseptics (green, iodine, etc.).

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

Classification of acute lymphadenitis

1. Acute lymphadenitis is purulent and serous (nasty).

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

2. Distinguish nonspecific and specific acute lymphadenitis, it all 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.
   • submaxillary.
   • odontogenic.
   • mesenteric.
   • inguinal.

[14], [15], [16]

Acute serous lymphadenitis

In acute serous lymphadenitis, the general state of health suffers little. The temperature may not be, and may rise to 38 ° C. At this stage, there are painful sensations in the lymph nodes, they increase in size. When they are feeling, they are slightly dense and mobile. With the timely identification and treatment of the primary focus, these lymph nodes decrease in size, passes their soreness, normalizes the overall well-being. In the opposite case, the serous inflammation becomes purulent.

[17], [18], [19]

Purulent acute lymphadenitis

When suppurative inflammation in the lymph nodes marked their pronounced soreness, an increase in temperature above 38 ° C. A dream is broken, there is a headache, weakness, i.e. The general or common state of health strongly suffers. Over time, the site of the lymph node forms an abscess, which will need to be surgically removed in a hospital, it will not go away. Do not engage in treatment of purulent acute lymphadenitis, very dangerous for health and life, because is fraught with the development of lymphadenoplegia and sepsis (blood infection).

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. Those. Such lymphadenitis arise from odontogenic infection. Therefore, timely treatment of carious teeth is important. Most often the infection penetrates into the following groups of lymph nodes and arises: 

• submandibular acute lymphadenitis.
• Genetic.
• acute cervical lymphadenitis.
• parotid.
• supra-maxillary and mandibular.

In the prevention of the above acute lymphadenitis, personal hand hygiene is important, with special care should be taken to remove acne, acne in the face and neck.

[20], [21], [22]

Acute mesenteric lymphadenitis (mesadenitis)

Acute mesenteric lymphadenitis is an inflammation of the lymph nodes of the mesentery of the intestine. There is such acute lymphadenitis after operations on the organs of the abdominal cavity (elimination of appendicitis, for example), after upper respiratory tract diseases, tuberculosis and many other diseases. Such lymphadenitis is more common in school-age children. Appears suddenly, there is an acute cramping pain in the abdomen, not associated with eating, dyspeptic disorders (nausea, possibly vomiting), an increase in temperature to high digits. In such a situation it is necessary to carefully collect the anamnestic data, to thoroughly study the clinic, to undergo the necessary instrumental and laboratory studies, which the specialist will appoint.

[23], [24], [25], [26],

Acute inguinal lymphadenitis

With acute inguinal lymphadenitis, lymph nodes in the inguinal region are enlarged and compacted. At the same time, soreness in the lower abdomen is noted, and in the inguinal region, especially during movement and physical exertion, the temperature increases. The cause of inflammation of the lymph nodes in the inguinal area can be: syphilis, metastasis of genital canals, rectum, fungal diseases and wounds on the lower limbs. At detection of the increased inguinal lymphonoduses, it is necessary to address immediately for help to the doctor (the therapist, the surgeon, if this child is a pediatrician).

[27], [28], [29]

Diagnosis with acute lymphadenitis

• Superficial acute nonspecific lymphadenitis is not difficult to diagnose. To do this, it will be sufficient to have clinical symptoms along with data from an anamnesis (medical history). The main thing is to determine the primary purulent inflammation, where is its source.
• Acute specific lymphadenitis is determined by clinical and laboratory data.
• If tuberculosis is suspected, Mantou and Pirke tuberculin tests are performed, chest radiography is performed, sputum is examined, a puncture of the corresponding lymph node is prescribed, if necessary.
• In case of suspected syphilis, a puncture of the affected lymph node is performed, where pale treponema is found in the punctate.

In addition, with specific lymphadenitis, consultation of narrow specialists is needed: venereologists, infectious disease specialists, phthisiatricians.

• If necessary, additional methods of examination of lymph nodes can be prescribed: ultrasound diagnostics, computer and magnetic resonance imaging of affected regions, radiocontrast lymphography, lymphoscintigraphy.

[30], [31], [32]

Treatment of acute lymphadenitis

Therapy 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, through which the infection got into the lymph nodes (caries treatment, if there are wounds their treatment with an antiseptic - iodine, zelenka and the imposition of a sterile bandage, etc.).
2. Symptomatic therapy: 

• with increasing temperature - antipyretic (paracetamol, ibuprofen)
• an excellent addition to therapy at this stage will be the use of the drug lymphomyositis, it very well removes the inflammation and soreness of the lymph nodes
• multivitamins, as a general restorative therapy (multifort, vitrum, multitabs)
• antiallergic drugs, will help in addition to remove the edema at the site of the pathological focus (erius, fenkarol, fenistil)
• if severe pain is noted, for example, as in the case of mesenteric lymphadenitis, analgesics are prescribed (analgin, ketalong, dicloberte)
• In the 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. Operative intervention - open the suppurative focus, remove dead tissue, wash the purulent cavity with antiseptic solutions and produce a tamponade of the wound, apply an aseptic bandage.
3. Purpose of antibacterial drugs.
   • With nonspecific acute lymphadenitis, antibacterial drugs are prescribed, taking into account the sensitivity of the microorganisms to the antibiotic (as a rule, widespread antibiotics are prescribed: cefotaxime, augmentin, azithromycin, sumamed).
   • With a specific acute lymphadenitis, antibiotics are prescribed depending on the underlying underlying disease: if it is syphilis, then prescribe penicillin, macropen, sumamed; if - tuberculosis, then appoint streptomycin, rifampicin.
4. The use of multivitamin complexes, as fortifying agents and with the purpose of improving the work of the immune system (multifort, vitrum).
5. Prescribe antihistamines to reduce the risk of allergic reactions from the use of antibiotics and further reduce swelling in the area of the pathological focus (fenkarol, erius, cetrin).
6. In the postoperative period, if necessary, prescribe painkillers (dicloberl, ketalong).
7. Due care for the patient (regular aseptic dressings of the postoperative area).
8. Compliance with the sanitary and hygienic regime (personal hygiene, airing the room, humidifying the air and regularly cleaning the room).
9. Rational diet with restriction of fatty, roasted and salted. It is necessary to avoid fast food. More use of vegetable, milk and protein products (low-fat varieties of meat, fish).
10. Physiotherapy in the postoperative period - UHF-therapy - reduces inflammation, accelerates the healing and repair of wounds. In addition, it helps to reduce the sensitivity of nerve receptors, which leads to a reduction in pain syndrome.

Prevention of acute lymphadenitis

The best prevention of acute lymphadenitis is timely and adequate therapy of the underlying disease, which can cause lymphadenitis. A timely diagnosis and therapy is necessary: 

• foci of infection in the body: treatment of carious teeth, sore throats, dissection of boils, carbuncles, panarization, etc. 
• such diseases as: tuberculosis and syphilis.

Sometimes minor scratches, corns or wounds, which many do not attach importance, can cause acute lymphadenitis. On this basis, in any incomprehensible cases of enlarged lymph nodes, accompanied by fever and pain, it is necessary to seek the help of specialists. Self-medication in such cases is dangerous.

Prognosis of acute lymphadenitis

Most often, the prognosis of acute lymphadenitis is favorable and results in recovery, especially at the initial stages and early onset of treatment.

With neglected forms of lymphadenitis (destructive), lymph nodes are destroyed, and scar tissue is subsequently formed in their place. When such a process occurs on the limbs, there is a violation of lymph drainage and the formation of lymphostasis, followed by the development of elephantiasis.

Also, do not forget that acute lymphadenitis is a sign of generalization, spread of infection in the body and conceals in itself a greater danger of the development of lymphadenoplegmons, and in the future - sepsis, especially when untimely started treatment.