Submandibular lymphadenitis: causes, stages and symptoms, treatment, prevention

Content:

1. Causes of pathology
2. Signs of inflammation of the submandibular lymph nodes 1.1. First stage 2.2. Second stage 2.3. Third stage
3. How to cure an enlarged lymph node in the submandibular area
4. Prevention of the inflammatory process

Inflammation of the submandibular lymph node is one of the most common types of lymphadenitis.
Its development is caused by inflammatory processes occurring in the oral cavity and less often in other parts of the body. Often the problem occurs with advanced caries, pulpitis, gingivitis, and inflammatory lesions of the tonsils. It is also caused by throat diseases. Let's take a closer look at why the submandibular lymph nodes are enlarged and what should be done to normalize the situation.

What is submandibular lymphadenitis, stages of development

Submandibular lymphadenitis is inflammation of the cervical and submandibular lymph nodes

, which can be acute or chronic. Often the disease is secondary, that is, it does not occur independently, but as a symptom of a primary infection.

Acute stage

In the acute form of the disease, one lymph node or several may become inflamed. Depending on what kind of exudate is contained in the inflamed node - pus or serous fluid - lymphadenitis is divided into purulent and non-purulent. The acute form of the disease is treated by removing pus from the lymph node and eliminating the root cause of inflammation.

If there is pus inside the lymph node, there is a danger of it breaking through and infecting surrounding tissues.

Chronic stage

The transition of the disease to the chronic phase is a consequence of the lack of adequate treatment. The node no longer increases in size and hardens. The pain syndrome intensifies, and severe intoxication of the body occurs. The skin around the node becomes purple.

Compared to the acute phase of the disease, with chronic lymphadenitis there is a clearly noticeable increase in the area of ​​inflamed tissue around the lymph node

. The danger of this form of pathology is that it may require removal of the lymph node.

Causes of pathology

If the lymph node changes its size, it can be assumed that a viral or bacteriological infection has spread. Taking into account the localization of the lesion, the doctor understands exactly where the source of the disease is located and which organs need urgent medical attention.

Among the dental provocateurs of enlarged submandibular lymph nodes:

• inflammation of the salivary glands;
• gingivitis;
• pulpitis;
• flux;
• stomatitis;
• alveolitis;
• periodontitis;
• deep caries;
• inflammation occurring under the crowns.

But the violation is not always associated specifically with dental diagnoses. Its reasons are:

• Respiratory diseases: pharyngitis, laryngitis, rhinitis.
• Pathologies related to the bone structures of the skull: damage to the bone structures of the lower jaw, damage to the temporomandibular joint, articular capsule.
• Infections: sore throat, measles, tonsillitis, otitis media, chicken pox, mumps. In all these cases, the lymphatic tissues swell a few days after the first symptoms of the disease appear.
• Specific pathologies caused by pathogenic pathogenic agents: toxoplasmosis, tuberculosis, syphilis, gonorrhea.
• Oncological neoplasms. Lymphatic tissue always reacts very sharply to tumor growth. Enlarged submandibular lymph nodes sometimes indicate the presence of a neoplasm in the area of ​​the tongue, neck, or salivary glands.
• Autoimmune disorders. Always associated with disruptions in the functioning of the immune system. Then, by mistake, lymphocytes begin to treat healthy cells as dangerous pathogens. They destroy them, causing inflammation of the lymph nodes.
• Hyperthyroidism. With an exacerbation of this disease, the neck and cheek area swells, the lymph nodes become more voluminous.

In young children, parents may notice large round “balls” under the jaw during the period of active teething. This often causes an increase in body temperature. There is no need to be afraid of such symptoms. It is associated precisely with the inflammatory process provoked by the eruption of milk units. But, if the situation does not return to normal within three to five days, it is still worth showing the baby to a pediatric dentist, surgeon or pediatrician.

Signs of inflammation of the submandibular lymph nodes

How the disorder manifests itself depends on how far the disease process has progressed. If you do not carry out the necessary therapeutic measures, one stage will quickly pass into another.

First stage

The size of the lymph nodes changes very slightly, but the person already feels that they hurt when pressed. Discomfort occurs when turning the head. Body temperature often rises and a sore throat appears. A tickle or dry, unproductive cough is annoying. Pain occurs only on one side of the neck or on both sides at once. The first case is more likely if it is a viral disease.

Second stage

It is called “acute lymphadenitis”. Now the lymph node can be distinguished visually - it becomes convex and protrudes forward. Externally it resembles a subcutaneous ball. Its diameter reaches three centimeters, but can be more impressive.

The node is painful to the touch. Because of this, it is difficult for the patient to turn and tilt his head, and open his mouth wide. The mobility of the upper and lower jaw is significantly limited.

The pain may radiate to the cheek or ear. Body temperature increases. Overall performance decreases.

Third stage

Called purulent lymphadenitis. Here, the inflammatory process even affects structures adjacent to the lymph node. The patient complains of pain in the throat, collarbone, armpit, and head. The nerve endings of the teeth may become inflamed. Then acute toothache occurs.

Pus formed in lymphoid tissues consists mainly of necrotic cells. If it gets into the blood (and such a possibility always exists), the outcome can be extremely unfavorable, so the inflammatory process should not be started.

Patients can understand that the submandibular lymph node is inflamed and needs treatment as soon as possible by the following signs:

• the “ball” enlarges and becomes red or bluish;
• every day it becomes more dense and solid;
• the skin located above the lymph node takes on a red tint and is hot to the touch;
• the lower jaw area swells.

Causes of enlarged submandibular lymph nodes

Two groups of 6-10 lymph nodes, located symmetrically on the right and left in the tissue behind the arch of the lower jaw, collect lymph from the salivary glands, tonsils, palate, tongue, cheeks, nose, jaws and lips. Therefore, their increase is observed when these organs and tissues are damaged. Lymphoid hyperplasia is provoked by infections of the nasopharynx and oropharynx, dental pathology, local tumor processes, and may indicate the development of lymphoma and lymphogranulomatosis. Less commonly, damage to the lymph nodes is complicated by eye diseases - dacryoadenitis, stye on the eyelid.

ARVI

Infection with pneumotropic viruses is a common and obvious cause of benign lymphadenopathy, in which the submandibular and cervical lymph nodes simultaneously enlarge. Changes in the lymphoid tissue through which lymph from the oropharynx and nasopharynx are filtered are more noticeable with the development of ARVI during pregnancy and in children. In the first case, this is due to a physiological decrease in immunity to reduce the threat of miscarriage, in the second - with the age-related development of protective mechanisms.

Submandibular lymphadenopathy is more often observed with adenovirus infection, parainfluenza, infection with rhinoviruses or an association of viral pathogens. Typically, the lymphatic reaction is preceded by so-called catarrhal phenomena - runny nose, sore throat, pain when swallowing, dry cough, lacrimation. The temperature often rises, and to high (febrile) numbers - from 38 ° C and above. Characterized by moderate asthenia - weakness, weakness, fatigue. Muscle and joint pain is possible.

With ARVI, the skin over the submandibular lymph nodes has a natural color. The increase in lymphoid formations is slight (slightly more than 1 cm). The lymph nodes are compacted, but not rocky, have a smooth surface, and are mobile. During palpation, pain may be detected. As a rule, there is a symmetrical increase in nodes in both submandibular groups, which is associated with the spread of viral particles through the lymphatic system. As the infectious process subsides, the normal size and density of the submandibular lymph nodes are restored.

Sore throat and chronic tonsillitis

The second most common cause of enlarged submandibular lymph nodes is an infectious-inflammatory lesion of the palatine tonsils. Lymphadenopathy develops in both acute and chronic processes. With angina, the lymph nodes enlarge within 1-2 days from the onset of inflammation, in some cases reaching a diameter of up to 2 cm. The symptom occurs against the background of severe intoxication, an increase in temperature to 38-40 ° C, intense pain in the throat with painful swallowing and irradiation to the ears, severe headaches, muscle and joint pain.

With unilateral acute tonsillitis, the jaw lymph nodes on the corresponding side react more often; with bilateral acute tonsillitis, a lymphoid reaction is detected on the left and right. Often the cervical lymphatic groups are involved in the process. To the touch, the nodes are dense, painful, and mobile. The increase in size can persist for 1-2 weeks after the underlying disease subsides, then the diameter of the submandibular lymph nodes gradually decreases to normal, if the process has not become chronic.

Chronic tonsillitis is characterized by a symmetrical moderate enlargement of the nodes of both mandibular groups without involvement of the lymphatic formations of the neck. The pain is less pronounced. In a simple form of chronic inflammation of the tonsils, prolonged grade I lymphadenopathy often becomes the most noticeable manifestation of the disease. In patients with the toxic-allergic variant of tonsillitis, symptoms of damage to the tonsils are expressed with pain and sore throat, discomfort when swallowing, and bad breath. A persistent low-grade fever often persists.

Other infectious diseases

Damage to the submandibular lymph nodes is determined by a number of systemic infections, bacterial, viral and fungal processes affecting the respiratory system and salivary glands. The reaction of the submandibular nodes is due to the performance of a barrier function when pathogens enter the lymphatic system from the mucous membranes of the nose, oral cavity, and head organs. Mandibular lymphadenopathy manifests itself in such general and local infectious diseases as:

• Infectious mononucleosis
  . The submandibular nodes are the first to respond to the introduction of the Epstein-Barr virus. Their increase is caused by lymphoid hyperplasia, primarily by the reaction of B-lymphocytes specifically affected by viral particles. At the initial stages of the pathological process, in addition to a local lymphoid reaction, low-grade fever is noted, a sore throat, and nasal congestion are felt. Later, the disease manifests itself as sore throat, generalized enlargement of the lymph nodes, liver and spleen.
• Herpetic infection
  . Hyperplasia of the lymph nodes of the submandibular groups is detected in herpetic stomatitis. Characterized by increased temperature, increased secretion of saliva, erosive and aphthous lesions of the oral mucosa. In addition to hyperplasia, inflammation of the lymphoid tissue with the development of mandibular lymphadenitis is possible. Kaposi's eczema herpetiformis is even more severe, in which the occipital and cervical lymph nodes are also affected, and vesicular, pustular, and erosive skin lesions are present.
• Cytomegaly (CMVI)
  . The involvement of the submandibular lymph nodes is due to the sensitivity of cytomegaloviruses to the ductal epithelium of the salivary glands with the occurrence of parotid sialadenitis as one of the pathognomonic signs of the disease. Submandibular lymphadenopathy is combined with the neck, high temperature, weakness, headache, and other signs of intoxication are determined. A clear clinical picture is observed in 4-5% of patients, while the manifestation of cytomegalovirus infection is more often observed in pregnant women.
• Respiratory mycoplasmosis
  . Moderate enlargement of the submandibular lymph nodes is characteristic of mycoplasma infections of the upper respiratory tract. Possible simultaneous damage to the cervical lymph nodes. Lymphadenopathy is preceded by a short period of catarrhal symptoms - a painful dry cough, runny nose with copious mucus, sore throat, injection of scleral vessels. In the future, respiratory mycoplasmosis can spread downward to the trachea, bronchi, and lungs.
• Cat scratch disease
  . The submandibular nodes are affected when a cat bite or scratch is localized in the facial area. Lymphadenopathy is quickly complicated by submandibular lymphadenitis. The combination of a lymphoid reaction with a reddish nodule (papule), and then an abscess (pustule) at the site of skin damage is pathognomonic. The inflamed lymph nodes are enlarged to 1.5-2 cm and are sharply painful. Lymphadenitis persists for up to 2 months and is accompanied by febrile temperature, weakness, fatigue, myalgia, and headache.
• Scrofuloderma
  . In lymphogenous colliquative tuberculosis of the skin, the leading symptom is the formation of dense reddish-purple nodes (tuberculous granulomas) in the area of ​​the submandibular and cervical lymph nodes, from which dissemination of Koch bacilli occurs. An increase in lymphatic formations corresponds to lymphadenopathy I, less often II degree and complements suppurating subcutaneous tubercles, which break through fistulas and are slowly replaced by coarse scar tissue.

Dental pathology

The submandibular nodes serve as the main collectors of lymph from organs located in the oral cavity. Therefore, they are among the first to respond to any inflammation of the oral mucosa, dental tissue, upper and lower jaws. The reason for the enlargement of the lymph nodes is protective hyperplasia of the lymphoid tissue in response to the presence and proliferation of the pathogen, and in more severe cases, with lymphogenous spread of the process, infiltration of the stroma with inflammatory elements.

A moderately pronounced increase in the nodes of the submandibular group on the side of the pathology is observed in periodontitis, alveolitis, and periostitis of the jaw. Typically, lymph nodes become hyperplastic due to pain in the projection of the lesion, putrid odor from the mouth, low-grade or febrile fever, weakness, weakness, and other manifestations of intoxication. Submandibular lymphadenitis, which developed against the background of bright redness, multiple ulcerations, dirty gray plaque and foci of necrosis of the oral mucosa, is a sign of ulcerative necrotic stomatitis.

Malignant neoplasms

Lymphogenic metastases in the submandibular nodes are found in patients with late stages of oncological diseases of the head organs. A combination of mandibular lymphadenopathy with an increase in nodes of other groups is typical: for lip cancer - with mental and jugular nodes, for tongue cancer - with mental and occipital nodes, for cancer of the lower jaw - with cervical nodes, and for eye melanoma - with cervical and parotid nodes. Compaction and enlargement of the submandibular nodes is an important sign of malignant tumors of the salivary glands.

The detection of altered lymphatic formations usually indicates that the oncological process is old (early metastasis is typical only for tumors of the lower jaw and melanomas). The diameter of the nodes can reach 2 cm. To the touch they are defined as hard, rocky, sometimes have a bumpy surface, and are fused together with each other and the surrounding skin into a single conglomerate. Lymphadenopathy is preceded by pathognomonic signs of the tumor process - growths and ulcerations of the skin, mucous membranes, dense infiltrates, local pain, limitation of movements, etc.

How to cure an enlarged lymph node in the submandibular area

Therapy must be carried out under medical supervision. Its main goal is to eliminate the infection that caused the disorder. If the root cause of the condition is not established, it will not be possible to be completely cured.

If the problem is related to an oral disease, mandatory treatment is carried out. For severe inflammatory pathologies of internal organs, antibiotic therapy is carried out. For pathologies of a viral nature, patients are prescribed antiviral drugs.

If the examination reveals that pus has accumulated inside the tissues, it is drained using a drainage tube. Additionally, a puncture is taken to recognize the pathogen and understand whether the disease has a benign or malignant course.

As soon as the infectious focus disappears, the lymph nodes begin to shrink, stop hurting and gradually reach their normal state.

Prevention of the inflammatory process

To reduce the risk of developing lymphadenitis, you must strictly follow the recommendations:

• Have annual preventive examinations at the dental clinic. Treat all emerging oral diseases in a timely manner. Avoid caries and take care of your gums.
• Do not ignore the presence of infections and treat them. During therapy, strictly follow all medical prescriptions.
• For any damage to the skin, treat wounds with antiseptics. This minimizes the risk of contracting an infectious disease.
• If you feel unwell, consult a doctor and get laboratory tests. This simple measure allows you to detect violations at the earliest stages.

It is necessary to understand that using “grandmother’s” methods for inflamed lymph nodes is dangerous. So, under no circumstances should you heat the inflamed area or apply cold compresses to it. It is unacceptable to massage him or put pressure on him. All of these actions can make the situation worse. Then it will be much more difficult to reverse the disease.

Therapeutic measures for lymphadenitis

If a lump appears under the skin on the lower jaw, it is certainly necessary to consult a specialist to clarify the diagnosis. Moreover, it does not matter whether palpation causes pain or does not cause any discomfort at all. Usually the first visit is to a therapist, who then refers you to the right doctor to get rid of the underlying disease.

When inflammation is caused by an infectious disease, no special local treatment is usually prescribed. All efforts are directed towards getting rid of the root cause. If infection occurs with streptococci or staphylococci, therapeutic measures will take quite a long time. Even after treatment, re-infection and enlargement of the lymph nodes cannot be ruled out.

If the problem arose due to dental diseases, then first of all they eliminate inflammation of the pulp or periodontitis, treat caries and get rid of periodontal lesions. To achieve a reduction in the volume of the lymph node, it is necessary to carry out high-quality sanitation of the oral cavity. Sometimes even a minor problem can cause similar symptoms.

The same thorough treatment is necessary for diseases of the upper respiratory tract. For example, tonsillitis is an extreme source of infection. During its course, not only the submandibular lymph nodes can enlarge.