Causes
In many cases, the formation of ulcers in the facial area contributes to the appearance of inflammatory processes. Staphylococci and streptococci are among the most common pathogens. In accordance with the cause of development, specific and nonspecific lymphadenitis are distinguished. The development of the former can be caused by serious diseases such as tuberculosis. The second form develops due to direct penetration of infection into the lymph node. Entry may occur through lesions in the neck. Those people who are at risk include: patients with weak immunity; people whose field of activity is related to animals, dirty waters, etc. As a rule, people over 18 years of age experience this disease.
Lymphadenitis in children
As a rule, lymphadenitis in children affects the lymph nodes in the face and neck (most often - submandibular and cervical on one or both sides, less often - parotid, buccal, occipital, behind-the-ear), in some cases - axillary, inguinal.
The serous stage of acute nonspecific lymphadenitis in children (days 1-3 of the disease) is manifested by painful, noticeably enlarged regional lymph nodes that are densely elastic to the touch, without loss of their mobility and the development of a local skin reaction. The child's general condition is not affected; the temperature ranges from normal to subfebrile values.
The transition of acute lymphadenitis to the purulent stage (days 3-6 of the disease) occurs with pronounced local signs and a sharp deterioration in the well-being of children. Signs of intoxication are observed: chills, high temperature (up to 40ºC), headache, severe weakness, lack of appetite and sleep disturbance. In the area of the affected lymph nodes, intense nagging or shooting pains, periadenitis, local hyperemia and swelling of the skin occur. The development of adenophlegmon with the appearance of foci of fluctuation and the release of purulent inflammation beyond the lymph node is possible. Adenophlegmons of the maxillofacial area can be complicated by thrombosis of the cavernous sinus, mediastinitis, and sepsis.
The chronic form of lymphadenitis in children can develop primarily if the causative agents are weakly virulent microorganisms, or become a continuation of the acute form of the disease. In a chronic course without exacerbation, the lymph nodes are enlarged, limited in mobility, quite dense, but painless; the child’s well-being is not impaired; suppuration develops rarely. If a child has a focus of chronic infection that maintains sluggish lymphadenitis for a long time, the lymph nodes are gradually destroyed and replaced by granulation tissue.
Tuberculous lymphadenitis in children has a long course and is usually limited to the cervical group of lymph nodes, collected in a dense, painless, large package, similar to a collar. Tuberculous lymphadenitis in children can be complicated by caseous decay, the formation of fistulous tracts, and cicatricial changes in the skin.
Specific lymphadenitis associated with vaccination against tuberculosis (“betsejeitis”) can develop in children with low and altered general reactivity, manifested by chronic calcific caseous lesions of the axillary lymph nodes. Generalized lymphadenitis in children is observed with disseminated pulmonary tuberculosis and chronic tuberculosis intoxication; accompanied by characteristic fibrosis of nodes (“pebble glands”).
What contributes to the development of the disease?
There are several factors that contribute to the spread of lymphadenitis in children and adults:
- infection of the nasal and oral cavities,
- dysfunction of the endocrine system,
- HIV,
- severe allergies,
- metabolic disorder,
- excessive consumption of alcoholic beverages.
Cervical lymphadenitis is not transmitted from one person to another, since it is only an additional process that appears as a complication. In accordance with the diseases occurring against the background of this pathology, treatment is prescribed by a certain specialist in his field (surgeon, infectious disease specialist, and so on). Initially, lymphadenitis occurs in an acute form, gradually turning into a chronic form.
causes of cervical lymphadenitis
Varieties
Types of cervical lymphadenitis:
- Penetration of infection into the lymph node (quickly cured, practically does not lead to complications).
- Presence of serious illnesses. In this situation, diagnosis is carried out in the acute form of the pathology.
There are several stages of the disease in acute form:
- Serous. Does not cause intoxication or severe fever. The initial stage of penetration of harmful organisms into the lymph node.
- Purulent. Indicates bacterial infection. Promotes the appearance of high temperature. In this case, surgical intervention is a necessary condition.
- Complicated. In this situation, we are talking about immediate surgical intervention, since the disease can cause infection of the entire body. The disease occurs along with the spread of infections through the lymph nodes. It is worth noting that this form is highly curable and does not cause complications. The development of pathology in other nodes can cause the spread of a serious disease, which is called generalized lymphadenitis.
Acute process
The serous form of this disease is characterized by a slight impairment of the general condition. The submandibular lymph nodes are painful on palpation, enlarged, elastic in consistency, oval in shape, not fused with the surrounding tissues. The skin over them is not changed. Usually, when the process that led to lymphadenitis is eliminated, the inflammatory phenomena subside.
However, in some cases, the serous process can turn purulent, in which case acute purulent lymphadenitis develops.
It begins with severe spontaneous pain in the lymph node, and the patient also notes fever, chills, headache and insomnia. Redness of the skin over the node and adhesion to the surrounding tissues are determined. Palpation reveals a round, painful infiltrate.
Treatment of acute lymphadenitis can be conservative (for the serous form, when physiotherapeutic methods are prescribed) and surgical (for the purulent form), the essence of which is the primary surgical treatment of the lesion, installing a drainage for the purpose of drainage of purulent exudate. But these measures will not bring effective long-term results if the cause that caused the disease is not eliminated. Therefore, it is extremely necessary to remove the causative tooth (or open its cavity), treat the tooth socket (for alveolitis), and also treat infections of the tonsils and ear. For purulent lymphadenitis, the following is indicated: antibiotic therapy, the use of desensitizing agents, rinsing the mouth with antiseptics.
Symptoms
The main symptoms that indicate the presence of lymphadenitis are the following: increased body temperature, insomnia, fatigue, nervous system disorders; indifference to life, poisoning, etc.
In the initial stage of acute lymphadenitis, thickening of the lymph nodes can be observed. When pressed, discomfort and pain occur. Such signs are considered dangerous, so patients should immediately consult a doctor for advice. Otherwise, further development of a dangerous disease may occur.
Symptoms of the chronic form of the studied lymphadenitis in adults and children include: hardening of the lymph nodes, high body temperature, weakness and fatigue, insomnia, pain when pressing the lymph nodes.
At the stage of the chronic form of the disease, the symptoms become somewhat muted. This is due to the fact that the body reduces the number of mechanisms spent on fighting pathology. As a result, the body is poisoned. Purulent inflammation leads to an increase in the number of external symptoms of the disease, which leads to exacerbation. Purulent inflammation is indicated by intense pain and swelling of the lymph nodes. A similar condition is life-threatening and requires urgent intervention.
lymphadenitis symptoms
Lymphadenitis is inflammatory changes in one or a group of lymph nodes. Lymphatic formations of all areas of the body can be affected. Lymphadenopathy of the cervical and submandibular region is most often observed in medical practice. This disease usually has a secondary genesis. If the inflammation becomes purulent, then the infection may break through with the development of abscesses and phlegmons. From the submandibular region, inflammation can move along anatomical formations to various sections. Such situations can be life threatening.
A huge number of diseases can indirectly or directly lead to inflammation of the lymph nodes, especially infectious diseases. The human lymphatic system belongs to the body's immune system and is represented by lymphatic vessels and lymph nodes. Immune cells circulate in this system. Lymph (fluid that flows from organs and tissues through lymphatic vessels to the lymph nodes) carries particles of pathogenic microorganisms for recognition by immune cells. In the lymph nodes, preparation and activation of immune cells (mainly lymphocytes) take place, which migrate to the pathological focus, destroy bacteria and other pathogens, resulting in recovery. There are other possible causes of lymphadenopathy: tumors of the immune system, systemic diseases, helminthic infestations, tumor metastases and others, but they are much less common and their main symptoms dominate over enlarged lymph nodes (which, by the way, is not always inflammatory in nature). Most often, inflammation of the regional lymph nodes of the submandibular region is odontogenic. This means that the main source of infection is the inflammatory process in the oral cavity. These are most often dental problems - periostitis, periodontitis, periodontitis, pulpitis. Inflammatory diseases of the respiratory system lead to enlargement of the lymph nodes in the cervical region - parotid, tonsillar, occipital and others. There are catarrhal and purulent forms of inflammation. Depending on the type of process, treatment tactics will change.
Having discovered such changes, patients usually first turn to a therapist. However, as mentioned earlier, if the inflammation is localized specifically in the submandibular nodes, one should assume an odontogenic nature and consult a dentist.
The clinical picture may differ depending on the location of the primary lesion. Lymphadenitis itself is accompanied by palpable formations in the submandibular region. They will have an elastic consistency, and painful sensations occur upon palpation. There may be discomfort while eating, but the general condition usually does not change. Such symptoms are characteristic of the catarrhal (serous) process. If inflammation progresses, the lymph node can be completely destroyed by a purulent process. In this case, the skin over the node becomes hot to the touch, turns red, and body temperature rises depending on the type of inflammation (an abscess or phlegmon develops). strong painful sensations of a tugging or pulsating nature occur already at rest.
Lymphadenitis can be diagnosed by inspection and palpation of the affected area. Depending on what the doctor suspects as the cause of the inflammation, appropriate diagnostic methods will be prescribed. Be sure to conduct an examination of the oral cavity: inflammatory changes in the teeth, oral mucosa, tonsils, pharynx, larynx and other organs can be noted. The dentist may prescribe a panoramic X-ray or an X-ray examination of the sinuses. All patients are shown a general blood test. In the absence of pathology on the part of the dentofacial apparatus, a consultation with a therapist or otolaryngologist is indicated. In some situations, consultation with an oncologist is required.
Additional methods include smears from the oropharynx to determine the causative agents of the infectious process, biochemical blood tests, ultrasound of regional areas (will reveal an increase in nodes inaccessible to palpation), various methods of visualization of the head and neck organs (for the presence of oncological pathology), puncture biopsy of the affected lymph node with cytological and histological examination and other methods.
Treatment depends on the type of inflammation. In the case of a purulent process, surgical treatment is indicated - opening and draining the lesion. If the inflammation is catarrhal, then a dentist or otolaryngologist treats the underlying disease (pharyngitis, tonsillitis, laryngitis, periodontitis, periostitis, pulpitis and others). In such a situation, the lymph nodes are not opened under any circumstances, but conservative therapy is carried out: UHF therapy, ointment dressings, heating using a dry heat source.
Diagnostic methods
neck lymphadenitis detected ? During the examination, the doctor presses on the lymph nodes to determine the cause. A general blood test will provide the necessary information about the course of pathological processes, which are characterized by an increase in the number of lymphocytes.
If the diagnosis is established without the presence of certain complications, the doctor immediately prescribes therapy. However, in cases where the doctor notes disturbances in other systems, it is necessary to conduct additional examinations, which include:
- general and biochemical blood test,
- histology examination,
- x-ray of the chest area,
- Ultrasound of the abdominal cavity,
- immune system examinations and blood tests to check for hepatitis.
In any case, consultation with a specialist is mandatory. An exacerbation of the disease can occur at any time.
Diagnosis of lymphadenitis
To establish the cause and type of lymphadenitis, a specialist needs to perform diagnostic procedures.
These include:
- Examination and interview of the patient, study of the anamnesis.
- General and biochemical blood tests.
- X-ray examination.
- Ultrasonography.
- Biopsy of an inflamed lymph node.
X-rays and ultrasound are used for abdominal and thoracic lymphadenitis, when it is not possible to determine their size and quantity during examination. A biopsy is used in rare cases and only when a specific type of disease is suspected.
Possible complications
This diagnosis is a good reason to consult a doctor and carry out urgent treatment. In the worst case, dangerous consequences may occur through:
- purulent pimples,
- thrombophlebitis,
- septicopyemia.
When purulent fluid is released into the esophagus or bronchi, then there is a high risk of the spread of dangerous complications (for example, fistulas in the esophagus).
As a result of the chronic form of the disease, inflammatory processes in the form of sepsis or adenophlegmon are often observed.
Which doctor should I contact?
In case of inflammatory processes in the lymph nodes, you should consult a general practitioner. He will examine and interview the patient, take tests, and then make a preliminary diagnosis and refer to specialists, if necessary.
Depending on the location of lymphadenitis, these may be:
- otolaryngologist – inflammation of the cervical, parotid, sublingual lymph nodes;
- dentist - inflammation of the lymph nodes under the jaw;
- urologist – inguinal lymphadenitis for diseases of the genital organs;
- mammologist – axillary and supraclavicular lymphadenitis;
- surgeon - purulent process with lymphadenitis.
If inflammation of the lymph nodes occurs in a child, you should consult a pediatrician or family doctor.
Therapy
Lymphadenitis is treated in an adult using traditional methods. These include:
- bed rest,
- treatment with antibiotics,
- UHF,
- electrophoresis,
- galvanization,
- no impact on damaged areas of the body,
- vitamin complexes.
Among other things, they may also prescribe special products and ointments.
Importance is attached to lymphadenitis treatment with antibiotics . Before prescribing this type of treatment, the specialist is obliged to conduct an examination to determine whether harmful organisms have reacted to such drugs. It is clear that the doctor prescribes to the patient those medications to which the pathogens give a reaction.
When it comes to urticaria lymphadenitis with purulent processes, then to cure it is necessary to open the purulent pimples and remove all the liquid from them.
If a tuberculosis bacillus is detected, the patient is transferred to hospital treatment. Within the clinical center, strict monitoring of the patient’s condition is carried out, as well as his isolation from healthy people to prevent the development of infection.
treatment of lymphadenitis
To treat chronic lymphadenitis, it is necessary to detect and eliminate the main factor of lymph node compaction. Only this will allow you to get rid of the pathology 100% forever.
