Otitis

Chronic lymphadenitis symptoms and treatment. How to properly treat lymphadenitis

If the disease process progresses and develops periadenitis , then the described symptoms may worsen. Painful sensations become sharper, the skin over the lymph nodes becomes hyperemic , and when palpating the nodes the patient feels pain. Lymph nodes, which previously could be very clearly palpated, now merge with each other and with the surrounding tissues, and they also become immobile.

Inflammatory processes in the lymph nodes they are characterized by their productive nature. They turn into a purulent form in quite in rare cases. Among the manifestations of chronic specific lymphadenitis The following symptoms stand out: the lymph nodes enlarge and become denser, the pain in them is mild, they do not adhere to each other. The lymph nodes remain in this state for quite a long period of time, later the connective tissue grows inside and they become smaller.

At tuberculous lymphadenitis manifests itself as a general disease. Lymphadenitis in children can manifest itself just during the period of primary tuberculosis. Microbacterium tuberculosis can cause tuberculosis of peripheral lymph nodes. The infection can spread in different ways. Yes, she can penetrate through tonsils . Most often, the infection penetrates through the lymphohematogenous route, spreading from the affected lymph nodes.

If the disease begins acutely, the patient experiences a sharp rise in temperature and symptoms of tuberculosis appear. intoxication , the lymph nodes become larger and manifest inflammatory-necrotic changes . As a special sign of tuberculous lymphadenitis, which distinguishes it from other forms, the presence of periadenitis is noted. They appear very rarely. Most often, lesions appear on the cervical, submandibular and axillary nodes. Chronic lymphadenitis in children sometimes develops in parallel with -,. At the very beginning of development, lymphadenitis appears in children at the locations of the lymph nodes. When pressing on it, the child may feel pain. And after a few days, the inflammation spreads to nearby tissues. The lymph node becomes difficult to palpate, the tissues become denser. If you have such symptoms, you should immediately contact your pediatrician.

Diagnosis of lymphadenitis

To make an appropriate diagnosis, the doctor is guided by the clinical picture, taking into account the anamnestic information. Superficial lymphadenitis (inguinal , cervical lymphadenitis ) the doctor determines quite easily. It is more difficult to diagnose lymphadenitis, the complication of which is periadenitis , and the inflammatory process involves the adipose tissue between the muscles, the cellular spaces of the mediastinum and the retroperitoneal space.

To establish a differential diagnosis, it is important to know where the primary purulent-inflammatory focus is located. It is important to differentiate chronic nonspecific lymphadenitis with enlarged lymph nodes in other infectious and other diseases. In the process of recognizing chronic lymphadenitis, the doctor evaluates a whole range of symptoms of the disease. If the diagnosis is difficult, then the lymph node should be removed or removed for subsequent histological examination. Such a study of the material means a lot in the process of differential diagnosis chronic lymphadenitis and identification.

Diagnosis specific lymphadenitis» is established based on the results comprehensive examination patient. This takes into account the patient’s contact with patients. tuberculosis , his reaction to, the presence or absence of tuberculosis in the lungs and other organs.

Also install correct diagnosis can be done by puncture of the affected lymph node. X-rays can be used to determine formation in nodes calcifications , which are on x-ray visible as dense shadows on the neck soft tissues, under the jaw, in the armpits and groin area. It is important to differentiate tuberculous lymphadenitis from nonspecific purulent lymphadenitis, metastases of malignant tumors, lymphagranulomatosis .

If inguinal lymphadenitis is suspected, a thorough examination of the rectal area and genital organs should be performed to determine the condition of the pelvic and hip bones. It is important to establish the correct diagnosis, because in some cases inguinal lymphadenitis is defined as strangulated hernia .

Treatment of lymphadenitis

Treatment lymphadenitis of acute nonspecific form is prescribed depending on the stage at which it begins. If only available initial forms disease, then treatment of lymphadenitis is carried out using conservative methods. So, the affected organ should be at rest; treatment is UHF therapy , therapy of the source of infection (i.e. autopsy, autopsy purulent leaks ), is also carried out antibiotic therapy .

For purulent lymphadenitis, a surgical treatment method is used: abscesses are opened and removed. , is carried out wound drainage . All subsequent measures are carried out the same as in the process of treating purulent wounds.

When treating lymphadenitis of a chronic nonspecific form, it is necessary first of all to eliminate the underlying disease, which became the source of this form of lymphadenitis. Treatment of specific lymphadenitis is carried out depending on the nature of the damage to the lymph nodes, as well as the presence of tuberculous changes in other organs. If the process is active, first-line drugs are used: Tubazid , in combination with or thrombophlebitis , the purulent process can spread to the cellular spaces, and the patient may also develop metastatic foci of purulent infection.

Prevention of lymphadenitis

To prevent lymphadenitis, it is necessary to avoid injuries and wounds, and to treat pyoinflammatory diseases rationally. In patients with axillary lymphadenitis, it may appear sepsis , subpectoral phlegmon .

List of sources

Dvoretsky L.I. Differential diagnosis for lymphadenopathy. // Directory of a polyclinic doctor. - Volume 03. - No. 2. - 2005.
Lymphadenopathy. Guide for doctors // Ed. Nikulicheva V.I. - Ufa: Bashkortostan. - 2001.
Melikyan A.L. Non-tumor lymphadenopathy: Dis. ...Dr. med. Sci. M., 2008

Lymphadenitis is an inflammation of the lymph nodes that occurs as a result of the ingress of various microorganisms and their toxins into them. It is characterized by an increase in the size of the lymph nodes and severe pain in the affected area. Only in rare cases does lymphadenitis represent an independent disease. Most often, this is nothing more than a symptom signaling some kind of problem in the body.

What kind of disease is this, what are its first signs, causes, why lymphadenitis is dangerous for humans if left untreated - we will consider further.

Lymphadenitis is an inflammatory disease of the lymph nodes, often purulent. Occurs when staphylo- and streptococci enter the body.

The disease occurs after microorganisms, toxins, and tissue breakdown products enter the lymph nodes with lymph. Penetration can occur through lesions on the skin, mucous membranes, and also through the hematogenous route.

Typically, lymphadenitis occurs as a complication of primary inflammation of any localization. Infectious pathogens (microorganisms and their toxins) penetrate the regional lymph nodes with the flow of lymph, which flows from the primary purulent focus. Sometimes, by the time lymphadenitis develops, the primary focus has already been eliminated and may remain unrecognized.

In other cases, lymphadenitis occurs when infection directly enters the lymphatic network through damaged skin or mucous membrane.

Signs most often appear on the neck, as well as in the axillary area and groin. Enlargement of lymph nodes can be single or observed simultaneously in different parts bodies.

General symptoms include local and general increase in body temperature, severe pain, skin hyperemia, chills and itching. Lymphadenitis is a pathology that can develop in any person, regardless of gender and age.

Classification

According to the duration of the disease, lymphadenitis can be, like many other diseases, acute and chronic, according to the type of infectious agent - specific and non-specific, according to its progression - purulent and non-purulent.

Classification of lymphadenitis depending on the intensity and duration of the inflammatory process:

Acute lymphadenitis

The onset of development of the pathological process is acute. The main reasons for the progression of the pathology: wound infection, the presence of an acute infectious disease in the body, surgical intervention.

Forms of acute inflammation:

catarrhal (simple inflammation);
hyperplastic (with active growth of lymphoid cells);
purulent.

Acute - manifests itself with vivid symptoms and turns into a purulent form if not treated. In the purulent form, the lymph nodes melt and the disease affects neighboring tissues.

There is redness and swelling around the lymph node, the contours of the node are blurred, the lymph node is fused with the surrounding tissues, movements in this area bring pain. As pus accumulates and tissue melts, movement of pus inside the node is noted. If it doesn't happen surgical treatment, an abscess in the area of the node can break out or into the depths of the tissue.

Chronic lymphadenitis

This pathology is directly related to the progression of cancer or the presence of an infectious process in the body that does not subside for a long time.

With chronic nonspecific lymphadenitis, inflammation in the lymph nodes is prolonged. This inflammation is productive. Its transition to a purulent form practically never occurs.

Symptoms of chronic nonspecific lymphadenitis include enlarged lymph nodes, they are dense, are not painful on palpation, and are not fused together. The lymph nodes remain enlarged for a long time, but gradually they decrease. In rare cases, the proliferation of connective tissue can lead to lymph circulation disorders and swelling.

By location:

Submandibular;
Cervical;
Axillary;
Parotid;
Mesenteric (mesadenitis);
Inguinal.

By prevalence:

Single;
Regional;
Total.

During acute lymphadenitis There are three successive stages:

catarrhal (with redness, dilation of blood vessels in the area of the node),
hyperplastic (with an increase in the size of the node, impregnation with plasma)
purulent (formation of a purulent cavity inside the node).

Simple lymphadenitis is distinguished by the fact that the inflammatory process does not extend beyond the capsule of the node itself. In destructive forms, the inflammatory process spreads to surrounding tissues. Changes in the surrounding tissues may be limited to serous inflammation or, in a more complex case, may develop into purulent inflammation with the subsequent formation of adenophlegmon.

Reasons

Lymphadenitis in adults develops against the background of harmful work and with advanced forms of disease. Both men and women have a disdainful attitude towards own health when they are sick. Self-treatment of infectious diseases is often attempted. This approach provokes suppuration of the lymphatic tissues, causing the disease to become chronic.

As a rule, lymphadenitis is a consequence of primary septic inflammation. Pathogenic (pyogenic) microflora - streptococci and staphylococci, and the toxins they produce migrate from the lesion through the lymphogenous route, or through the bloodstream. It is also possible to introduce infectious agents into lymphatic vessels through injured skin or mucous membranes (contact route).

Inflammation of the tissues of the lymph nodes develops due to the influence of infectious and non-infectious factors.

Often lymphadenitis occurs as a result of inflammation in the oropharynx with tonsillitis, adenoiditis, influenza, scarlet fever. Lymph nodes can become enlarged due to childhood infections - rubella, mumps or diphtheria.

Among the commonly found non-infectious causes lymphadenitis can be distinguished as follows:

oncology of lymph nodes (lymphoma);
metastatic (secondary) cancer that has spread from other areas of the body;
inflammation as a response to the introduction of a foreign body.

Symptoms of lymphadenitis in adults

Signs of lymphadenitis largely depend on its type and stage. So, for example, if the symptoms of acute lymphadenitis cannot be ignored, then the so-called simple lymphadenitis is generally painless and does not cause concern for the time being.

Symptoms:

Edema and hyperemia are local phenomena that characterize the struggle of lymphocytes with viruses and pathogenic bacteria.
Loss of appetite, weakness, headache- develop against the background of poisoning of the body with toxins released by inflammatory agents.
Suppuration in the area of the lymph node - if pus forms, then we are talking about the development of an abscess; sometimes purulent melting of the lymph node occurs.
Development of tachycardia - when the process is started, inflammation increases and causes complications on the cardiovascular system.
Gas crepitus - when palpating the affected lymph node, a slight crunching sensation is felt.
Violation of the functional characteristics of the location of inflammation - due to severe pain, a person cannot move an arm or leg, neck, depending on the area in which the lymph node is inflamed.

Symptoms of acute lymphadenitis

Signs of acute lymphadenitis depend on the form of the disease and the nature of the inflammation. Basically, the general condition of the patient with catarrhal lymphadenitis is not particularly disturbed. Symptoms may include:

pain in the area of regional lymph nodes.
In this case, there is an increase in the lymph nodes and their pain during palpation.

If the disease process progresses and periadenitis develops, then the described symptoms may worsen.

Painful sensations become sharper, the skin over the lymph nodes becomes hyperemic, and when palpating the nodes the patient feels pain.
Lymph nodes, which previously could be very clearly palpated, now merge with each other and with the surrounding tissues, and they also become immobile.

Signs of chronic form

Chronic lymphadenitis is divided into primary, as a result of penetration of weakly infectious microflora into the body, and acute, which has taken a protracted form. The clinical picture of these forms of lymphadenitis includes the following symptoms:

lymph nodes are dense and painless on palpation,
have no adhesions.

Often their own cells are replaced by connective tissue, which leads to impaired lymphatic circulation, lymphostasis and extensive swelling.

The increased sizes can last a long time, but then the nodes decrease due to the proliferation of connective tissues. The general condition of a person with chronic lymphadenitis is not disturbed, the body temperature is normal.

Specific lymphadenitis also has its own characteristics:

with gonorrheal form inguinal nodes excessively painful and enlarged;
tuberculosis form gives severe weakness(due to intoxication) and sharp increase temperature, which can last for a long time, the surrounding tissues become inflamed;
the syphilitic nature of inflammation occurs as a one-sided process. Lymph nodes resemble a “chain”. When palpated, they are free, not welded together and rarely contain pus.

Lymphadenitis	Symptoms
Cervical	Pressing on the formed compaction of the lymph nodes causes pain. In addition to inflammation with cervical lymphadenitis: the general health of the patient worsens, he develops a headache and fever. In the acute form, severe suppuration forms in the area of the lymph nodes
Submandibular	Pain. Intensifies as the disease progresses. Changes in the skin over the lymph nodes: redness swelling local temperature increase of 1-2 degrees Suppuration of the lymph nodes (develops with a bacterial infection).
Inguinal	Lymph nodes increase in size, pain is noted, both at rest and during palpation. When walking, patients feel: feeling of discomfort in the lower abdomen sharp pain. Associated symptoms include: high temperature, weakness and chills. Inguinal lymphadenitis is complicated by: localized edema skin hyperemia.
Axillary form	Symptoms of the axillary form of pathology: enlarged lymph nodes and their suppuration; increased body temperature; sharp pain in the nodes; phenomena of general intoxication; swelling of surrounding tissues; it is possible for the abscess to break outward (with the formation of fistulas in the armpit) and inward (formation of adenophlegmon).

Some symptoms of lymphadenitis indicate the development of serious conditions that are potentially life-threatening. If they are present, it is necessary to seek qualified help as soon as possible, sometimes the count is literally hours and minutes. It's about about such signs as:

elevated body temperature (above 38.5C);
difficulty or rapid breathing;
severe pain, swelling, pronounced redness;
rapid heartbeat.

When the first symptoms of lymphadenitis appear, such as pain in the lymph node, swelling, fever, you should immediately consult a physician or surgeon. These specialists will help directly determine the cause and prescribe the correct treatment or further diagnosis. Under the mask of lymphadenitis, various diseases can be hidden, such as plague, tuberculosis, and various tumor processes.

Complications

Among the local complications of lymphadenitis, one should remember the likelihood of the development of suppuration (usually in childhood). Progressive inflammation of the lymph nodes without proper treatment often entails:

abscess formation;
tissue necrosis;
blood poisoning;
formation of fistulas;
thrombophlebitis of adjacent veins.

Purulent lymphadenitis can be complicated by the development of phlegmon, corrosion of the walls of blood vessels with bleeding.

Diagnostics

Lymph nodes in healthy person soft, not enlarged, displaced relative to adjacent tissue, painless. Very often, in people with a normal physique, the lymph nodes cannot be felt. They are easily detected in children and adolescents of thin build.

When diagnosing, the doctor will first examine the lymph nodes and identify all of the above signs. Next, guided by the data obtained, the issue of laboratory and instrumental diagnostic methods will be decided.

Examinations for the diagnosis of lymphadenitis:

clinical blood test;
HIV test;
allergic skin tests;
computed tomography;
X-ray examination;
node biopsy.

When examining children, it is necessary to exclude or confirm angioedema, congenital tumors and cystic neoplasms in the neck area. When examining patients with inguinal lymphadenitis, it is necessary to exclude the presence of an inguinal hernia and venereal diseases.

Many people confuse the concepts of “lymphadenopathy” and “lymphadenitis” because these words sound similar. In fact, only the second is the name of the disease, since the first is only a symptom or a painless reaction of the body to a rather serious pathology (AIDS, syphilis, etc.). Of course, in such cases the diagnosis requires clarification. Only after examination and testing is the patient given a diagnosis.

Treatment of lymphadenitis

So, if the initial stages of lymphadenitis occur, then the treatment is quite conservative:

creating rest conditions for the affected area;
physiological treatment: electrophoresis, ultrasound therapy, galvanization;
anti-inflammatory ointments and drugs.

In most cases, hyperplastic and catarrhal lymphadenitis, which occurs in an acute form, is treated conservatively. The patient is recommended to provide a state of rest for the affected area and is prescribed antibiotic therapy taking into account the sensitivity of the pathogenic flora, as well as vitamin therapy and UHF therapy.

In case of chronic nonspecific lymphadenitis, elimination of the underlying disease that maintains inflammation in the lymph nodes is required. Specific lymphadenitis is treated taking into account the etiological agent and the primary process (syphilis, gonorrhea, tuberculosis, actinomycosis, etc.).

The main thing is to treat the underlying disease, against which inflammation of the lymph nodes has developed. Medicines that are used in the treatment of lymphadenitis are:

Nonsteroidal anti-inflammatory drugs: Ketorolac, Nimesulide;
Antihistamines: Cetirizine;
Antibiotics: Amoxiclav, Ceftriaxone, Clindamycin, Benzyllenicillin;
Antiviral drugs: Acyclovir, Rimantadine;
Anti-tuberculosis drugs: Ethambutol, Rifampicin, Capreomycin;
Antifungals: Fluconazole, Amphotericin B.

Operation

Surgical treatment is resorted to when purulent complications lymphadenitis - abscess and adenophlegmon.

Operation stages:

Under local or general anesthesia The purulent focus is opened, pus and destroyed tissue are removed.
Prevalence is determined purulent process, the degree of damage to nearby organs and tissues.
At the end of the operation, the source of suppuration is washed with antiseptic solutions (for example, furatsilin), the wound is sutured and drained - a special tube (drainage) is installed into the wound cavity, through which inflammatory fluid and pus flow out, and various antiseptic solutions can also be injected.

Prevention

Prevention of lymphadenitis implies:

prevention of skin microtraumas;
preventing infection of resulting abrasions, wounds and other damage to the epidermis;
timely elimination of foci of infection (for example, treatment of dental caries or sore throat), autopsy
purulent pathological formations(boils and felons);
timely, accurate diagnosis and adequate treatment of diseases causing specific
forms of lymphadenitis (gonorrhea, tuberculosis, syphilis, actinomycosis and others).

Lymphadenitis, as a disease of the immune system, signals the presence of pathogenic flora in the body, so it is necessary to treat not only the inflamed lymph node itself, but first of all the disease that contributed to lymphadenitis.

Cervical lymphadenitis is a disease in which the cervical lymph nodes become enlarged and painful. A disorder occurs because the lymphatic system is part of the immune system, and when various pathogenic microflora (viruses, bacteria, fungi) enter the body, the number of lymphocytes increases. Next, we will consider what cervical lymphadenitis is, what are its main causes and symptoms, as well as diagnostic methods and treatment options.

Lymphadenitis of the neck is rarely independent disease, more often – a consequence and accompanying symptom other diseases. However, according to the international classification of diseases (ICD 10), acute lymphadenitis is classified as a separate group and has an ICD code of L04. Acute cervical lymphadenitis is more common in adults than in children.

Causes of neck lymphadenitis

Most often, acute lymphadenitis is caused by the following reasons:

Infectious diseases of various origins (viral, bacterial or fungal). This includes all groups of acute respiratory viral infections and acute respiratory infections, diseases of the ENT organs (tonsillitis, pharyngitis, rhinitis, sinusitis, sinusitis, otitis media, etc.), dental disorders of an infectious-inflammatory nature (stomatitis, periodontal disease, caries, periodontitis, etc.) , measles, jaundice, scarlet fever, meningitis, tuberculosis, skin diseases. Some sexually transmitted diseases (for example, syphilis) can cause not only cervical lymphadenitis, but also inguinal lymphadenitis.
Diseases such as HIV and AIDS should be included in a separate group, since their immediate manifestation is enlargement of the lymph nodes, often in several places simultaneously (neck, armpits, groin).
Autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, autoimmune thyroiditis, etc.
Installation of various implants (silicone, metal, plastic, etc.). The immune system perceives the implant as a foreign object and may begin to reject it.
Pathologies thyroid gland.
Oncological diseases. And this includes both oncology itself lymphatic system, as well as other organs.
Other reasons:

decreased immunity due to seasonal vitamin deficiency and colds, stress, chronic diseases;
drafts. In this case, lymphadenitis will be an independent disease when the lymph nodes are simply blown through by an open window or air conditioner;
allergic reactions;
alcohol abuse.

Symptoms

Clinical manifestations of cervical lymphadenitis can be divided into main and associated.

The main ones include pain in the neck, enlargement and swelling of the lymph nodes themselves, discomfort when turning the head and pressing on the neck. The lymph nodes may be slightly red and hot..

Associated symptoms with cervical lymphadenitis depend on the cause of the disease:

increased body temperature (from low-grade to high);
sore throat, runny nose, cough;
sneezing (allergic or cold);
difficulty swallowing;
weakness, general malaise associated with intoxication of the body by infectious agents;
headaches, poor appetite, etc.

Types of disease

There are several classifications of lymphadenitis, they differ on the following grounds:

Based on the duration and severity of the course, acute and chronic types. Acute develops as a reaction to an infection entering the body (for example, with a sore throat). The chronic form most often occurs in the case of chronic throat diseases (pharyngitis, tonsillitis). In this case, the lymph nodes are only slightly enlarged, and there may be no pain at all.
Depending on the cause of occurrence, cervical lymphadenitis can be specific or nonspecific. The first is the most dangerous and more difficult to treat, as it is caused by serious infectious diseases (syphilis, tuberculosis, plague). Nonspecific usually occurs with colds and ARVI, and is easily eliminated with cure of the underlying disease.
Depending on cellular composition The inflamed lymph node is divided into serous, purulent and simple. Serous occurs with a viral course of the disease or with oncology, purulent - with a bacterial one. Purulent lymphadenitis is the most dangerous, as an abscess or phlegmon may occur (spread of purulent contents beyond the lymph node capsule to neighboring tissues). It is purulent lymphadenitis that is fraught with the development of sepsis. That is why, if symptoms such as redness of the skin on the lymph node, its severe enlargement, pain and hotness of the skin appear, you should immediately consult a doctor.

How to determine cervical lymphadenitis

To make a correct diagnosis and determine a treatment strategy, diagnosis must take place in several stages:

Collection of anamnesis and symptoms. The doctor finds out what symptoms are bothering you and collects a medical history.
External examination and palpation allows you to determine which group of lymph nodes is inflamed, how enlarged and painful they are. Also at this stage, the doctor can diagnose the presence of a purulent process.
Blood tests. For a reliable result, you need to take several tests: general, “for sugar”, biochemical, SOI, C-reactive protein, for tumor markers. If you suspect the presence of sexually transmitted diseases, blood is also donated.
Ultrasound. It is done, if necessary, to determine the structure of the lymph node, whether there are any pathologies in it, as well as disruptions in the functioning of neighboring tissues.
Puncture. This is a fine needle biopsy (no sampling) large quantity lymph node tissue) to determine its cellular composition.
If a specific disease is suspected, the doctor prescribes additional tests. For example, if pulmonary tuberculosis is suspected - fluorography; MRI (magnetic resonance imaging) or CT (computed tomography).

Only after all necessary laboratory and clinical trials The doctor makes a diagnosis and prescribes specific medications.

Treatment of cervical lymphadenitis

Treatment of lymphadenitis is based, first of all, on eliminating the cause that caused it (only if lymphadenitis is not an independent disease). For this, various drugs (drug treatment) and physical therapy are prescribed. Traditional medicine recipes can also be used.

Drugs

Medications are selected only by the attending physician on an individual basis. In most cases, the following is prescribed:

Antibiotics to eliminate bacterial infections. Antibiotics currently come in different groups and spectrums of action, so to select the correct drug, it is necessary to find out which pathogen caused the disease. Most often, the doctor prescribes complex antibiotics, since there may be more than one pathogen.
Antiviral agents can be used either independently or simultaneously with antibacterial agents. Most Popular antivirals– Kagocel, Ingavirin, Arbidol, Oscillococcinum.
Antifungal agents are needed when the fungus appears primarily or after antibiotic therapy. For example, Candida fungus is a normal representative of the throat microflora, but after antibacterial drugs its number may increase. Therefore, Fluconazole or Nystatin is prescribed.
Drugs for correcting immunity (immunomodulators and immunostimulants) can be prescribed by the attending physician to children in cases of severe disease, cancer, chronic pathologies of the ENT organs, and in many other cases. Most effective drugs this group: Cycloferon, Viferon, Immunal, echinacea extract, Interferon, Lykopid.
For allergic manifestations of lymphadenitis, antihistamines (Suprastin, Tavegil, Claritin, etc.) are prescribed.
Therapy for thyroid diseases is quite specific, and if lymphadenitis is a consequence of thyroid pathologies, then treatment and the choice of remedies will depend on the specific disease.

Seasonal lymphadenitis, caused by decreased immunity, must be treated with measures aimed at strengthening the body's defenses, and the prevention of colds must also be present.

Physiotherapy

Physiotherapy allows you to eliminate the inflammatory process on cellular level and cure lymphadenitis faster. For these purposes, ultrasound with hydrocortisone ointment is widely used. The popularity of this procedure is growing among those patients whose cervical lymphadenitis is caused by chronic throat diseases (tonsillitis, pharyngitis). Among the positive reviews, there is information that after a course of ultrasound, discomfort in the neck disappeared, and the condition of the throat improved significantly.

Since it is prohibited to heat the lymph nodes, physiotherapy using heat (UHF) is not used to treat lymphadenitis.

Home Remedies

It may take considerable time until the underlying disease is eliminated. Until this point, a number of measures can be taken to alleviate the symptoms of lymphadenitis.

If the doctor allows, you can make gauze compresses using ichthyol ointment or Vishnevsky ointment. You can also simply wrap a wool scarf around your neck. Heating lymph nodes is strictly prohibited even in the absence of a purulent process.

Cervical lymphadenitis is a rather dangerous disease. It can be a consequence of a harmless cold, or it can hide more serious pathologies. Therefore, at the first signs of inflamed lymph nodes, you should immediately consult a doctor.

Lymphadenitis– inflammation of the lymph nodes, resulting from the ingress of various microorganisms and their

toxins

It is characterized by an increase in the size of the lymph nodes and severe pain in the affected area. In most cases, lymphadenitis is not an independent disease, but only indicates the presence of pathology in a particular organ or part of the human body. Meanwhile, the prolonged presence of an inflammatory process in the lymph nodes can develop into an independent pathology and lead to a number of serious complications, often dangerous to human life.

Lymphadenitis is a fairly common pathology. Inflammation of regional lymph nodes accompanies almost all infectious diseases, but the absence of lymphadenitis does not exclude the presence

infections

in the body.

Interesting facts

More than 80% of people experience painless enlargement of the submandibular lymph nodes, which is considered normal. No other groups of lymph nodes are normally palpable.
The development of lymphadenitis is natural defensive reaction organism, arising in response to the introduction of foreign agents (bacteria, viruses, fungi). The purpose of this reaction is to prevent the infection from spreading throughout the body.
Not all enlarged lymph nodes are lymphadenitis. Exists a whole series diseases (various tumors, systemic rheumatic diseases), which lead to enlargement of the lymph nodes without signs of inflammation in them.

The structure of lymphatic vessels and lymph nodes The lymphatic system is part of the body's vascular system. It takes part in metabolism and also performs a protective function, which is to neutralize various microorganisms and other foreign particles.

The lymphatic system includes:

spleen;
lymphatic fluid (lymph);
lymphatic vessels;
lymph nodes.

Spleen In period embryonic development Blood cells are formed in the spleen. After birth, the processes of hematopoiesis in it are inhibited, and it turns into the central organ of the lymphatic system, in which differentiation (acquisition of specific functions) of the main cells of the immune system - lymphocytes - occurs.

Lymphocytes are a type

leukocytes

- the so-called white blood cells that provide

immunity

protecting the body from various external and internal influences

). Lymphocytes are produced in red bone marrow, which is located inside the body's bones (

in the bones of the pelvis, vertebrae, ribs, sternum and others

). From bone marrow Immature forms of lymphocytes are released into the bloodstream and enter the spleen, where their differentiation processes end.

Lymph formation occurs in almost all tissues of the body due to the passage of a small amount

and some of the fluid from the blood capillaries (

smallest blood vessels

) into lymphatic capillaries. Blood vessels that carry blood to organs and tissues (

), gradually branch out and decrease in diameter. The smallest vessel in the human body is the capillary. At the capillary level, part of the liquid and small quantity proteins leave the vascular bed (

filtered

) and enters the organ tissue (

intercellular space

). Most of the filtered fluid returns to the blood capillaries. They form larger vessels (

venules, veins

), through which the outflow of venous blood from organs to

A certain proportion of proteins and about 10% of fluid from the intercellular space does not return to circulatory system, but enters the lymphatic capillaries. In this way, lymph is formed, which, in addition to proteins and plasma, contains various

microelementsfat

carbohydrates

As well as cellular elements (

predominantly lymphocytes

Lymphatic vessels

When several lymphatic capillaries merge, larger lymphatic vessels are formed. They carry out the outflow of lymphatic fluid from all tissues of the body to the lymph nodes, which correspond to a certain body or body parts.

Efferent lymphatic vessels emerge from the lymph nodes, which also merge to form large lymphatic trunks and ducts. Through them, lymphatic fluid is transported to the large veins of the body, thus returning to the systemic circulation.

There are several large lymphatic ducts in the human body:

Thoracic lymphatic duct - collects lymph from the legs, pelvic organs, abdominal cavity and left half of the chest.
Left subclavian trunk - collects lymph from the left hand.
Left jugular trunk - collects lymph from the left half of the head and neck.
Right lymphatic duct - is formed by the fusion of several lymphatic trunks and collects lymph from the right half of the head, neck, right half of the chest and right arm.

Lymph nodes Lymph nodes are round or oval-shaped formations, small in size (from a few millimeters to 1 - 2 centimeters), which are located along the lymphatic vessels that carry lymph from various organs and tissues. The surface of the lymph node is covered with a connective tissue capsule, under which there is a cluster lymphoid tissue containing many cells - lymphocytes.

Lymphocytes are formed in the lymph nodes, starting from the period of embryonic development. Their main function is the recognition of foreign agents (

viruses, fragments of bacteria and their toxins, tumor cells and so on

) and activation of other protective systems of the body aimed at neutralizing them.

Lymph entering the lymph nodes slowly leaks through narrow, slit-like spaces called sinuses. Thus, it is cleansed from various foreign bodies, and also ensures contact between foreign agents and lymphocytes.

The main function of the lymph nodes is to prevent the spread of pathological processes in the body. This is realized due to the presence of several groups of lymph nodes, which filter lymph from different parts of the body. They are located in such a way as to become a barrier to infectious processes and prevent foreign antigens from entering various organs and tissues.

The main groups of lymph nodes in the human body are:

lymph nodes of the head and neck (cervical, submandibular, occipital and others);
lymph nodes of the chest cavity;
lymph nodes of the abdominal cavity and abdomen (mesenteric, iliac, pelvic);
lymph nodes of the lower extremities (inguinal, popliteal);
lymph nodes of the upper extremities (axillary, elbow).

Each group of lymph nodes collects lymph from the tissues and organs of a specific area of the body. Before entering the systemic circulation, the lymphatic fluid is sequentially filtered in several lymph nodes, as a result of which it is almost completely cleared of foreign inclusions that may be present in it. In addition, it is enriched with lymphocytes, which enter the systemic bloodstream and are carried through the bloodstream to all tissues and organs, where they perform their protective functions.
Development of the inflammatory process in the lymph node

If foreign agents appear in any organ (

viruses, bacteria, toxins

), then some of them, together with the interstitial fluid, pass into the lymphatic capillaries and are delivered with the lymph flow to the regional lymph nodes. In addition, the infection can enter the lymph nodes by hematogenous (

through blood

) or by contact (

with direct spread from nearby tissues and organs

). In rare cases, it is possible to introduce pathogenic

microflora

directly from the environment (

when a lymph node is injured

In the lymph nodes, foreign antigens interact with lymphocytes, as a result of which the latter are activated and begin to produce specific antibodies - an inflammatory process develops. A large number of other types of leukocytes enter the lymph node from the bloodstream, which contribute to the development of inflammation and the destruction of foreign substances.

The migration of a large number of leukocytes to the site of inflammation, as well as the activation of lymphocyte growth processes in the inflamed lymph nodes, leads to the proliferation (hyperplasia) of lymphoid tissue, which is externally manifested by an increase in the size of the lymph node. The release of a large number of biologically active substances causes increased sensitivity and soreness of the inflamed area.
When do lymph nodes become inflamed?

As mentioned earlier, the main function of the lymph nodes is to prevent the spread of pathological processes in the body. Any infectious agent that gets into them is retained and destroyed by lymphocytes. However, with a massive influx of foreign microorganisms, the existing lymphocytes may not cope with their function - in this case, they begin to multiply intensively, and also stimulate the entry of other types of leukocytes into the site of inflammation, which leads to an enlargement of the lymph nodes.

Causes of lymphadenitis Lymphadenitis is caused by various pathogenic microorganisms that enter the lymph nodes.

Depending on the type of infection, lymphadenitis can be:

nonspecific;
specific.

Nonspecific lymphadenitis Nonspecific lymphadenitis is caused by a number of microorganisms that are different in structure and virulence (infectiousness), but have similar development mechanisms and clinical manifestations.

The causes of nonspecific lymphadenitis may be:

Bacteria and their toxins. A bacterium is a living cell that is capable of existing and multiplying in various organs of the human body, infecting them. Inflammation of the lymph nodes can be caused by the ingress of staphylococcus, streptococcus, E. coli and many other microorganisms into them. Some of them, during their life activity (or after their death), release certain toxic substances, which can also cause lymphadenitis.
Viruses. Viruses are small fragments of nucleic acids - DNA (deoxyribonucleic acid) or RNA (ribonucleic acid) that can only reproduce inside living cells. In the cells of the human body, nucleic acids are contained in the nucleus and are responsible for the processes of cell growth, the performance of specific functions, as well as for the storage and transmission of genetic information. When infected by a virus, its DNA is introduced into the genetic apparatus of the host cell, as a result of which it begins to produce new viral particles. When an infected cell is destroyed, the newly formed viruses are released into the surrounding tissue and infect neighboring cells. Some of the viral fragments seep into the lymphatic capillaries, lingering in the regional lymph nodes and causing the development of an inflammatory process in them.
Mushrooms. Fungi are a special class of bacteria-like microorganisms that can grow in the human body. Science knows many types of fungi (yeast, mold, and so on). Some of them are dangerous to humans and, if ingested, can cause the development of various diseases (mycoses). Others are normal inhabitants of the skin and mucous membranes and acquire pathogenic properties only when the functions of the immune system are impaired - for example, in AIDS (acquired immune deficiency syndrome).

Specific lymphadenitis Specific lymphadenitis develops as a result of entry into the lymph nodes certain types microorganisms.

The cause of specific lymphadenitis may be:

Mycobacterium tuberculosis;
Treponema pallidum (the causative agent of syphilis);
plague bacillus (causative agent of plague);
actinomycete (pathogenic fungus, causative agent of actinomycosis);
Brucella (causative agents of brucellosis);
tularemia bacteria (causative agents of tularemia).

Infection with these microorganisms leads to the development of specific clinical picture characteristic of each disease. With the lymph flow, pathogens enter the lymph nodes, causing specific changes in them.
Types of lymphadenitis

Depending on the type of microorganism and its virulence, the inflammatory process in the lymph nodes can develop differently.

Depending on the speed of development of the inflammatory process, the following are distinguished:

Acute lymphadenitis. Develops as a result of damage to the lymph nodes by a highly virulent infection. Characterized by rapid and severe inflammation of the lymph nodes, often accompanied by common manifestations infectious process (fever, general weakness, headaches and muscle pain). Without appropriate treatment, acute lymphadenitis can turn into a purulent form, which will ultimately lead to purulent melting of the lymph node and damage to surrounding tissues (the development of an abscess or adenophlegmon).
Chronic lymphadenitis. It develops when infected with a weakly virulent infection or is the outcome of untreated acute lymphadenitis, when the inflammatory process takes a protracted course. Also quite often chronic course Characterized by specific lymphadenitis (tuberculous, syphilitic).

Depending on the nature of the inflammatory process, there are:

Catarrhal (simple) lymphadenitis. Characteristic of the initial stage of the disease. Violation of capillary permeability in an inflamed lymph node leads to the fact that the liquid part of the blood leaves the vascular bed and permeates the tissue of the lymph node. There is also a moderate migration of leukocytes to the site of inflammation.
Hyperplastic lymphadenitis. It is a later stage of the development of the disease and is characterized by the proliferation (hyperplasia) of lymphocytes in the inflamed lymph node, as well as pronounced infiltration by leukocytes (neutrophils, eosinophils and other cells).
Purulent lymphadenitis. It is the last stage of development of bacterial lymphadenitis, when suppuration and purulent destruction of the lymph node occurs. The outcome of this form of the disease can be the formation of an abscess (a limited space filled with pus) or the development of adenophlegmon (a diffuse purulent process that spreads far beyond the primary focus of infection).

Causes of lymphadenitis in various areas

As mentioned earlier, lymph from different areas of the body is collected in different groups of lymph nodes. Consequently, an infectious lesion of a certain area will initially manifest itself as inflammation of the corresponding regional lymph nodes.

If regional lymph nodes fail to cope with their barrier function (

in case of a severe infectious disease or as a result of a weakening of the body’s defenses

), infectious agents can enter the systemic bloodstream and spread to other organs and tissues, which can lead to the development of generalized lymphadenitis (

inflammation of various groups of lymph nodes throughout the body

Reasons submandibular lymphadenitis

Submandibular lymph nodes are located medially from the angle lower jaw. Their total number is 8 – 10 pieces.

The organs from which lymph flows into the submandibular lymph nodes are:

skin and soft tissues of the face (lower eyelids, cheeks, nose, lips, chin);
oral cavity (mucous membrane of the palate, back of the tongue);
gums and teeth;
submandibular and sublingual salivary glands.

The development of infection in any of these areas can lead to inflammation of the submandibular lymph nodes.

Causes of submandibular lymphadenitis

Facial skin infections	Injuries and abrasions in the facial area - through them infection with various pathogenic microorganisms can occur. Furuncle – purulent inflammation of the hair follicle (usually of staphylococcal etiology). Carbuncle – purulent inflammation of the group hair follicles and sebaceous glands. Hidradenitis – purulent inflammation of apocrine sweat glands located in the skin of the wings of the nose and eyelids. Impetigo – an infectious disease caused by streptococcus, characterized by the formation of many small pustules in the facial area. Erysipelas (erysipelas) – acute infectious disease caused by hemolytic streptococcus. Herpes – a viral disease caused by herpes virus type 1. Shingles - viral disease caused by a virus chickenpox and manifested by the appearance of a small rash on the skin along the nerve trunks.
Oral infections	Gingivitis – infectious inflammation of the gums caused by staphylococci and certain types of fungi (actinomycetes). Caries – the process of destruction of tooth tissue, caused mainly by staphylococci and streptococci. Glossitis – inflammation of the tongue associated with its trauma and infection with various microorganisms that are constantly present in the oral cavity. Infectious stomatitis - inflammation of the oral mucosa caused by various bacteria, viruses or fungi.
Salivary gland infections	Viral infections – mumps (mumps), cytomegaly (caused by cytomegalovirus). Bacterial infections – staphylococcal, streptococcal and others.

Causes of cervical lymphadenitis

The cervical lymph nodes filter the lymph flowing from the head and neck. Consequently, any infectious processes in this area can lead to inflammation of the cervical lymph nodes.

There are several groups of lymph nodes in the neck area:

Superficial. Collect lymph from the skin and soft tissues of the neck and head (except muscles).
Deep. They drain lymph from internal organs neck (from the pharynx, larynx, trachea, upper esophagus, thyroid gland and neck muscles), as well as from the nasal cavity, mouth, ear and other organs. In addition, the draining lymphatic vessels from the submandibular and other smaller lymph nodes of the head and neck flow into them. Therefore, all of the above infectious processes can cause cervical lymphadenitis (if the barrier function of the submandibular lymph nodes is impaired).

The cause of inflammation of the cervical lymph nodes can also be:

Fungal diseases of the scalp– trichophytosis (ringworm), microsporia, scab.
Otitis – inflammation of the ear caused by pathogenic microorganisms (pneumococci, staphylococci).
Tonsillitis – inflammation of the lymphoid formations of the oral cavity (tonsils), caused by the ingress of pathogenic bacteria or viruses into them.
Pharyngitis – infectious inflammation of the pharyngeal mucosa.
Rhinitis – inflammation of the nasal mucosa.
Sinusitis – inflammation of one or more paranasal sinuses nose - maxillary (sinusitis), frontal (frontitis), sphenoid (sphenoiditis) and ethmoidal labyrinth (ethmoiditis).
Infectious thyroiditis - inflammation of the thyroid gland caused by viruses or bacteria.
Infectious mononucleosis – a viral disease in which primary damage occurs to the cervical and subsequently other groups of lymph nodes.
Rubella – a systemic viral disease that develops when a pathogen enters the body through the mucous membranes of the respiratory tract (airborne), which leads to inflammation of the cervical and subsequently other groups of lymph nodes.
Adenoviral infection - a group of colds of the upper respiratory tract caused by adenoviruses.
Flu - acute respiratory viral infection (ARVI) caused by the influenza virus.
Festering wounds in the head and neck area.

Causes of axillary lymphadenitis Axillary lymph nodes are also divided into superficial and deep. They collect lymph from the skin, soft tissues and bones of the upper limb, as well as from the upper part of the abdominal wall, chest and mammary gland.

The cause of inflammation of the axillary lymph nodes may be:

Purulent-inflammatory diseases of the skin of the upper limb - boil, carbuncle, hidradenitis of the axillary sweat glands, impetigo, erysipelas (described earlier).
Suppuration of cuts and abrasions in the arms, chest and upper abdomen.
Fungal skin lesions– sporotrichosis, trichophytosis, microsporia.
Osteomyelitis of the hand bones – an inflammatory process caused by pyogenic microorganisms and affecting bone tissue.
Panaritium – a purulent-inflammatory process of the soft tissues of the fingers, which can spread to tendons, bones and joints.
Mastitis – inflammatory disease of the mammary gland in women, most often occurring during breastfeeding.

Causes of inguinal lymphadenitis Inguinal lymph nodes collect lymph from all tissues of the lower limb, as well as from the external genitalia, perineum, lower abdominal wall and back.

All infectious diseases of the skin, soft tissues and bones described earlier can cause inflammation of the inguinal lymph nodes if lymph flows into them from the area of the body in which the source of infection is located.

The cause of inflammation of the inguinal lymph nodes can also be:

Gonorrhea – an infectious disease caused by gonococcus, which is sexually transmitted and is characterized by purulent inflammation of the mucous membranes of the external genitalia (mainly in men, very rarely in women).
Balanoposthitis – inflammation of the skin of the glans penis and foreskin caused by various infectious agents (usually due to non-compliance with personal hygiene rules).
Colpitis – infectious inflammation of the vaginal mucosa.
Vulvitis – infectious inflammation of the external female genitalia.

Symptoms of lymphadenitis in various areas Manifestations of lymphadenitis are caused, first of all, by the presence of an inflammatory process in the lymph nodes, as well as the spread of infection in the body.
Symptoms of submandibular lymphadenitis

The manifestations of this form of the disease depend on the size of the lymph nodes, as well as on the nature of the inflammatory process.

Symptoms of submandibular lymphadenitis are:

Enlargement of the submandibular lymph nodes. To the touch (by palpation) they are defined as dense, painful formations of a round or oval shape, located in the submandibular region on one or both sides, not fused with the surrounding tissues (easily move under the skin from side to side). The size of the lymph nodes varies from a few millimeters in the initial stage to several centimeters in the hyperplastic stage of the disease. Quite often, inflamed lymphatic vessels are palpated in the submandibular region - dense, thin, thread-like structures extending from the inflamed lymph node.
Pain. In the initial stage of the disease, mild pain upon palpation of the submandibular region may be observed. As the disease progresses, the pain intensifies, accompanies any movement of the jaw (when talking, while eating), and can also appear at rest.
Changes in the skin. In the initial stages, the skin over the lymph nodes may not change. As the inflammatory process develops, redness and swelling of the skin above the source of inflammation and in the surrounding area is noted (which is due to expansion and increased permeability small vessels). There is a local increase in temperature (by 1 - 2 degrees compared to normal skin).
Suppuration of the lymph nodes (develops with a bacterial infection). In the purulent stage, the lymph nodes grow together and with surrounding tissues, turning into dense, almost immobile formations. The skin over the source of inflammation is bright red, tense, and swollen. There is pronounced pain on palpation and at rest, which limits movement of the lower jaw and neck.
Systemic manifestations. When the infection spreads beyond the lymph nodes, there is a general increase in body temperature to 38 - 40ºC, general weakness, drowsiness, muscle pain, and headaches.

Symptoms of cervical lymphadenitis The manifestations of this form of the disease are determined by the size of the lymph nodes, their location and the nature of the inflammatory process.

Symptoms of cervical lymphadenitis are:

Enlarged cervical lymph nodes. They can be located on the front or side of the neck, above the collarbone. When palpated, they are characterized by the same signs as inflamed submandibular nodes (described above). With inflammation of the superficial lymph nodes, inflamed lymphatic vessels may be palpable.
Pain. There is pain on palpation, when turning the head, when talking, while chewing and swallowing food.
Changes in the skin. With cervical lymphadenitis, swelling and swelling of the skin is noted at the site of inflammation, as well as beyond it. As the purulent form develops, the skin becomes red in color, and small breakthroughs of pus may be visible on its surface. General symptoms at the same time, they are very pronounced - there is an increase in body temperature up to 40ºС, weakness, sleep disturbance, headaches.
Limitation of movements. Associated with pain syndrome that develops in the later stages of the disease - with any turn or tilt of the head the patient experiences severe sharp pain in the area of inflammation. In addition, a pronounced increase in deep lymph nodes can lead to compression of various organs of the neck - vocal cords, trachea, esophagus, large vessels, which will be manifested by corresponding symptoms (change in voice, difficulty breathing, disruption of the process of swallowing food).

Symptoms of axillary lymphadenitis Manifestations of axillary lymphadenitis depend on the activity of the inflammatory process in the affected lymph nodes. In addition, compression (by enlarged lymph nodes) of tissues, nerves and vessels located near the source of inflammation can lead to the appearance of certain symptoms.

Symptoms of axillary lymphadenitis are:

Enlarged lymph nodes in the axillary region. More often one is detected, less often – several enlarged lymph nodes. Their palpation characteristics do not differ from lymphadenitis in other areas. Inflamed lymphatic vessels can be detected (with inflammation of the superficial lymph nodes).
Pain. There is severe pain in the axillary region, which can spread to the shoulder and lateral surface of the chest on the affected side. The patient often takes a forced position with his arm retracted to the side, which reduces pressure on the inflamed lymph nodes and somewhat reduces pain.
Skin changes in the armpit area. When the axillary nodes are inflamed, the color of the skin over them may remain unchanged for a long time. Only with the development of the purulent process does the skin acquire a purplish-red color and become swollen and tense.
Impaired hand movements. The pain intensifies when touching the area of the inflamed lymph nodes and when moving the hand, which can limit the patient’s daily activity. Movement may also be limited as a result of a pronounced enlargement of the axillary lymph nodes, reaching several centimeters in diameter.
Swelling of the hands on the affected side. They may occur as a result of compression of the large veins of the shoulder and axillary region by enlarged lymph nodes. In this case, the outflow of fluid from the upper limb is hampered; it leaves the vascular bed and permeates the surrounding tissues, leading to the development of edema.
Loss of sensation in the hand on the affected side. This symptom may appear in the case of severe enlargement of the axillary lymph nodes. This will lead to compression of the nerve trunks passing in the axillary and shoulder areas, which can be manifested by paresthesia (tingling sensation, crawling on the skin) in the arm area on the affected side, impaired sensitivity, pain and various motor disorders.

Symptoms of inguinal lymphadenitis Symptoms of this form of the disease are determined by the localization and severity of the inflammatory process, as well as the size of the enlarged lymph nodes and the degree of compression of nearby tissues.

Symptoms of inguinal lymphadenitis are:

Enlarged lymph nodes in the groin area. Enlarged lymph nodes are located in the inguinal ligament area and can reach several centimeters in diameter. Palpation characteristics do not differ from lymphadenitis in other areas.
Pain. Inguinal lymphadenitis is characterized by severe pain both in the source of inflammation and in the lower abdomen, in the upper part of the leg. The pain increases with walking, which may limit the patient's normal movement.
Skin changes. The skin above and around the site of inflammation is tense and swollen. If a purulent process has not developed, the color of the skin may be normal or pinkish.
Swelling of the legs on the affected side. The cause of this symptom is both a direct violation of the outflow of lymph through the inflamed lymph nodes, and a pronounced increase in their size, which can lead to compression of large vessels (including the femoral vein, passing directly behind the inguinal lymph nodes).
General condition of the body. Not changed if suppuration of the inflamed lymph node did not occur. In this case, there is an increase in body temperature to 38 - 40ºС, general weakness, pain in the muscles of the legs and abdomen, headaches, increased heart rate and other symptoms of intoxication of the body.

Diagnosis of lymphadenitis Diagnosing lymphadenitis, based on the symptoms listed above, is quite easy. It is much more difficult to identify the cause of the disease, which is a necessary condition for prescribing proper treatment. IN in this case a number of additional laboratory and instrumental studies are used.

In the diagnosis of lymphadenitis the following is used:

general blood test;
ultrasound examination;
X-ray research methods;
lymph node biopsy.

Complete blood count (CBC) This is one of the first methods prescribed when an infectious process in the body is suspected. It allows you to identify signs and assess the severity of inflammatory processes, and in case of generalized infections, identify the pathogen and determine its sensitivity to various antimicrobial drugs.

Ultrasound examination (ultrasound) is a simple and fast research method that does not require special preparation of the patient, is absolutely safe, has virtually no contraindications and can be performed directly in the doctor’s office.

Using ultrasound it is possible to determine:

Location, number, shape, size and structure of lymph nodes.
The relationship of the lymph node with surrounding tissues (fused or not).
The presence of inflammation in the lymphatic vessels of the area being examined.
The presence of purulent complications of lymphadenitis (abscess, phlegmon).
The presence of a focus of infection in the internal organs.

X-ray research methods are used when there is a suspicion of damage to deep-lying groups of lymph nodes, which is typical for a number of systemic infectious diseases.

X-ray methods include:

Plain X-ray of the chest and abdomen. Allows you to identify groups of enlarged lymph nodes (bronchopulmonary, tracheal and others), to determine damage to the bones of the extremities in osteomyelitis. With specific tuberculous lymphadenitis, it is possible to identify foci of tuberculosis in the lung tissue.
Computed tomography – modern method studies that allow you to more accurately determine the size, location and shape of inflamed lymph nodes, the presence of abscesses or adenophlegmon, the degree of spread of the purulent process in the affected area.

Lymph node biopsy An invasive research method (associated with a violation of the integrity of the skin), the essence of which is the removal and further examination of part of the inflamed lymph node. This method is associated with a number of complications, so its use for lymphadenitis is strictly limited.

Indications for performing a lymph node biopsy are:

suspicion of the tumor nature of an enlarged lymph node;
chronic lymphadenitis;
suspicion of specific lymphadenitis;
lack of effect from the treatment provided (for acute or chronic lymphadenitis).

Execution method The biopsy is performed in a sterile operating room under local or general anesthesia.

To take material from inflamed lymph nodes, the following is used:

Needle biopsy. In this case, a special hollow needle is inserted into the affected lymph node, and some of its tissue passes into the lumen of the needle.
Fine needle aspiration biopsy. A special thin needle is used, the internal diameter of which is less than 1 millimeter. The needle is connected to an empty syringe and inserted into the affected lymph node (often under ultrasound guidance), after which the lymph node tissue is aspirated into the syringe and further examined.

Research results The resulting material is sent to the laboratory, where it is stained with special dyes and examined under a microscope. This makes it possible to identify tumor cells in the lymph node (

if available

), as well as determine the severity and nature of the inflammatory process - the predominance of lymphocytes will indicate in favor of viral damage to the lymph node, the predominance of neutrophils - in favor of a bacterial infection.

The resulting material is also sown on special nutrient media designed for growing certain types of microorganisms. The nutrient medium with the test material is placed in a special thermostat, which creates optimal conditions for the growth and reproduction of bacteria. If an infectious agent is present in the lymph node punctate, it will begin to actively multiply, and after some time entire colonies of these microorganisms will appear on the nutrient medium. This allows you to accurately determine the type of pathogen, as well as determine its sensitivity to various antibacterial drugs, which will allow you to prescribe the most effective treatment.

Treatment of lymphadenitis

As mentioned earlier, lymphadenitis is a manifestation of the presence of infection in a specific area of the body. Therefore, to completely eliminate inflammation, it is necessary to eliminate its root cause - the primary infectious focus. At the same time, the inflammatory process itself should not be ignored, as it can progress, leading to the development of serious complications.

Which doctor should I contact?

If you experience painful enlargement of the lymph nodes in any part of the body, you should consult your family doctor as soon as possible. The doctor will carefully examine the affected area, examine all other groups of lymph nodes, and prescribe laboratory tests, and if necessary, refer you for consultation to other specialists.

Depending on the location and type of lymphadenitis, consultation with the following specialists may be necessary:

Otorhinolaryngologist (ENT) and/or dentist – with inflammation of the submandibular and cervical lymph nodes.
Urologist – with inflammation of the inguinal lymph nodes.
Therapist – with inflammation of the lymph nodes in the chest or abdominal cavity (detected using various instrumental methods diagnostics).
Dermatologist – for chronic infectious skin diseases.
Phthisiatrician – with tuberculous lymphadenitis.
Surgeon - if there are signs of a purulent process in the inflamed lymph nodes.

The main directions in the treatment of lymphadenitis are:

drug treatment;
physiotherapy;
traditional methods of treatment;
surgical treatment.

Drug treatment The principles of drug treatment of lymphadenitis are etiotropic therapy aimed at eliminating the root cause of the disease (in this case, the primary foci of infection in the body), as well as symptomatic therapy, the purpose of which is to reduce the manifestations of the inflammatory process in the lymph nodes and improve the general well-being of the patient.

Drug treatment of lymphadenitis

Symptomatic therapy
Group of drugs	Representatives	Mechanism of therapeutic action	Directions for use and dosage
Nonsteroidal anti-inflammatory drugs	Ketorolac	In all tissues of the body, the activity of the enzyme cyclooxygenase, which is involved in the formation of prostaglandins - biologically active substances that play an important role in the development and maintenance of the inflammatory process, is inhibited. It has anti-inflammatory, analgesic and antipyretic effects.		Take orally, after meals, with a glass of warm water or milk. The recommended dose is 5 – 10 milligrams (mg) 3 – 4 times a day. The maximum daily dose is 40 mg. The course of treatment is no more than 5 days.
	Nimesulide (Nimesil)	Preparation latest generation, selectively inhibiting the activity of cyclooxygenase at the site of inflammation. Virtually no effect on healthy tissues of the body, due to which it is deprived of many side effects, characteristic of conventional anti-inflammatory drugs. It has a pronounced anti-inflammatory, analgesic and antipyretic effect.		It is taken orally in powder form. Dissolved in 100 ml of hot boiled water. The recommended dose is 100 mg (1 sachet) 2 times a day. The course of treatment is no more than 10 days.
Antihistamines	Cetirizine	Blocks H1-histamine receptors located on the inner surface of the walls of blood vessels and cell membranes of leukocytes (lymphocytes, basophils and neutrophils). The mechanism of action of cetirizine is due to: Constriction of blood vessels at the site of inflammation. Reducing the permeability of capillaries at the site of inflammation, which prevents the release of leukocytes and fluid from the vascular bed and the development of edema. Inhibition of chemotaxis (the process of migration of leukocytes to the site of inflammation). Inhibition of the release of biologically active substances (mainly histamine) from basophils and eosinophils, which reduces the activity of the inflammatory process.		Take orally with a glass of warm water. children under 6 years old – 2.5 mg 2 times a day; children over 6 years of age and adults – 5 mg 2 times a day.
Etiotropic therapy
Antibacterial drugs	Amoxiclav	A combination drug consisting of the antibiotic amoxicillin (a derivative of penicillin) and clavulanic acid. Amoxicillin blocks the formation of bacterial cell wall components, which leads to the death of microorganisms. Clavulanic acid protects amoxicillin from the action of beta-lactamases, special enzymes that destroy penicillins (produced by some pathogenic bacteria and reduce the effectiveness of penicillin antibiotics). Used to treat nonspecific lymphadenitis.		Take orally 15 minutes after meals. children from 1 to 2 years old – 60 mg 3 times a day; children from 2 to 7 years old – 125 mg 3 times a day; children from 7 to 12 years old – 250 mg 3 times a day; children over 12 years of age and adults - up to 300 - 500 mg 3 times a day. The course of treatment is at least 7 - 10 days.
	Ceftriaxone	A synthetic broad-spectrum antibiotic resistant to beta-lactamases. The mechanism of action is associated with disruption of the formation of cell membrane components and the death of bacteria. Used to treat nonspecific lymphadenitis.		It is administered intramuscularly (injections are very painful) or intravenously. children under 12 years old – 20 – 80 milligrams per 1 kilogram of body weight (mg/kg) 1 time per day; children over 12 years old and adults – 1 – 2 grams 1 time per day. The course of treatment is at least 1 week.
	Clindamycin	Binds to the 50S subunit of ribosomes (intracellular structures responsible for the synthesis of bacterial cell components). Inhibits the processes of division (reproduction) of bacteria.		Inside, after eating. children – 3 – 6 mg/kg 3 times a day; adults – 150 mg every 6 hours. The course of treatment is at least 10 days.
	Benzylpenicillin	A penicillin derivative used in the treatment of specific lymphadenitis in syphilis. The mechanism of action is associated with the suppression of the formation of bacterial cell wall components (including Treponema pallidum, the causative agent of syphilis), which leads to their death.		It is administered intravenously or intramuscularly. children – 25 – 100 thousand action units per kilogram of body weight (IU/kg) 2 – 4 times a day; adults – 1 – 1.5 million units 4 times a day.
Antiviral drugs	Acyclovir	It is integrated into viral DNA, disrupting the processes of virus reproduction. Does not affect the DNA of human cells. Prescribed for viral lymphadenitis caused by the herpes virus, Epstein-Bar, cytomegalovirus.		Orally, at a dose of 200–500 mg 4–5 times a day. The minimum course of treatment is 10 days.
	Rimantadine	Suppresses the processes of viral reproduction in the cells of the body, and also stimulates antiviral immunity. Prescribed for lymphadenitis caused by influenza and herpes viruses.		Inside, after eating, with a glass of warm water. children under 10 years old – 5 mg/kg 1 time per day; children over 10 years of age and adults – 100 mg 2 times a day.
Anti-tuberculosis drugs	Ethambutol	Inhibits the processes of RNA formation in actively growing Mycobacterium tuberculosis, leading to the cessation of reproduction and cell death.		Orally, 1 time per day, 30 minutes before meals, at a dose of 15 – 25 mg/kg. The duration of treatment is several months.
	Rifampicin	Suppresses the formation of various protein structures of bacterial cells (including Mycobacterium tuberculosis), which leads to their death.		Take orally, on an empty stomach, 30 minutes before meals. children – 10 – 20 mg/kg/day; adults – 450 – 600 mg per day. Courses of treatment range from several months to several years.
	Capreomycin	Suppresses the synthesis of protein molecules in Mycobacterium tuberculosis, providing a bacteriostatic effect (stops the processes of bacterial reproduction).		It is administered intramuscularly or intravenously at a dose of 15–20 mg/kg/day. The course of treatment is several years, during which the dosage and frequency of administration may vary.
Antifungal drugs	Fluconazole	It disrupts the formation of structural components and increases the permeability of fungal membranes, which disrupts the processes of their growth and reproduction.		Orally, at a dose of 200–400 mg 1 time per day. The duration of treatment depends on the type and location of the infection.
	Amphotericin B	It disrupts the permeability of fungal membranes, as a result of which their structural components escape into the extracellular space and the fungus dies.		Administer intravenously, drip, slowly. The recommended daily dose is 0.25 – 0.3 mg/kg.

Physiotherapy

It consists of influencing the body by various physical factors in order to obtain a therapeutic effect. The use of physiotherapy for lymphadenitis alleviates the patient’s general condition, reduces inflammation in the lymph nodes and promotes the rapid restoration of damaged tissues.

Physiotherapeutic methods in the treatment of lymphadenitis are used:

ultra-high frequency (UHF) therapy;
laser therapy;
galvanization.

UHF therapy This method involves influencing the human body with high-frequency electromagnetic field. This leads to an increase in temperature in the affected area, promotes vasodilation and migration of leukocytes to the site of inflammation, and the growth of connective tissue there. The described effects contribute to strengthening the local anti-infective immunity of tissues and a more rapid resolution of the inflammatory process.

UHF therapy is indicated in the presence of an acute inflammatory process in the lymph nodes. Absolute contraindications are suspicion of a tumor process, as well as specific tuberculous lymphadenitis. Not recommended for use this method if there are symptoms of a general infectious process in the body (

increased body temperature, chills, rapid heartbeat, muscle pain, and so on

Laser therapy The essence of this method is the effect of light waves of a certain length on the tissues of the body. This leads to improved microcirculation in the inflamed lymph node, has an anti-inflammatory and analgesic effect, and also stimulates reparative (restorative) processes.

This method is prescribed for acute and chronic lymphadenitis. Contraindications are the same as for UHF therapy. In addition, laser exposure should be avoided to areas of the skin that contain benign tumors (

moles, age spots and others

Galvanization The essence of the method is to influence the body with a direct electric current of low strength (up to 50 milliamps) and low voltage (30 - 80 volts), which passes through the body tissues, causing a number of complex problems. physiological processes. It has a local analgesic effect, improves microcirculation in the area exposed to current, and promotes the restoration of damaged tissues and nerve fibers.

This method is used at the recovery stage of treatment after eliminating the cause of lymphadenitis and reducing the activity of the inflammatory process in the lymph nodes, as well as when chronic forms lymphadenitis.

Traditional methods of treatment

Folk remedies are used mainly to reduce the symptoms of inflammation in the lymph nodes, improve the general condition and speed up the healing process. It is worth noting that the use of methods

traditional medicine

permissible only in combination with antibacterial therapy and only after establishing the real reason enlarged lymph nodes. The greatest effect can be achieved by early stages nonspecific lymphadenitis, when inflammatory and destructive (

destructive

) processes are expressed insignificantly.

The most common folk methods for treating lymphadenitis are:

warming up the lymph nodes;
herbal preparations;
Echinacea tincture.

Warming up the lymph nodes It is a widespread folk method, effective in the initial stages of lymphadenitis, as well as in the recovery period. Before using this method, you must consult your doctor and determine the true nature of the enlarged lymph nodes.

Warming the lymph nodes is absolutely contraindicated:

if available tumor process in enlarged lymph nodes;
with specific tuberculous lymphadenitis;
with the development of adenophlegmon;
if there are signs of intoxication of the body (fever, muscle and headaches, rapid heartbeat).

It is necessary to warm up the inflamed lymph nodes with nonspecific lymphadenitis with dry heat. To do this, you can take sand or salt (coarse), heat it in a frying pan, place it in a fabric bag (or sock) and apply it to the site of inflammation for 15 - 20 minutes. After completing the procedure, the warming area must be wrapped in a warm scarf or scarf to prevent hypothermia. The procedure can be repeated 2 – 3 times a day. The recommended duration of treatment is no more than 5–7 days.

If there is a progressive enlargement of the lymph nodes after the start of treatment, an increase in body temperature or a deterioration in general health, warming should be stopped immediately and consult a specialist.

Herbal infusions The anti-inflammatory and antimicrobial properties of various plants have been used in the treatment of lymphadenitis for many decades. They should be used in combination with other treatment methods.

Dandelion root infusion. Pour 10 g of crushed raw materials into a glass of boiling water. Leave for 4 hours, then strain and take 1 tablespoon 3-4 times a day.
Infusion of nettle flowers. 5 tablespoons of dried nettle flowers should be poured with 1 liter of boiling water. Leave for 2 hours, then strain and take 100 ml 2 times a day. This infusion has a certain anti-inflammatory effect and also helps remove toxins from the body.
Aloe juice. Aloe leaves must be washed, crushed and squeezed out the juice. Add 200 g of honey to 100 g of juice and leave for 1 day. Take 1 teaspoon 2 times a day. It has a certain anti-inflammatory and antimicrobial effect.

Echinacea tincture Echinacea is an herbal plant whose components are included in more than 200 different medicines. Stimulates the general immunity of the body, increases resistance to the effects of pathogenic microorganisms (both bacteria and viruses, fungi).

The beneficial effects of Echinacea for lymphadenitis are due to:

increased migration of lymphocytes to the site of inflammation;
increased phagocytic activity of leukocytes;
facilitating the release of biologically active substances at the site of inflammation.

You can buy echinacea tincture at a pharmacy or prepare it yourself. To do this, you need to pour 100 grams of dry and crushed echinacea roots into 500 ml of 60% alcohol and place it in a place protected from light. Leave for 14 days, then strain through cheesecloth. Store the tincture in a place protected from light at a temperature not exceeding 20ºС.

Echinacea tincture can be used:

Externally. A compress with Echinacea tincture is usually used. To do this, you need to dilute 10 - 20 ml of the tincture with warm (not hot!) water in a ratio of 1:2, moisten a bandage or gauze in it and apply a compress to the source of inflammation overnight. It is not recommended to use this method for more than 5 - 7 days.
Inside. Adults take 20–40 drops of tincture dissolved in 100 ml of warm water, 1–2 times a day. Dose for children – 5 – 10 drops 1 – 2 times a day.

Surgical methods of treatment Surgical treatment is resorted to in the development of purulent complications of lymphadenitis - abscess and adenophlegmon. Under local or general anesthesia, the purulent focus is opened, pus and destroyed tissue are removed. The prevalence of the purulent process and the degree of damage to nearby organs and tissues are determined. At the end of the operation, the source of suppuration is washed with antiseptic solutions (for example, furatsilin), the wound is sutured and drained - a special tube (drainage) is installed into the wound cavity, through which inflammatory fluid and pus flow out, and various antiseptic solutions can also be injected.

Cervical lymphadenitis is manifested by acute or chronic inflammation of the lymph nodes located in the neck. This disease immediately exhibits typical symptoms, such localization is easy to diagnose, so treatment can be started in time to prevent complications. The cause of cervical lymphadenitis in young children and adults is often diseases of the oral cavity caused by viral and bacterial microorganisms. A distant purulent focus can also become a factor in the development of the disease.

Reasons

Damage to regional lymph nodes is often preceded by a purulent process in the facial area. Among the most common causative agents of the disease are staphylococci and streptococci. Depending on the causative factor, lymphadenitis is classified into specific and nonspecific. In the first case, the cause will be a severe infection, diseases such as tuberculosis, diphtheria and many others. Nonspecific inflammation occurs when an infectious agent directly enters the lymph node through wounds in the neck without aggravating pathologies.

The risk group includes people with weakened defense mechanism, children with frequent infectious diseases, adults who work with animals, land and contaminated water. More often diagnosed in people over 18 years of age.

Risk factors:

infection in the oral cavity and nasopharynx;
pathology endocrine system, especially the thyroid gland;
immunodeficiency, HIV;
complicated allergic reaction;
violation of metabolic processes;
alcohol abuse.

Cervical lymphadenitis is not a contagious disease; it is a secondary process and develops as a complication of an advanced bacterial or viral process.

The treatment of lymphadenitis is carried out by a surgeon, ENT specialist, pediatrician, infectious disease specialist and other specialists, depending on the consequences and associated disorders in the body.

Stages of inflammation

The inflammation is acute, then gradually progresses to chronic stage. Depending on the state of the immune system, clear signs of initial stage pathologies may be absent, then lymphadenitis is diagnosed already at the chronic stage.

Stages of acute cervical lymphadenitis:

Serous. Develops after the pathogen penetrates the lymph nodes. Accompanied by moderate symptoms without severe intoxication of the body. The temperature rarely rises to 38 degrees, the prognosis for treatment is favorable.
Purulent. Occurs when damaged by bacteria. Manifests itself with severe symptoms with an increase in temperature up to 39 degrees. Immediate surgical treatment is required.
Complicated. Without surgery, the infection spreads to neighboring lymph nodes. Adenophlegmon, inflammation appears deep layers skin.

The transition to the chronic stage is accompanied by a subsidence of clinical manifestations, pronounced signs pass, but intoxication of the body continues, which is accompanied by constant weakness, lack of appetite, low-grade fever bodies.

Forms of the disease

Depending on the pathogen, specific and nonspecific lymphadenitis are distinguished. According to the intensity and duration of the pathology, acute, chronic, complicated and recurrent pathology are noted.

Features of the course, depending on the etiology:

nonspecific inflammation occurs against the background of fungal or viral infection, easier to treat, less likely to lead to complications;
specific inflammation is a sign of severe pathology, including tuberculosis, syphilis, typhoid fever and plague.

A complicated form of inflammation in a small child and adults can result in the spread of pathology to other lymph nodes, which will lead to a serious illness - generalized lymphadenitis. Less dangerous consequences include adenophlegmon and exacerbation of existing diseases against the background of decreased immunity.

Symptoms

General signs of the disease:

in the acute form, the temperature rises;
weakness, bad dream and lack of appetite;
neurological symptoms (migraine, apathy, dizziness);
intoxication.

At the initial stage of the disease, enlargement and thickening of regional lymph nodes can be observed. On palpation they are painful and adherent to the surrounding tissues. This is the serous stage of the disease, if you do not seek help, the symptoms increase, swelling of the lymph nodes persists for several weeks, and the process becomes chronic.

Symptoms of chronic lymphadenitis:

swelling of the lymph nodes;
temperature rise to 37.5-38 degrees;
malaise, drowsiness, loss of sleep;
mild pain during palpation.

At the chronic stage, the symptoms are poorly distinguishable, the body “gets used to it” and fewer resources are spent on fighting the disease. This leads to slow poisoning by decay products and areas of necrosis.

As purulent tissue damage occurs, external signs of inflammation increase and at one point the disease worsens. The transition to the purulent stage will be indicated by severe pain and pulsation during palpation, swelling of the lymph nodes, which are already fused with the surrounding tissues. Body temperature rises to 38 degrees and above, the condition becomes life-threatening.

In children, lymphadenitis is more active and moves faster from one stage to another. More often, a child can experience inflammation of the submandibular nodes and the spread of the pathological process to the neck.

Diagnostics

During an external examination, the doctor pays attention to the affected lymph nodes and surrounding tissues to identify the causative factor. A clinical blood test will show the inflammatory process, an increase in the level of lymphocytes, and if lymphadenitis is not complicated by other disorders, treatment begins immediately. When the doctor sees changes in other organs, instrumental diagnostics and additional tests are prescribed.

A comprehensive examination includes:

clinical blood test;
puncture, histological examination of the node material;
chest x-ray if tuberculosis is suspected;
ultrasound examination of the abdominal cavity for unknown causes of inflammation;
computed tomography to visualize the focus of the disease and surrounding tissues;
analysis for HIV and hepatitis.

Visiting a doctor should not depend on the stage of the disease. A decrease in swelling and absence of pain does not indicate recovery. At any moment, lymphadenitis can worsen, in which case urgent surgical treatment will have to be performed. The best option would be to visit a doctor when the first symptoms appear: swelling and pain in the neck. In this case, it will be possible to plan a scheme drug therapy and prepare for surgery.

Treatment methods

For purulent lymphadenitis, surgical treatment is indicated. The lesion is opened, the contents removed, treated and drained. Then symptomatic treatment is prescribed.

Drug therapy is carried out depending on etiological factor. Symptomatic medications for pain relief, anti-inflammatory and restorative drugs are prescribed. The doctor prescribes antibacterial drugs. During the period when symptoms subside, you can undergo physiotherapeutic procedures, including UHF therapy, galvanization and medicinal electrophoresis.

Prevention

For the primary prevention of cervical lymphadenitis, it is important to promptly treat inflammatory and purulent diseases in the face and chest. Considering the risk of the disease arising from oral diseases, it is necessary to regularly visit the dentist for professional hygiene and rehabilitation.

Pathogenic microflora accumulates in hard dental deposits, which can trigger inflammation of the gums and periodontal disease. Without treatment in case of weakened immunity, this threatens the spread of infection to regional lymph nodes and bone tissue.

Prevention includes:

taking vitamin complexes;
treatment of wounds and scratches on the skin;
treatment of boils, abscesses and other foci of purulent infection.

It is not allowed to treat cervical lymphadenitis at home without first being examined by a doctor. Warm compresses and many other traditional medicine methods can lead to the spread of infection and blood poisoning.

Everyone knows that there are lymph nodes in the structure of the human body, however, not everyone understands their importance for the body. These small oval or round structures play a vital role, serving as a filter, a kind of barrier point for infections and bacteria, preventing their spread throughout the body.

– this is a peculiar reaction of the body, its signal to a person that the coefficient of harmful components significantly exceeds the norm. Medicine tends to call inflammatory processes in the lymph nodes lymphadenitis. In this article we will tell you what kind of disease this is, consider its main types, symptoms, causes of lymphadenitis and the methodology of its treatment.

What is lymphadenitis?

To understand the meaning of the name of the disease called “lymphadenitis,” it is necessary to take a short excursion into the functioning of the body. At in good condition of a person, when his immunity and health indicators are normal, when negative components of the infectious or viral class enter the body, foreign elements first enter the lymph nodes and are destroyed there through the action of leukocytes.

The situation is aggravated when an infectious focus appears in the human body, from which foreign components that are unusual for the body are constantly released. These components also enter the lymph nodes, however, the white blood cells cannot properly cope with the problem. In the problem area, namely in the lymph node, which has been exposed to foreign agents, leukocytes are activated in order to destroy negative organisms, provoking an inflammatory process. As a result of inflammation, the lymph node increases in size and begins to signal to the person that immediate measures need to be taken to eradicate the source of infection.

- this is an ailment that, on the one hand, can be called useful for a person, since it shows that the body is actively fighting infectious agents, while simultaneously asking for help from the victim; on the other hand, the disease is classified as dangerous and carries many serious consequences if not taken effective measures to eliminate the outbreak.

Classification and stages of lymphadenitis

Modern medicine distinguishes several types, stages and forms of pathology, depending on which the methodology for treating lymphadenitis varies. Let's consider the main classifications of pathology.

According to the method of infection penetration into the lymph nodes, experts distinguish lymphadenitis into the following categories:

hematogenous – intervention of foreign bodies through the bloodstream;
contact – transportation of infectious components from organs close to the node;
mechanical - penetration of the counterparty into the lymph node through a wound on the body.

For reasons of ontogenesis, pathology is usually figuratively divided into two types:

Specific lymphadenitis is a disease that develops against the background of infection of the body by various types of fungal, infectious or bacterial microorganisms. Most often these are staphylococcal and streptococcal bacilli.
Nonspecific lymphadenitis is a type of pathology formed due to human infection with special microorganisms that develop during HIV infection, AIDS, tuberculosis and other autoimmune diseases of complex etiology. In some cases, if the pathology is of a purely tuberculous nature of a certain class, they are separated from the category non-specific type There is a separate class of diseases - tuberculous lymphadenitis.

Based on the nature of progression, the following forms of the disease are distinguished:

Acute lymphadenitis is characterized by bright and painful symptoms; it can turn into a purulent process in the absence of treatment or its incorrectness.
Chronic lymphadenitis often acts as a continuation of the acute form of pathology if the treatment was carried out improperly.
Reactive lymphadenitis is characterized by rapid enlargement of lymph nodes.

Based on the type of inflammatory process, medicine identifies the following pathology criteria:

Purulent lymphadenitis is an acute inflammatory process characterized by the presence of purulent formations inside the lymph node, followed by the spread of the abscess through adjacent tissues, without the use of conservative or surgical treatment methodologies.
The simple or catarrhal type of the disease is characterized by the destruction of capillaries of the lymphatic class with a parallel release of blood from the vascular lines.
Granulomatous lymphadenitis is characterized by the presence of granulomas or a number of histiocytes in the lymph node.
The serous type of pathology is characterized by intensive growth of one or several nodes, and they have rounded shape, remain mobile inside. There is a moderate deterioration in the patient's health indicators.
The hyperplastic type of pathology is diagnosed in the late stages of the disease with maximum leukocyte intensity indicators.
The necrotic inflammatory process is characterized by intensive progression of tissue death and has a large scale.

According to the prevalence class, the disease is divided into the following groups:

single - only one lymph node is inflamed;
regional lymphadenitis – inflammation is observed in a group of lymph nodes in a certain location;
total type of pathology - global inflammation of nodes in different regions of the body.

Based on the positioning of inflamed lesions, doctors distinguish:

: lesions are located on the lower jaw of a person, in the area of the tonsils.
Cervical lymphadenitis.
Lymphadenitis of the axillary type.
Parotid type of disease.
Mesenteric lymphadenitis is characterized by inflammation of the mesenteric lymph nodes located in the navel area. Some medical sources also call it “mesenteric lymphadenitis.”
The inguinal type of pathology is more typical for people of mature age, but is not typical for children and adolescents.

Symptoms of pathology

Lymphadenitis is characterized by symptoms that vary depending on the stage of the pathology, its type and location of the inflamed area.

At the initial stage of the disease, the symptoms are not pronounced and do not bother the patient much. Most often, a person begins to complain of minor pain when touching the inflamed lymph node. As the pathology progresses, the pain begins to intensify, and more serious symptoms are added.

The acute form of the pathology has the following symptoms:

increase in body temperature: with purulent inflammation often the temperature reaches forty degrees;
intense pain that shoots into areas of the body close to the source;
a significant increase in the volume of the inflammation focus, often with parallel swelling of nearby tissues;
redness of the inflamed area, in the later stages the lesion acquires a burgundy or bluish tint;
hardening of the skin segment and loss of mobility by the node, which indicates the beginning of necrosis of epithelial tissues inside the lesion;
deterioration of the patient's general well-being, with the appearance increased fatigue, malaise and severe headaches.

Chronic lymphadenitis most often has the following symptoms:

Lymph nodes have increased parameters even without the presence of an infectious disease. At the same time, they practically do not hurt; they cause some discomfort when palpating them.
On palpation, a slight compaction is felt inside the lesion, but the nodes have a movable structure.
In rare cases, slight swelling of the tissues adjacent to the lesion is possible, which is explained by stagnation of lymph in the node that has lost its former functionality.

Most often it develops against the background of an incorrect attitude towards one’s health and personal hygiene standards, as well as incorrect treatment of simple infectious diseases. However, the children's population may also be susceptible to pathology due to infection with infectious diseases and their inappropriate treatment. Let's consider the main reasons that most often act as the primary sources of the development of the disease.

Reasons for the development of pathology

Lymphadenitis is very rarely a disease that progresses on its own. Most often, this is a secondary reaction of the body to the main pathological process that has intensified in the human body.

Medicine considers oncological diseases to be non-infectious factors of pathology. The disease can be provoked by both oncology of the lymph node itself and cancer of another organ, affecting the node with metastases. Mechanical damage lymph node can also cause an inflammatory process in it.

Most often, diagnosing a disease called “lymphadenitis” is not difficult; it is more difficult to identify the cause of intensified inflammation, which is very important: the effectiveness of therapy is possible only after eliminating the original source of the pathology. Let's consider the main methods for determining accurate diagnosis, and which doctor to contact with the problem that has arisen.

Diagnosis of lymphadenitis

If you experience discomfort or painful sensations from the lymph nodes, it is immediately recommended to contact medical care. The first authority for diagnosing a disease is a family doctor or therapist for adults, or a pediatrician for children. Based on the patient’s complaints, the general picture of the disease, visual examination of the problem area and its palpation, the patient will be given a preliminary diagnosis of “lymphadenitis”, with specification of the location and form of the pathology.

Further diagnostic measures may vary depending on the form of the disease and the provocateur of the disease. For example, an acute respiratory infection that provoked lymphadenitis can be identified by a therapist and immediately prescribe appropriate treatment. If the primary source of the pathology is unclear, the patient will need to undergo narrow specialists in order to determine the factor that provoked the development of lymphadenopathy.

Additionally, the patient will need to have his blood tested and have an x-ray, as well as an ultrasound examination of the lymph node or their system to check for the presence of pus. If there is a purulent formation, it may be necessary to take a puncture from the lesion for analysis in order to determine the type of stick that provoked the inflammatory process. This will help you select the most effective category of drugs for their effect on the source of pathology. The need for further analyzes, as well as the criteria for their depth, depend on the individual characteristics of the course of the disease.

The above diagnostic methods will allow the doctor to confirm or refute the preliminary diagnosis. In the patient's card, according to modern medical requirements, the diagnosis will be indicated in accordance with the International Classification of Diseases, Tenth Revision. According to the official document, lymphadenitis is classified as a disease of the class “Infections of the skin and subcutaneous tissue.” Lymphadenitis has an ICD-10 code from L04.0 to L04.5, depending on the location of the inflamed focus. In addition, the diagnosis can be supplemented by a code of the pathogen from B95 to B97, which provoked the inflammation, if it could be established in the laboratory. If lymphadenitis is caused by causes of a nonspecific class, the pathology can be classified in the section “Diseases of the veins, lymph nodes and blood vessels.”

Treatment and prognosis of lymphadenitis

The methodology for treating lymphadenitis provides for an integrated therapeutic approach to the problem, the complexity of which comes from the severity and neglect of the disease. Let's consider how to treat lymphadenitis depending on the form and stage of the pathology.

At the initial stages of pathology, it is provided exclusively conservative method therapy, which includes taking medications, undergoing physiotherapeutic procedures, etc. At complex stages of pathology with the presence of purulent formation, the use of surgical intervention may be rational if other methods of therapy do not produce positive results. It is worth noting that surgery is a radical method that is used exclusively in extreme cases. The operation is a simple surgical procedure that involves opening the formation and draining the purulent fluid, followed by antibacterial and supportive therapy.

Antibiotics for lymphadenitis are an integral part therapeutic treatment for any form of disease progression. Without taking antibiotics, it is impossible to completely cure the inflammatory process in the lymph nodes. Depending on the severity of the inflammatory process, the patient may be prescribed both broad-spectrum drugs - Ceftriaxone, Amoxiclav or Biseptol - and specific antibiotics that have a targeted effect on a specific class of infectious elements.

In parallel with taking antibiotics, the use of antiallergic drugs is prescribed, which soften the aggressive effects antibacterial agents on the human body. Additionally, the patient may be prescribed drugs of the anti-inflammatory category, drugs of the analgesic class, if necessary, as well as medications whose action is aimed at eliminating the provocateur of the disease, the underlying disease.

Today, in combination with drug treatment, physiotherapeutic procedures are actively used, which contribute to a faster recovery of a person. These include laser therapy, electrophoresis and others.

No less in demand, even recognized doctors, are the following folk remedies in the fight against lymphadenitis:

Drinking tea with echinacea, rose hips, raspberries, which helps reduce inflammatory processes in the body and more effective result fight against viruses, simultaneously provoking an increase in human immunity.
Local treatment of the inflamed area with herbal infusions that have a pronounced anti-edematous and anti-inflammatory effect. These include aloe juice, dandelion roots, celandine, and plantain.

Additionally, the patient should give up bad habits that depress the immune system, rationalize their diet by enriching the diet with dishes with the maximum content of vitamins, and pay more attention to personal hygiene.

Lymphadenitis, although it is a complex disease due to all sorts of dangerous consequences and complications for humans, is not considered by doctors to be a fatal pathology if therapy is started in a timely manner. The disease, provoked by nonspecific factors, can be successfully treated and has an excellent prognosis.

In a situation with lymphadenitis of a specific nature, the patient’s life prognosis is more determined by the underlying disease, especially if the pathology is provoked by HIV, AIDS or tuberculosis. The situation is similar with lymphadenitis of non-infectious origin: in this case, only an oncologist can assess the approximate prospects for life.

Let's sum it up

Inflammation of the lymph nodes is dangerous illness requiring immediate medical attention. Timely initiation of antibacterial therapy and elimination of the source of infection will help eliminate the pathology in the optimal time frame and prevent complications. Acute, complicated purulent lymphadenitis is dangerous not only for the general health of the human body, but also for life.

Be attentive to your body, respond to any alarming signals by immediately going to the doctor and appropriately eliminating the problem - this will help you avoid such a serious illness as lymphadenitis and its consequences.

Lymph nodes are numerous organs of the lymphatic system. They act as barrier filters, as they prevent the penetration and spread of foreign agents and pathogens throughout the body.

The nodes of the lymphatic system are round formations made of connective tissue filled with lymph containing huge amount cells - lymphocytes. Their main function is to recognize viral particles, bacteria, toxic substances, malignant cells and other foreign agents. Thanks to the consistent filtration of lymph coming from different parts of the body, the spread of pathological processes throughout the body is prevented.

A massive attack by pathogenic organisms or substances can lead to the fact that the currently available lymphocytes are unable to cope with their task. In this case, immune cells begin to rapidly divide, and leukocytes from neighboring tissues actively migrate to the site of inflammation. These processes lead to a significant increase in the size of the lymph nodes.

Signs of lymphadenitis most often appear on the neck, as well as in the axillary area and groin. Enlarged lymph nodes can be isolated or observed simultaneously in different parts of the body.

REASONS

Inflammation of the tissues of the lymph nodes develops due to the influence of infectious and non-infectious factors.

The spread of infection occurs by lymphogenous and hematogenous routes. Less frequently recorded are cases of direct contact infection when infected material comes into contact with the tissue of the lymph node during injury.

Lymph from certain areas of the body is collected in adjacent lymph nodes. Inflammation in these tissues will be indicated by an increased size of regional lymph nodes.

CLASSIFICATION

Lymphadenitis is systematized according to several criteria.

According to the severity and duration of the infectious process:

Spicy. Begins suddenly after a wound becomes infected, surgery or due to the development of a highly virulent infection. Severe inflammation without necessary treatment develops quickly and can turn into a purulent form with the further development of an abscess.
Chronic. It is the result of a weakly virulent infection, protracted inflammatory diseases or the progression of cancer.
Recurrent. It is characterized by periodic exacerbations in the same or neighboring lymph nodes, which occur against the background of chronic infection.

By etiology:

Specific. They develop under the influence of a pathogen for which lymphadenitis is one of the characteristic symptoms (tuberculosis, tularemia).
Nonspecific. Caused by opportunistic bacteria and fungal microorganisms that live on the surface of the skin and mucous membranes, they respond well to therapy.

According to the nature of the inflammatory reaction:

Purulent - accompanied by pain, deterioration in general well-being and threatens the development, occurs under the influence of a chronic bacterial infection.
Serous - may precede purulent lymphadenitis, develops under the influence of viruses and cancer, symptoms may be unclear.

According to the localization of the inflammatory process:

Cervical - common among people prone to colds, is associated with pathologies of the soft tissues of the neck, head, as well as the internal organs of the neck, mouth, ear and nose.
Axillary - can be superficial or deep, it can be provoked by purulent and inflammatory diseases of the upper extremities, suppuration of skin lesions in the chest, arms, skin mycoses, inflammatory diseases of the mammary glands, infectious processes in the soft tissues of the fingers.
Inguinal - is a continuation of the primary infection, more often occurs in adults and manifests itself against the background of sexually transmitted diseases or infected wounds in the groin area, which occur with decreased immunity.
Parotid - appears as a result of inflammatory processes of the auricle or inner ear, as well as adjacent tissues.
Submandibular - develops under the influence of infection in the oral cavity and in the soft tissues of the face, and is rare.

SYMPTOMS

Lymphadenitis is varied in its manifestations; its symptoms depend on the location of the inflammatory process and the causes of the development of the disease.

General symptoms of lymphadenitis:

significant increase in body temperature;
swelling;
increase in the size of the lymph node by 1.5-2 times;
hyperemia (redness) with a local increase in temperature;
increased number of leukocytes in the blood.

The acute form of lymphadenitis manifests itself unexpectedly and clearly. It makes itself felt by sharp pain in the lymph node area, which can limit the patient’s mobility. The condition is aggravated by weakness and increased body temperature. The boundaries of the node lose their outline and merge with the surrounding tissues.

With the serous type of the disease, the patient’s well-being may not change. The pain syndrome is moderate and is noted in the regional nodes, they are enlarged and dense, there is no inflammation on the skin. Due to impaired lymph flow, swelling of the limb or tissues adjacent to the node may occur.

The development of a purulent process is indicated by a sharp, jerking pain. Lymph nodes become immobile due to their fusion with each other and with adjacent tissues. The outer integument over the node is reddened.

In the absence of proper treatment, the purulent form can develop into adenophlegmon. In this case, pronounced hyperemia is observed on the skin, the boundaries of the edema area are blurred, and there are areas of softened tissue.

DIAGNOSTICS

When making a diagnosis, the doctor pays attention to the clinical manifestations of the disease and information from the medical history. At the first stage of the examination, palpation of the inflamed nodes is carried out, then instrumental and laboratory diagnostic methods are included.

Examinations for the diagnosis of lymphadenitis:

clinical blood test;

HIV test;

allergic skin tests;

computed tomography;

X-ray examination;

node biopsy.

When examining children, it is necessary to exclude or confirm congenital tumors and cystic neoplasms in the neck area. When examining patients with inguinal lymphadenitis, it is necessary to exclude the presence of an inguinal hernia and sexually transmitted diseases.

TREATMENT

In the treatment of lymphadenitis, conservative, physiotherapeutic and surgical techniques. To eliminate inflammation, it is necessary to get rid of the primary source of infection. In addition to etiotropic therapy, symptomatic drugs (painkillers and anti-inflammatory drugs) are used to alleviate the patient’s condition.

If the cause of lymphadenitis is an infection, then antibiotics of the group to which the pathogen is sensitive are prescribed. If tuberculosis is confirmed, the patient is isolated in specialized infectious diseases departments.

Purulent lymphadenitis requires surgical intervention in order to open purulent phlegmons and abscesses, then their contents are removed and the wound is drained.

Physiotherapeutic measures (UHF, laser therapy, galvanization) are aimed at suppressing the inflammatory process and restoring damaged tissues. They are used during treatment and during the recovery period.

Treatment of lymphadenitis should be started as early as possible in order to prevent its further development on the principle of a chronic recurrent disease.

COMPLICATIONS

Despite the fact that in some cases self-healing of lymphadenitis is observed, it is necessary to consult a doctor at the first symptoms of the disease in order to avoid severe complications of the disease.

Complications of lymphadenitis:

abscess;

blood poisoning;

adenophlegmon;

development of general infection;

chronic bronchopulmonary and esophageal fistulas;

oncological diseases;

thrombophlebitis of adjacent veins;

elephantiasis of the limbs.

PREVENTION

Measures to prevent the development of inflammatory phenomena in the lymph nodes include timely treatment of primary infectious diseases and regular sanitation of the oral cavity.

Damage to the skin in the form of abrasions and cuts should be treated with antiseptics, followed by application of bandages, and splinters should be removed to prevent the development of foci of infection. Also great value has the diagnosis and treatment of specific infectious diseases such as tuberculosis, etc.

PROGNOSIS FOR RECOVERY

The acute form of nonspecific lymphadenitis, when treated in a timely manner, has a favorable prognosis and is completely curable. With the destructive course of the pathological process, the disease leads to the destruction of lymph node tissue and its further scarring. Acute forms of inflammation can provoke disturbances in lymph flow, lead to lymphostasis and increase the risk of developing elephantiasis in the future.

The prognosis of chronic lymphadenitis when its cause is identified and timely treatment is generally favorable. Negative consequences may include swelling of the tissue and scarring at the site of inflammation.

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Lymphadenitis is a pathology that is characterized by specific or nonspecific inflammation lymph nodes. As it develops, pain on palpation and general malaise are noted. The cause of inflammation is infection. The nature of the pathogen and the degree of its sensitivity to antibiotics are determined in a test taken from the affected node. Against the background of lymphadenitis, it is possible to develop purulent complications in the form of abscesses or. Such lesions are subject to mandatory opening and drainage.

Stages and classification

The purulent-inflammatory process can affect one node or a whole group of closely located lymph nodes.

The following nodes are most often affected:

parotid;
submandibular;
cervical;
axillary;

Less commonly affected are the ulnar, popliteal, deep iliac and pelvic lymph nodes.

Depending on the type of pathogen, specific and nonspecific types of lymphadenitis are distinguished.

According to the nature of the course, it is customary to distinguish between acute and chronic variants of the disease..

Forms of acute inflammation:

catarrhal (simple inflammation);
hyperplastic (with active growth of lymphoid cells);
purulent.

In the initial stages it occurs. Congestive hyperemia (blood accumulation) develops. Serous impregnation of the tissues of the node occurs. Leukocytes actively migrate to the affected area, and proliferative cell growth occurs in the lymphoid tissue. All pathological changes are localized within the capsule. With catarrhal and hyperplastic forms, chronic infectious inflammation is possible.

If the pathology progresses, the lymph node undergoes purulent melting with the formation of a purulent focus. An abscess appears (a limited abscess in the capsule). Its contents can break into the cellular space, which leads to the development (purulent, diffuse process without limitation by capsule) and spread of the inflammatory process to surrounding tissues - paralymphadenitis .

Important:The most severe form of lymphadenitis is ichorous. It is a consequence of putrefactive decay of the tissue of the node.

With rapid and extensive necrosis (death) of the lymph node, necrotic variety pathology.

Fibrinous lymphadenitis characterized by abundant exudation with parallel loss of fibrin clots.

With such dangerous infectious diseases as plague and anthrax, the lymph node becomes saturated with blood. In these cases we talk about hemorrhagic form .

Reasons

As a rule, lymphadenitis is a consequence of primary septic inflammation. Pathogenic (pyogenic) microflora - both, and the toxins they produce migrate from the lesion through the lymphogenous route, or through the bloodstream. It is also possible for infectious agents to be introduced into the lymphatic vessels through injured skin or mucous membranes (contact route).

Primary foci may be:

bone;
infected wounds;
abscesses;
inflammation of the bone and bone marrow ().

One of the common causes of lymphadenitis is dental diseases, incl. Chronic lesion infection is capable of maintaining the inflammatory process for a long time.

Important:pathology often occurs against the background.

Diseases leading to specific lymphadenitis:

venereal diseases -,;
plague;

Please note:in some cases, the primary focus cannot be found, since by the time lymphadenitis develops it can be eliminated (including spontaneously).

Inflammation of the lymph node creates a barrier that prevents further spread of bacteria.

With this pathology, the development of septic complications, which pose a serious threat to the health and life of the patient, cannot be ruled out.

Symptoms of lymphadenitis

The first manifestations of acute nonspecific lymphadenitis are local swelling and tenderness of the node. Its consistency when palpated is densely elastic. Against the background of catarrhal and hyperplastic forms, complaints indicating intoxication of the body are mild or completely absent. The pain when palpating the node is insignificant. Pathology is often accompaniedlymphangitis – inflammation of regional lymphatic vessels.

Manifestations of the purulent process:

The patient is forced to limit movements in certain parts of the body so as not to provoke increased pain.

With purulent melting, a sign such as fluctuation appears (fluid rolling when palpating the area of inflammation).

A manifestation of a breakthrough of an abscess with the formation of adenophlegmon is the definition of a diffuse dense infiltrate with individual softened fragments.

The presence of a crunching sound upon palpation (gas crepitus) indicates a putrefactive form.

With septic melting of the node, signs of general intoxication sharply increase - moderate or high fever and tachycardia.

Possible complications of the purulent process:

thrombophlebitis;
mediastinitis (inflammation of the mediastinum);
septicopyemia (blood poisoning);
formation of lymphatic fistulas (when an abscess breaks into the esophagus or bronchi).

In the chronic version of the course, the lymph nodes increase in size and gradually become denser. But at the same time, they are clearly demarcated and not fused with the surrounding tissue structures. Over time, the lymph node shrinks, its own tissue is scarred and replaced by connective tissue.

Severe chronic processes are manifested by pronounced edema, as a result of the problem of lymph circulation - stagnation. Over time, a characteristic manifestation appears - elephantiasis.

Specific lymphadenitis also has its own characteristics:

in the gonorrheal form, the inguinal nodes are excessively painful and enlarged;
the tuberculosis form gives severe weakness (due to intoxication) and a sharp increase in temperature, which can last for a long time, the surrounding tissues become inflamed;
the syphilitic nature of inflammation occurs as a one-sided process. Lymph nodes resemble a “chain”. When palpated, they are free, not welded together, and rarely contain pus.

Diagnostic criteria for lymphadenitis

It is not difficult to suspect the development of catarrhal and uncomplicated lymphadenitis. A simple examination, collecting complaints and feeling the nodes make it possible to make a preliminary diagnosis.

It is more difficult to correctly identify the disease with concomitant periadenitis, as well as the addition of adenophlegmon, especially if the inflammatory process spreads to the mediastinal tissue, to the retroperitoneal region. In these cases, the diagnostician’s task is to find the primary focus; only in this case is further and successful treatment possible.

If tuberculous lymphadenitis is suspected, tuberculin tests and analysis of puncture material should be performed. The goal is to detect specific giant cells, which are named after the names of the scientists who discovered them - Pirogov-Langhans cells. Characteristic changes are also observed in the organs of the chest cavity, including calcifications.

Syphilitic lymphadenitis requires a puncture examination for the presence of Treponema pallidum (the causative agent of this disease).

For more accurate diagnosis A collegial examination of patients is often carried out with the involvement of narrow specialists - venereologists, TB specialists and doctors of other specialties.

Acute lymphadenitis should be distinguished from osteomyelitis, phlegmonous foci, suppurative processes in the subcutaneous fat, complicated by pyogenic atheroma infection.

To clarify the diagnosis, carry out: