The active role of the lymphatic system in the development of infectious pathology in syphilis is known. The first manifest signs of its involvement in the pathological process are two of the three components that make up the clinical picture of the primary period of syphilis - regional lymphadenitis and lymphangitis of the vessels running from the chancre to the regional lymph nodes.

Clinically pronounced regional lymphadenitis (scleradenitis, accompanying bubo) occurs 5-8 days after the appearance of chancroid and, according to the definition of Ricor and Fournier, serves as its constant and obligatory companion. Regional lymph nodes gradually, often unnoticed by the patient, increase to the size of a pea, plum, walnut and more, remaining painless. Typically, several lymph nodes react with anogenital localization of the chancre on both sides, but one of them enlarges more. On palpation, the lymph nodes have a dense elastic consistency, are not fused to each other and surrounding tissues, and are mobile; the skin over them is not changed. Without treatment, regional lymphadenitis persists much longer than primary chancre and gradually undergoes reverse development in the same time frame as polyadenitis with secondary fresh syphilis. In the process of specific treatment, regional lymphadenitis also resolves much later than chancre. Regional inguinal scleradenitis occurs when chancre is localized on the genitals, in the perigenital area; when chancre is localized on the fingers, hands, palms, the ulnar and axillary nodes react, when chancre is localized on the head - submandibular, anterior, posterior cervical, occipital, preauricular.

Some changes in the clinical course of syphilis in recent years have also affected the response of the lymphatic system to the introduction of Treponema pallidum. Fournier noted the absence of scleradenitis in only 0.06% of 5000 patients; P.S. Grigoriev - only in 1% of patients with primary syphilis. According to M.A. Karagezyan et al., G.R. Karsybekova, T.V. Rychkova, R.S. Babayantsa, B.I. Zudin, inguinal lymphadenitis was absent in 5.2-8% of patients; according to our observations, it was not present in 4.4% of patients. We observed a unilateral reaction of regional inguinal lymph nodes in 26.7%, A.X. Abdullaev - 12.2%, M.A. Karagezyan et al. -in 37.5% of patients with primary syphilis. In some cases, when hard chancre is localized in the anal region, rectum, or cervix, the lack of reaction of the inguinal lymph nodes can be explained by the fact that the pelvic lymph nodes, which are inaccessible to examination (palpation), are regional in this localization of primary syphiloma.

Along with the insufficient response of the lymphatic system to the introduction of infection, a number of researchers note the possibility of a hyperergic reaction in primary syphilis with a sharp increase in lymph nodes welded into conglomerates, severe pain, with symptoms of periadenitis, inflammation of the underlying tissues and even the formation of fistulas.

In some patients, regional scleradenitis preceded chancroid or occurred simultaneously with its appearance. Typically, such facts are combined with an extension of the incubation period as a result of patients taking small doses of antibiotics, metronidazole, or intoxications.

The third component of the clinical picture of primary syphilis - specific lymphangitis - inflammation of the lymphatic vessel along the chancre to the regional lymph nodes is not constant and is currently observed rarely, in 7-8% of patients. More often, clinically pronounced lymphangitis is observed when chancre is localized in men in the area of ​​the glans penis, coronary sulcus and preputial sac. Lymphangitis is presented in the form of a palpable painless cord, sometimes clearly shaped, not fused with the surrounding tissue, on the dorsum of the penis (dorsal lymphangitis). The phenomena of lymphangitis undergo reverse development without leaving a trace.

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• Jan 14 Enlarged lymph nodes Enlarged lymph nodes with syphilis

  Enlarged lymph nodes with syphilis

  Syphilis is an infectious disease caused by Treponema pallidum. Spreads primarily through sexual contact.

  Main path of promotion the pathogen in the infected body is the lymphatic system. Spreading through the lymphatic tract in the primary period, Treponema pallidum affects them. Through the thoracic duct they penetrate the bloodstream and spread to all organs and tissues.

  Primary period of syphilis

  The primary period of syphilis begins with the formation of primary syphiloma (chancroid) at the site of introduction of pale treponema, and 5-7 days after its onset, an increase in regional lymph nodes is detected.

  Secondary period of syphilis

  The secondary period of syphilis, which develops approximately 2.5 months after infection, is characterized by the appearance of generalized rashes on the skin and mucous membranes, as well as enlarged lymph nodes. During this period, internal organs (liver, kidneys, cardiovascular and nervous systems) may be involved in the pathological process.

  Lymph nodes in syphilis

  Lymph nodes in syphilis reach sizes from the size of a cherry to a pigeon egg, have a dense elastic consistency, are not fused to each other and surrounding tissues, are mobile, and are painless on palpation. The skin over them is unchanged and of normal color.

  Regional lymphadenitis resolves very slowly even with specific treatment.

  Diagnosis of syphilis

  The presence of a saucer-shaped ulcer on the genitals and regional lymphadenitis allows one to suspect syphilis.

  To confirm the diagnosis, the presence of treponema is determined in the chancre discharge or in the punctate of regional lymph nodes, and the Wasserman, Kahn, Sachs-Vitebsky and others reactions are performed.

  To treat syphilis, consult a lymphologist or venereologist. Endolymphatic therapy provides the fastest and most effective treatment results.

  Lymph nodes are the most important component of the entire lymphatic system. The lymph node performs a protective function, creating a barrier to the penetration and spread of cancer cells and infection throughout the body.

  The lymphatic system is very complex and consists of ducts and nodules, oval or round in shape, ranging in size from 1 mm to 2 cm. They are located in the neck, armpit, knee and elbow bend, and groin. A large number of lymph nodes are also located in the chest and abdominal cavity. This human protective system, like a network, permeates all human organs and tissues, providing him with protection from the penetration of microbes, dangerous infections, toxins, etc. When the lymph nodes become inflamed, it becomes clear that a malfunction has occurred in the body that requires immediate resolution.

  It is known that Treponema pallidum penetrates and spreads throughout the body through the lymphatic system. In the primary stage and the formation of ulcers or hard chancre, after 5-7 days you can find that the nodes closest to the chancre are inflamed. Lymph nodes with syphilis, as a rule, are more often inflamed in the neck (mandibular) or in the groin, and can reach the size of a walnut.

  It should be noted that upon palpation, the inflamed vessel is painless, high density, mobile and elastic. The swollen node is also called “syphilitic bubo”, which will appear without fail following the appearance of a chancre on the skin. There is a certain pattern: a chancre formed on the lip or in the oral cavity warns of imminent inflammation of the mandibular lymph node, and a chancre on external genitalia - to an increase in the vessel in the groin. Since chancre and inflammation of the lymph nodes with syphilis do not cause any painful conditions, people sometimes do not even realize that they are infected with spirochetes. But it is precisely this consistent manifestation of the disease that suggests that this is not a sore throat or a cold infection, but syphilis in the primary stage.

  Lymphadenitis in syphilis is a characteristic sign of the primary stage of the disease. Occurring a few days after the appearance of chancre, lymphadenitis remains for quite a long time. Inflammation of the lymph nodes is clearly visible in the first and second stages, that is, during periods when there are the most spirochetes in the body, and during the tertiary period it may not appear, since the number of pale treponema in the body is insignificant.

  Lymphadenitis is an acute inflammatory disease characterized by enlargement and local tenderness of the lymph nodes, accompanied by weakness, malaise, headache, and fever.

  Quite rarely, lymphadenitis acts as a primary disease; more often it is a complication of other pathologies. Usually the submandibular and cervical lymph nodes, as well as the lymph nodes located in the armpits and groin area, become inflamed.

  Diagnosis of the disease is based on medical history, physical examination and biopsy of the inflamed lymph node.

  Treatment of lymphadenitis depends on the cause that caused it. Antibiotic and physiotherapy are most often used. If an abscess occurs or adenophlegmon develops, the lymph nodes are opened and drained.

  Causes of lymphadenitis

  Nonspecific lymphadenitis develops as a result of infection of the lymph node with pathogenic microorganisms (staphylococci, streptococci, pneumococcus, Escherichia coli and Pseudomonas aeruginosa). An accumulation of inflammatory reaction cells in the area where the microorganism is detected leads to an enlargement of the lymph node. Infectious pathogens enter the regional lymph nodes along with lymph flowing from the primary purulent focus, which can be a purulent wound localized on the skin, a boil, panaritium, carbuncles, phlegmon, trophic ulcers, caries, erysipelas, osteomyelitis, thrombophlebitis. Local inflammatory processes are often accompanied by regional lymphadenitis. In some cases, by the time lymphadenitis appears, the primary focus may have already been eliminated.

  Sometimes the cause of lymphadenitis is the direct penetration of infection through damage to the skin and mucous membranes into the lymphatic system.

  Inflammation of the lymph nodes is a specific defense mechanism, due to which the infection does not spread throughout the body.

  Quite often, the infection spreads hematogenously (that is, through the bloodstream). In this case, the source of infection may be located in the internal organs (tonsillitis, inflammatory bowel diseases, ovaries, liver).

  The causes of lymphadenitis in children, as a rule, are: inflammatory diseases of the ENT organs (otitis, influenza, tonsillitis, chronic tonsillitis), childhood infections (mumps, diphtheria, scarlet fever), dermatological diseases (infected eczema, exudative diathesis, pyoderma).

  The causes of specific lymphadenitis can be: pathogens of syphilis, tuberculosis, gonorrhea, plague, actinomycosis, tularemia, anthrax.

  Symptoms of lymphadenitis

  Depending on the nature of the course, lymphadenitis can be acute or chronic.

  Symptoms of lymphadenitis, which occurs in an acute form, manifest themselves quite clearly in the form of enlargement and increasing pain in the lymph node, which can lead to a limitation in the range of movements of the part of the body where the lymphadenitis is located. The patient experiences a constant, aching or dull headache, general weakness, malaise, and a fever may occur.

  Chronic lymphadenitis develops as a result of prolonged untreated infection. Symptoms of chronic lymphadenitis may not manifest themselves in any way. There may be a slight low-grade fever of about 37°C, to which the patient may get used and not notice it, and slight swelling in the area of ​​the affected lymph nodes.

  According to the nature of exudation, lymphadenitis can be: serous, hemorrhagic (characterized by the soaking of the lymph node with blood), fibrinous (characterized by abundant exudation with fibrin loss), purulent.

  Symptoms of serous lymphadenitis are: a violation of the general condition, dull pain in the regional lymph nodes, which can increase in volume. The lymph nodes are quite dense and slightly painful when touched.

  Purulent lymphadenitis is characterized by sharp pain, in some cases shooting in nature. The skin over the inflamed lymph node is hyperemic, the node is painful.

  In the absence of treatment for purulent lymphadenitis, adenophlegmon can develop, which looks like diffuse hyperemia of the skin with dense swelling without clear boundaries with areas of softening. This condition is also characterized by an increase in temperature to high values, the appearance of chills, rapid heartbeat, weakness, and headache.

  Lymphadenitis in children occurs with general malaise, high fever, sleep disturbances, and loss of appetite.

  Specific gonorrheal lymphadenitis is characterized by enlargement and severe pain of the lymph nodes located in the groin area. Tuberculous lymphadenitis is characterized by fever, periadenitis, severe intoxication, and necrotic changes in nodes. With syphilis, lymphadenitis is characterized by moderate unilateral enlargement of several lymph nodes. Syphilitic lymphadenitis is not characterized by the development of a purulent process in the lymph nodes.

  

  Diagnosis of lymphadenitis

  When diagnosing lymphadenitis in children and adults, the doctor first examines the lymph nodes and then decides on the need to perform instrumental and laboratory tests:

  The patient may be prescribed:

  • General blood test to determine quantitative and qualitative changes in its composition;
  • Biopsy of the node for histological examination;
  • Microscopic examination of sputum and blood;
  • Skin allergy tests;
  • Radiography;
  • Doppler ultrasound examination of lymphatic vessels;
  • Computer and magnetic resonance imaging of the affected segments;
  • Lymphoscintigraphy or radiopaque lymphography;
  • Test for HIV infection;
  • Ultrasound of peripheral lymph nodes, abdominal cavity.

  Lymphadenitis in children must be differentiated from angioedema, a tumor or a congenital cyst in the neck.

  If a patient has acutely swollen lymph nodes in the groin area, the doctor must first rule out an inguinal hernia to prevent its progression with subsequent strangulation.

  Treatment of lymphadenitis

  Treatment of lymphadenitis in the initial stages of its development comes down to creating rest for the inflamed lymph node.

  Lymphadenitis at any stage requires the use of antibiotic therapy. In this case, the group of antibacterial drugs is determined by the sensitivity of the pathogen to it. In the case of nonspecific infectious lymphadenitis, penicillins and cephalosporins are used. Physiotherapeutic treatment (ultrasound therapy, medicinal electrophoresis, galvanization), various local agents with an anti-inflammatory effect are also indicated.

  If suppuration of lymphadenitis occurs, then drainage of the suppuration cavity is performed.

  Lymphadenitis is a serious disease that can be avoided by: maintaining a high level of immunity, timely treatment of chronic infections and skin lesions.

  (l. syphilitica; synonym: syphilitic bubo, syphilitic scleradenitis) L. for syphilis, characterized by painlessness and dense elastic consistency of the affected lymph nodes.

  "syphilitic lymphadenitis" in books

  Lymphadenitis

  From the book Great Soviet Encyclopedia (LI) by the author TSB

  Acute lymphadenitis

  From the book Paramedic's Handbook author Lazareva Galina Yurievna

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  REGIONAL LYMPHADENITIS

  From the book Skin and venereal diseases author Ivanov Oleg Leonidovich

  REGIONAL LYMPHADENITIS Regional lymphadenitis (concomitant bubo, regional scleradenitis) is the second mandatory clinical symptom of primary syphilis. It is expressed in a peculiar enlargement and hardening of the lymph nodes closest to the chancre. Very

  Lymphadenitis

  From the book Green Encyclopedia of Health. The best alternative medicine recipes author Korodetsky Alexander

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  Syphilitic arthritis

  From the book Massage for Arthritis author Schumacher Olga

  Syphilitic arthritis Arthritis of the tertiary (gummy) period - acquired, congenital and late - have a similar clinical picture. Hereditary - late - syphilitic arthritis is detected between the ages of 20 and 30 years. In the gummous period, everyone can be affected

  Syphilitic arthritis

  From the book Massage for Arthritis author Schumacher Olga

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  From the book Health Pharmacy according to Bolotov author Pogozhev Gleb

  Lymphadenitis Lymphadenitis is inflammation of the lymph nodes when infectious agents are introduced into them. Lymphadenitis often occurs with a cold, and the lymph nodes in the neck under the jaws, under the armpits, and in the groin become inflamed

  Lymphadenitis

  From the book Golden Recipes for Health and Longevity author Pogozhev Gleb

  Lymphadenitis Lymphadenitis is inflammation of the lymph nodes when infectious agents are introduced into them. Lymphadenitis often occurs with a cold, and the lymph nodes in the neck under the jaws, under the armpits, in the groin area and in other places become inflamed. Recovery

  LYMPHADENITIS

  From the book “Living Water” of the body. Lymph cleansing author Bogdanova Anna Vladimirovna

  LYMPHADENITIS Lymphadenitis is inflammation of the lymph nodes, including purulent inflammation. The reason for its occurrence is inflammation in the wound, abrasion of the skin, a source of inflammation in the body (tuberculosis, abscess, phlegmon). The disease manifests itself as an increase in body temperature,

  Lymphadenitis

  From the book Healing Aloe author

  Lymphadenitis When treating and preventing lymphadenitis, it is useful to take 1 tsp. dandelion root powder mixed 1:1:1 with aloe juice and honey, washed down with a decoction of rose hips in silicon water, 3-4 times a day 30 minutes before meals. For long-term use, a mixture of powder with

  Syphilitic arthritis

  From the book Symphony for the Spine. Prevention and treatment of diseases of the spine and joints author Kotesheva Irina Anatolevna

  Syphilitic arthritis Syphilitic arthritis belongs to the group of infectious arthritis. In the primary and secondary periods of the disease, in most cases only arthralgia is observed, less often - reactive transient polyarthritis with nocturnal (in the first half of the night) pain.

  Lymphadenitis, inflammation of the lymph nodes

  From the book Healing Apple Cider Vinegar author Danikov Nikolay Illarionovich

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  From the book Ginger. A storehouse of health and longevity author Danikov Nikolay Illarionovich

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  From the book Healing activated carbon author Danikov Nikolay Illarionovich

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