Lymphadenitis

November 29, 2011

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Lymphadenitis   is an inflammation lymph nodes . It is a disease of the secondary type, it appears after the inflammation has arisen in a particular area of ​​the body. In rare occasions diagnosed primary purulent inflammation of lymph nodes . The agents of this disease are streptococci As well as a number of other pathogens. However, often there is a mixed flora. The disease occurs after organisms . Toxins , and decomposition products   fabrics come from lymph   lymph nodes. Infiltration may occur through the break in the skin, mucous membranes, and hematogenous route.

Lymphadenitis is usually divided into purulent . serous . Productive inflammation . If the process of inflammation spread to other tissues, the result may develop periadenit . For this state of the characteristic symptom is stiffness of nodes in which the inflammation extends, for example, if a person is diagnosed cervical lymphadenitis , Similar phenomena are observed in the neck area. Lymphadenitis may occur in acute or chronic. The course of acute lymphadenitis occurs in different ways. If suppurative focus to eliminate as soon as possible, the hyperemia   then disappear, there will be resolution exudate And after reducing nodes stop their pain.

At the beginning of suppurative lymphadenitis observed symptoms catarrhal-hyperplastic lymphadenitis Later formed purulent infiltration site and there are several foci. After their merger lymph node is melted. If purulent process involved his capsule and surrounding tissue, the result is developed phlegmonous adenitis . With the development of putrid lymphadenitis lymph nodes are affected sphacelism .

There is also a classification based on the division of the hearth of the inflammatory process ( bubonadenitis . cervical lymphadenitis ). One of the most common types of this disease is bubonadenitis.

Symptoms lymphadenitis

The patient feels lymphadenitis lymphadenitis following symptoms: severe pain, because of which he holds the limb in a forced position. Fever, swelling occurs. If lymphadenitis is superficial, it may be observed redness and increased temperature locally. At a late stage of the disease manifested fever, fluctuation . leukocytosis . Thus the primary site of infection is already irrelevant.

Lymphadenitis is like sharp And chronic , As distinguished specific   and nonspecific lymphadenitis . Nonspecific lymphadenitis usually provoke staphylococci More rarely pathogens are streptococci and other pyogenic bacteria . Foci of the disease may become purulent wound, carbuncle . boil , erysipelas, osteomyelitis . trophic ulcer   and other entities. Also, bacteria can enter the lymph node during his wounds. In such a situation is the primary disease lymphadenitis.

Inflammation in the lymph nodes is manifested and develops according to the general type. If progressing purulent lymphadenitis, inflammation can trigger destructive forms of the disease - abstsedirovanie   and necrosis And putrid infection can cause ihoroznym disintegration of the lymph nodes . Simple lymphadenitis   - This form of the disease in which inflammation, as a rule, does not come out within the lymph node. If there is a destructive form of lymphadenitis, the inflammation can spread to the tissues adjacent. Due to changes in the serosal tissue may serous inflammation or purulent inflammation with subsequent formation phlegmonous adenitis . Particularly severe symptoms lymphadenitis ihoroznym manifested in the form of the disease.

In acute non-specific form of the disease manifest the following symptoms of lymphadenitis. Swollen lymph nodes and sore appears periodically appears headache , Weakness, feeling of malaise, can increase the body temperature. Quite often in acute lymphadenitis manifested inflammation of the lymphatic vessels. Signs of acute lymphadenitis depends on the form of the disease and the nature of inflammation. Basically, the general condition of the patient at catarrhal lymphadenitis is not particularly disturbed. As symptoms can manifest pain in the area regional lymph nodes . At the same time there is an increase of lymph nodes, their pain during palpation.

If the disease process progresses and develops periadenit , The described symptoms may get worse. Soreness acquire the sharpness, the skin over the lymph nodes to become giperemirovanoy And node palpation the patient feels pain. Lymph nodes that previously it was possible to very accurately palpate now merge with each other and with the surrounding tissue, moreover, they become immobile.

Inflammatory processes   lymph nodes differ productive. In purulent form they pass on rare occasions. Among the manifestations of chronic nonspecific lymphadenitis are the following symptoms: increased and compacted lymph nodes, tenderness they felt weak, they are not soldered together. In this state, the lymph nodes stay long enough period of time later in the connective tissue grows and they decrease.

At tuberculous lymphadenitis   as a general disease manifests tuberculosis . Lymphadenitis in children may occur at a time of primary tuberculosis. Mycobacterium tuberculosis can cause tuberculosis of peripheral lymph nodes. The infection can be spread in many ways. Thus, it can penetrate through tonsils . Most often, the infection penetrates lymphohematogenous path extending from the affected lymph nodes.

If the disease begins acutely, the patient has been a sharp rise in temperature, symptoms of tuberculosis intoxication , Lymph nodes become more manifest in them inflammatory and necrotic changes . As a special feature of tuberculous lymphadenitis, which distinguishes it from other forms note the presence periadenita. Very rarely appear fistulas . The most common lesions occur on the neck, submandibular and axillary nodes. Chronic lymphadenitis in children sometimes develops in parallel with infectious diseases - sinusitis . tonsillitis . rhinitis . periodontitis . At the beginning of lymphadenitis in children manifests itself tumor   at the locations of the lymph nodes. When pressed on her child can feel pain. A few days later the inflammation goes to the next placed tissue. Lymph node becomes palpable hard, compacted tissue. In the presence of these symptoms should immediately contact the pediatrician.

Diagnosis lymphadenitis

To put appropriate diagnosis, the doctor is guided by the clinical picture, considering the medical history information. Surface lymphadenitis   ( inguinal . cervical lymphadenitis ), The doctor will determine quite easily. More difficult to diagnose lymphadenitis, which is a complication periadenit And is involved in the inflammatory process of the adipose tissue between the muscles, cellular spaces of the mediastinum and retroperitoneal space.

To install the differential diagnosis, it is important to know where the primary focus of purulent inflammation. It is important to differentiate chronic nonspecific lymphadenitis   with an increase in lymph nodes in other infectious and other diseases. In the process of recognition of the type of chronic lymphadenitis doctor evaluates a range of symptoms. If the diagnosis is difficult, it is necessary to carry out biopsy   lymph node, or remove it for subsequent histological examination. Such study material means a lot in the differential diagnosis of chronic lymphadenitis and detection metastases of malignant tumors .

Diagnosis " specific lymphadenitis "Established by the results of a comprehensive survey of the patient. This takes into account the patient's contact with patients Tuberculosis His reaction to tuberculin , Presence or absence of tuberculous lesions in the lungs and other organs.

It is also possible to establish the correct diagnosis by puncture of the affected lymph node. Using x-ray can determine the formation of the nodes calcifications Which can be seen on x-ray as a dense shadow on the soft tissues of the neck, under the jaw, in the area of ​​the armpits and groin. Important differentiation of tuberculous lymphadenitis with nonspecific purulent lymphadenitis, metastases of malignant tumors, limfagranulematozom .

If you suspect a bubonadenitis should conduct a thorough examination of the rectal area and genitals, determine which is the state of the pelvis and hips. It is important to establish the correct diagnosis, because in some cases, defined as bubonadenitis incarcerated hernia .

Treatment lymphadenitis

Treatment lymphadenitis acute nonspecific form   is assigned depending on the stage at which it starts. If the presence of only the initial form of the disease, the treatment of lymphadenitis made using conservative methods. Thus, the affected body should remain at rest, as the treatment is applied Ultrahigh frequency therapy Therapy focus of infection (that is, an autopsy abscesses Autopsy purulent streaks ), Shall also be Antibiotic .

When purulent lymphadenitis used operative method of treatment: abscesses burst, the pus is removed from them, held drainage of wounds . All subsequent activities carried out are the same as in the treatment of purulent wounds.

In the treatment of chronic nonspecific lymphadenitis form must first eliminate the underlying disease, which was the source of this form of lymphadenitis. Lymphadenitis specific treatment is carried out depending on the nature of the lymph node, and in the presence of other bodies tuberculous changes. If a process is active, use first-line drugs: tubazid . streptomycin   in conjunction with PAS or Ethionamide . pyrazinamide . protionamid . ethambutol . The treatment process lasts from 8 to 15 months.

Also in the node with the defeat introduced streptomycin , It imposed tubazidovoy bandages, ointment tibonovoy and streptomycin. If purulent process is pronounced, it is used to treat antibiotics   broad spectrum of activity.

Complications lymphadenitis

The disease can cause a number of complications. The patient may manifest thrombophlebitis , Purulent process may spread to the cellular spaces, and the patient may receive the metastatic foci of purulent infection.

Prevention lymphadenitis

To prevent lymphadenitis to avoid injuries and wounds, rationally relates to the treatment of inflammatory diseases. In patients with axillary lymphadenitis may occur sepsis . subpektoralnaya abscess .