4/17/2024 0 Comments Shotty lymph nodeThe diagnostic approach to children with cervical lymphadenitis is presented separately. The clinical manifestations of the most common infectious causes of cervical lymphadenitis in children are described below. INFECTIOUS CAUSES - Infectious causes of cervical lymphadenitis frequently are considered in four broad categories: acute bilateral, acute unilateral, subacute/chronic bilateral, and subacute/chronic unilateral ( table 2). Mycobacterial, fungal, and Bartonella henselae infections generate a more chronic granulomatous inflammatory response with typically less dramatic clinical features, although suppuration can occur. Recruitment of neutrophils to the lymph node may result in abscess formation. Involvement of pyogenic organisms, such as Staphylococcus aureus and Streptococcus pyogenes (group A Streptococcus), usually results in acute reactions within the lymph node, manifested by a sudden onset of swelling, erythema, warmth, and tenderness. If the lymph nodes filter infectious and antigenic materials from the lymphatic fluid, lymphocytes proliferate, causing subsequent nodal enlargement. Although obvious infection of the anatomically drained area may be present, the infiltration of organisms often is asymptomatic, with no clinical evidence of an inoculation site. PATHOPHYSIOLOGY - The pathophysiology of cervical lymphadenitis has not been fully elucidated, but it is suspected that infection of cervical lymph nodes results from contact with potential pathogens by airborne droplet transmission or when microorganisms penetrate the mucosa or skin of the head and neck, infiltrate the surrounding tissue, and are transported by afferent lymph vessels to lymph nodes. The jugulodigastric node, part of the superior deep cervical nodes and located below the mandible at the angle of the jaw, is commonly involved in cervical lymphadenitis. More than 80 percent of childhood cervical lymphadenitis involves the submandibular or deep cervical nodes because they filter much of the lymphatic fluid from the head and neck. Generalized lymphadenopathy – Enlargement of two or more noncontiguous lymph node regions (eg, cervical and axillary) and is the result of systemic disease (see "Peripheral lymphadenopathy in children: Etiology", section on 'Generalized lymphadenopathy')ĪNATOMY - Lymph nodes frequently associated with cervicofacial lymphadenitis of childhood and the anatomic areas they drain are listed in the table ( figure 1 and table 1).Subacute/chronic lymphadenitis – Develops over weeks to months.Acute lymphadenitis – Develops over a few days (but may persist for weeks to months).Cervical lymphadenitis – Enlarged, inflamed, and tender lymph node(s) of the neck although strictly speaking, "lymphadenitis" refers to inflamed lymph nodes, the terms "lymphadenitis" and "lymphadenopathy" often are used interchangeably.Cervical lymphadenopathy – Enlarged lymph node(s) of the neck, including preauricular, parotid, jugulodigastric, submental, submandibular, posterior cervical, superficial cervical, deep cervical, occipital, and posterior auricular (mastoid) ( figure 1) lymphadenopathy encompasses both inflamed and noninflamed lymph nodes.(See "Cervical lymphadenitis in children: Diagnostic approach and initial management" and "Peripheral lymphadenopathy in children: Etiology" and "Peripheral lymphadenopathy in children: Evaluation and diagnostic approach".) The evaluation and treatment of cervical lymphadenitis in children is discussed separately, as is peripheral lymphadenopathy. The etiology, pathophysiology, and clinical manifestations of cervical lymphadenitis in children will be reviewed here. The incidence is difficult to ascertain because it is usually caused by a viral upper respiratory infection and is self-limited. INTRODUCTION - Cervical lymphadenitis is common in childhood.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |