Swollen lymph nodes: Causes, diagnosis, and treatment

Swollen lymph nodes usually indicate a common infection, but they can also signal a medical condition, such as an immune disorder or, rarely, a type of cancer.

Lymph nodes are small, round structures that play a vital role in the body’s immune system. Swollen lymph nodes are also known as swollen glands.

In this article, we look at the causes of swollen lymph nodes, when to see a doctor, and treatment options.

The lymph nodes collect and filter fluids, waste materials, and harmful germs. The human body has hundreds of lymph nodes. The main lymph nodes that people may see or feel are found:

• under the jaw
• on each side of the neck
• under the armpits
• on either side of the groin

Lymph fluid flows in and out of the lymph nodes throughout the body before finally making its way back to the chest. While doing so, it collects and traps harmful matter, such as bacteria, viruses, and bodily waste products. The lymph nodes filter the fluid and release it back into the bloodstream together with salts and proteins.

Lymph nodes also contain immune cells that help fight infection by attacking the germs that the body’s lymph fluid has collected.

The lymph nodes may swell when a person has a temporary infection. The swelling occurs as a result of immune cell activity in the lymph nodes.

The location of the swelling often relates to the affected area. For example, an ear infection may cause swollen lymph nodes near the ear, while someone with an upper respiratory tract infection may notice swollen lymph nodes in their neck.

People can check whether their lymph nodes are swollen by gently pressing around the area, such as the side of the neck.

Swollen lymph nodes will feel like soft, round bumps, and they may be the size of a pea or a grape. They might be tender to the touch, which indicates inflammation. In some cases, the lymph nodes will also look larger than usual.

Lymph nodes appear in parallel on both sides of the body. People can check the nodes on each side and compare them to see if one is larger than the other, which is likely to indicate swelling.

Many people with swollen glands also experience pain while making sudden or strained movements. Such movements include sharply turning the neck, bobbing the head, or eating foods that are difficult to chew.

Swollen lymph nodes often occur alongside other symptoms. These vary depending on the underlying problem but may include a sore throat, cough, or flu-like symptoms.

Many different conditions cause the lymph nodes to swell, particularly the nodes in the head and neck. These conditions include autoimmune disorders, specific types of cancer, and common infections, such as the flu. Certain medications, such as antimalarials and antiseizure drugs, can also cause swelling.

Most people have localized lymphadenopathy, in which only the lymph nodes in one particular area of the body swell up. When more than one region swells, this is called generalized lymphadenopathy, and it usually signifies a systemic, or body-wide, disease that may require medical attention.

In the following sections, we discuss the possible causes of swollen lymph nodes in more detail.

Infections

Share on PinterestColds and flu may cause swollen lymph nodes.

The infections that can cause swollen lymph nodes are mostly viral. Common infections include:

• the common cold
• the flu
• sinus infections
• mononucleosis
• tonsillitis
• tooth or gum infections
• staph infections
• strep throat
• skin infections
• fungal infections

More severe infections that can cause swelling in one or multiple lymph node areas include:

• chicken pox
• tuberculosis
• measles
• rubella
• herpes
• Lyme disease
• HIV
• toxoplasmosis

Cat scratch fever, which is also called cat scratch disease, can cause localized lymph node swelling in the area near the cat scratch.

Immune system disorders

Immune disorders that can cause swollen lymph glands include:

• systemic lupus erythematosus (lupus)
• rheumatoid arthritis
• Sjogren’s syndrome

Cancers

Much less commonly, swollen lymph nodes can also indicate a malignancy, or cancer, including:

• lymphoma
• Hodgkin disease
• leukemia
• metastases, or the spread of an existing cancer
• Kaposi sarcoma

Certain risk factors make a person more likely to have a malignant lymph problem, such as lymphoma. These include:

• being aged 40 years or older
• being male
• having white skin

People with a malignant lymph node may notice that the node feels hard or rubbery. They may also experience systemic symptoms, such as fever, night sweats, and unexplained weight loss.

Swelling in the groin lymph nodes

Sexually transmitted infections (STIs), such as syphilis and gonorrhea, can cause swollen lymph nodes, typically in the groin area. Lymph nodes in the groin are also known as inguinal lymph nodes.

Recurring infections, lower body infections, and injury to the legs can also cause swollen lymph nodes in the groin.

In many cases, swelling reduces and then disappears within 2 to 3 weeks once the body has successfully fought the infection. If the problem persists for longer than a couple of weeks, it might warrant a visit to the doctor.

Other reasons to visit the doctor include:

• a lymph node that feels hard or rubbery to the touch
• a node that does not move freely
• a node that is an inch or more in diameter
• swollen lymph nodes that accompany night sweats, abdominal pain, unexplained weight loss, or a high fever

A doctor can often diagnose the cause of swollen lymph nodes by carrying out a physical examination with a focus on the affected area and by discussing the person’s symptoms and medical history.

However, they may also order medical tests to determine the cause of the swelling. These tests may include a routine blood test to look for signs of infection.

Imaging tests can help a doctor look closely at the lymph nodes and the surrounding structures of the body. Imaging tests include:

• ultrasound
• CT scan
• MRI scan

If the swelling continues for several weeks or a person has other warning signs, a doctor may recommend a lymph node biopsy. During this procedure, the doctor will numb the area, make a small cut, and remove a section of lymph node tissue to send to a laboratory for examination under a microscope.

Alternatively, they may opt for fine needle aspiration, which involves using a needle to remove some cells from the lymph node for analysis.

Share on PinterestDrinking plenty of fluids will help reduce symptoms that an infection may cause.

Lymph node swelling will usually disappear once the infection clears. The swelling may also go away when the person takes prescribed medications, such as antibiotics or antivirals.

Doctors may prescribe anti-inflammatory medication if a person has tissue swelling.

If an underlying medical condition is responsible for the lymph nodes swelling, treating this condition should reduce the swelling.

Common home remedies to treat the symptoms of swollen lymph nodes include:

• taking over-the-counter pain medicines, such as acetaminophen or ibuprofen
• applying a warm wet compress to the affected area
• drinking plenty of fluids, such as water and fresh juices
• resting to help the body recover from the illness

Swollen lymph nodes are usually a symptom of another condition, such as an infection, and they tend to resolve on their own within several weeks.

It is best to consult a doctor if swollen lymph nodes persist for longer than 3 weeks or occur alongside other symptoms, such as high fever, abdominal pain, or night sweats. The cause of the swelling will determine the treatment.

Read the article in Spanish.

Swollen lymph nodes: Causes, diagnosis, and treatment

Swollen lymph nodes usually indicate a common infection, but they can also signal a medical condition, such as an immune disorder or, rarely, a type of cancer.

Lymph nodes are small, round structures that play a vital role in the body’s immune system. Swollen lymph nodes are also known as swollen glands.

In this article, we look at the causes of swollen lymph nodes, when to see a doctor, and treatment options.

The lymph nodes collect and filter fluids, waste materials, and harmful germs. The human body has hundreds of lymph nodes. The main lymph nodes that people may see or feel are found:

• under the jaw
• on each side of the neck
• under the armpits
• on either side of the groin

Lymph fluid flows in and out of the lymph nodes throughout the body before finally making its way back to the chest. While doing so, it collects and traps harmful matter, such as bacteria, viruses, and bodily waste products. The lymph nodes filter the fluid and release it back into the bloodstream together with salts and proteins.

Lymph nodes also contain immune cells that help fight infection by attacking the germs that the body’s lymph fluid has collected.

The lymph nodes may swell when a person has a temporary infection. The swelling occurs as a result of immune cell activity in the lymph nodes.

The location of the swelling often relates to the affected area. For example, an ear infection may cause swollen lymph nodes near the ear, while someone with an upper respiratory tract infection may notice swollen lymph nodes in their neck.

People can check whether their lymph nodes are swollen by gently pressing around the area, such as the side of the neck.

Swollen lymph nodes will feel like soft, round bumps, and they may be the size of a pea or a grape. They might be tender to the touch, which indicates inflammation. In some cases, the lymph nodes will also look larger than usual.

Lymph nodes appear in parallel on both sides of the body. People can check the nodes on each side and compare them to see if one is larger than the other, which is likely to indicate swelling.

Many people with swollen glands also experience pain while making sudden or strained movements. Such movements include sharply turning the neck, bobbing the head, or eating foods that are difficult to chew.

Swollen lymph nodes often occur alongside other symptoms. These vary depending on the underlying problem but may include a sore throat, cough, or flu-like symptoms.

Many different conditions cause the lymph nodes to swell, particularly the nodes in the head and neck. These conditions include autoimmune disorders, specific types of cancer, and common infections, such as the flu. Certain medications, such as antimalarials and antiseizure drugs, can also cause swelling.

Most people have localized lymphadenopathy, in which only the lymph nodes in one particular area of the body swell up. When more than one region swells, this is called generalized lymphadenopathy, and it usually signifies a systemic, or body-wide, disease that may require medical attention.

In the following sections, we discuss the possible causes of swollen lymph nodes in more detail.

Infections

Share on PinterestColds and flu may cause swollen lymph nodes.

The infections that can cause swollen lymph nodes are mostly viral. Common infections include:

• the common cold
• the flu
• sinus infections
• mononucleosis
• tonsillitis
• tooth or gum infections
• staph infections
• strep throat
• skin infections
• fungal infections

More severe infections that can cause swelling in one or multiple lymph node areas include:

• chicken pox
• tuberculosis
• measles
• rubella
• herpes
• Lyme disease
• HIV
• toxoplasmosis

Cat scratch fever, which is also called cat scratch disease, can cause localized lymph node swelling in the area near the cat scratch.

Immune system disorders

Immune disorders that can cause swollen lymph glands include:

• systemic lupus erythematosus (lupus)
• rheumatoid arthritis
• Sjogren’s syndrome

Cancers

Much less commonly, swollen lymph nodes can also indicate a malignancy, or cancer, including:

• lymphoma
• Hodgkin disease
• leukemia
• metastases, or the spread of an existing cancer
• Kaposi sarcoma

Certain risk factors make a person more likely to have a malignant lymph problem, such as lymphoma. These include:

• being aged 40 years or older
• being male
• having white skin

People with a malignant lymph node may notice that the node feels hard or rubbery. They may also experience systemic symptoms, such as fever, night sweats, and unexplained weight loss.

Swelling in the groin lymph nodes

Sexually transmitted infections (STIs), such as syphilis and gonorrhea, can cause swollen lymph nodes, typically in the groin area. Lymph nodes in the groin are also known as inguinal lymph nodes.

Recurring infections, lower body infections, and injury to the legs can also cause swollen lymph nodes in the groin.

In many cases, swelling reduces and then disappears within 2 to 3 weeks once the body has successfully fought the infection. If the problem persists for longer than a couple of weeks, it might warrant a visit to the doctor.

Other reasons to visit the doctor include:

• a lymph node that feels hard or rubbery to the touch
• a node that does not move freely
• a node that is an inch or more in diameter
• swollen lymph nodes that accompany night sweats, abdominal pain, unexplained weight loss, or a high fever

A doctor can often diagnose the cause of swollen lymph nodes by carrying out a physical examination with a focus on the affected area and by discussing the person’s symptoms and medical history.

However, they may also order medical tests to determine the cause of the swelling. These tests may include a routine blood test to look for signs of infection.

Imaging tests can help a doctor look closely at the lymph nodes and the surrounding structures of the body. Imaging tests include:

• ultrasound
• CT scan
• MRI scan

If the swelling continues for several weeks or a person has other warning signs, a doctor may recommend a lymph node biopsy. During this procedure, the doctor will numb the area, make a small cut, and remove a section of lymph node tissue to send to a laboratory for examination under a microscope.

Alternatively, they may opt for fine needle aspiration, which involves using a needle to remove some cells from the lymph node for analysis.

Share on PinterestDrinking plenty of fluids will help reduce symptoms that an infection may cause.

Lymph node swelling will usually disappear once the infection clears. The swelling may also go away when the person takes prescribed medications, such as antibiotics or antivirals.

Doctors may prescribe anti-inflammatory medication if a person has tissue swelling.

If an underlying medical condition is responsible for the lymph nodes swelling, treating this condition should reduce the swelling.

Common home remedies to treat the symptoms of swollen lymph nodes include:

• taking over-the-counter pain medicines, such as acetaminophen or ibuprofen
• applying a warm wet compress to the affected area
• drinking plenty of fluids, such as water and fresh juices
• resting to help the body recover from the illness

Swollen lymph nodes are usually a symptom of another condition, such as an infection, and they tend to resolve on their own within several weeks.

It is best to consult a doctor if swollen lymph nodes persist for longer than 3 weeks or occur alongside other symptoms, such as high fever, abdominal pain, or night sweats. The cause of the swelling will determine the treatment.

Read the article in Spanish.

symptoms, causes, classification, what to do with inflammation of the lymph nodes

Therapist deals with the treatment of this disease

The information provided on this page should not be used for self-treatment or self-diagnosis. If you suspect a disease, you should seek help from a qualified specialist. Only your doctor can diagnose and prescribe treatment.

Article content:

• What is the lymphatic system
• Functions of the lymph nodes
• What is lymphadenitis
• Causes
• Disease classification
• Symptoms
• Routes of infection
• Possible complications
• When to see a doctor
• Diagnostics
• Methods of treatment
• Disease prognosis and prevention

What is inflammation of the lymph nodes?

The lymphatic system ensures the normal functioning of the immune system, internal organs and tissues. One of the most common diseases of the lymphatic system is lymphadenitis of the lymph nodes. The disease has a different etiology, symptoms and degree of danger to health. In the article we will talk about how to recognize pathology and what methods of treatment exist.

What is the lymphatic system

The lymphatic system is a network of lymph vessels and nodes. These vessels transport a special liquid – lymph. It is responsible for the transport of proteins, salts and metabolites into the blood.

Lymph nodes act as a filter. They purify the lymph from pathogenic microorganisms and foreign substances, due to which purified and safe lymphatic fluid enters the bloodstream. Source:
The role of lymph nodes in human life. Okunyaka O.M., Tumasyan T.I. Bulletin of science. 2019. №3. pp.60-62.

The lymphatic system performs three main functions:

1. Participates in immune defense. Together with the flow of lymph, pathogenic microorganisms enter the lymph nodes, where they are recognized and destroyed.
2. Maintains proper fluid levels in tissues. With an excessive amount of fluid, the lymphatic vessels “drain” organs and tissues.
3. Produces fat metabolism. Lymphatic vessels transport lipids, which are involved in almost all metabolic processes.

Functions of the lymph nodes

There are about 500 lymph nodes in the human body. They play the role of a barrier and a pump and perform several important functions:

• Hematopoietic. Lymph nodes are involved in the development of white blood cells – lymphocytes. Lymphocytes are cells of the immune system responsible for fighting various infections and diseases.
• Drainage, or transport. Lymph nodes play an important role in the transport of lymph, which enters the lymphatic vessels from the intercellular spaces of tissues. Due to this, exudate and metabolic products are utilized from the tissues.
• Barrier. Lymph nodes serve as a barrier to infected cells and microorganisms, preventing them from spreading throughout the body. They can also form antibodies that help neutralize and destroy infectious agents.

What is lymphadenitis

Lymphadenitis is an inflammation of the lymph nodes. In most cases, this is not an independent disease, but a complication of the primary pathology. It is most often a sign of a bacterial, viral, fungal, or protozoal infection. Source:
Lymphadenopathy. Melikyan A.L., Egorova E.K., Kovrigina A.M. Clinical guidelines. 2018. p.5-30. Therefore, to find the cause of the inflammatory process, complex diagnostics are needed.

Depending on the etiology, one or more lymph nodes may become inflamed. With lymphadenitis, the following types of lymph nodes are usually affected:

• cervical;
• elbow;
• submandibular;
• popliteal;
• inguinal;
• axillary.

In lymphadenitis, the lymph node becomes enlarged and painful. This is due to an increase in the number of lymphocytes and other cells of the immune system that collect inside it. If an infectious agent has entered the lymph node and caused the formation of an abscess or abscess, purulent inflammation may develop.

In the absence of timely treatment, lymphadenitis provokes the development of dangerous complications: the spread of infection to other tissues and organs, the formation of fistulas, sepsis. Therefore, it is important to consult a doctor at the first sign of illness.

Causes

Most common causes:

• Infections. In most cases, inflammation in the area of ​​the lymph node occurs precisely against the background of infection: tonsillitis, scarlet fever, stomatitis, SARS, influenza, tuberculosis, brucellosis, chicken pox, etc.
• Injuries and operations. Any injury, surgery and other damage to the lymph node can cause inflammation.
• Allergic reactions. Some allergens activate a cascade of inflammatory responses.
• Oncological diseases. Lymphadenitis sometimes becomes one of the signs of malignant tumors of the lymphatic system, especially lymphoma.
• Autoimmune diseases. Lymph node inflammation can accompany systemic lupus erythematosus and rheumatoid arthritis.

In some cases, it is not possible to determine the etiology of inflammation of the lymph node. Then a diagnosis of “lymphadenitis, unspecified” is established.

Clinical recommendations of the Ministry of Health of the Russian Federation offer several classifications of lymphadenitis.

Origin:

• Primary. Occurs when an infection or other cause of inflammation occurs directly in the lymph node. This most commonly occurs when bacteria or other pathogens enter the body through a skin wound, or when certain viruses, such as the Epstein-Barr virus, infect the lymphatic system.
• Secondary. Occurs when an infection or other cause of inflammation is localized not in the lymph node itself, but elsewhere in the body. In this case, the inflammatory process spreads from the primary focus to the lymph nodes through the lymphatic vessels. For example, secondary lymphadenitis can occur with an infection of the pharynx or teeth, as well as in the presence of cancer or blood diseases.

Intensity and duration of inflammation:

• Acute. It is characterized by an abrupt onset, rapid progression, and an acute inflammatory response. Usually acute lymphadenitis is accompanied by pain, swelling, redness of the skin, fever and other signs of inflammation. Source:
  Treatment of chronic tonsillitis and acute lymphadenitis. Pavlova K.V. Medicines and rational pharmacotherapy. 2022. No. 5-2. pp. 90-91.
• Chronic. It is characterized by a sluggish long course and a low intensity of the inflammatory process. Most often it develops against the background of untreated acute lymphadenitis. The chronic form is characterized by two periods: exacerbation and remission. In the first case, clinical manifestations are pronounced, in the second – weakly or completely absent, an imaginary recovery occurs.
• Recurrent. It is characterized by periodic exacerbations of inflammation after a temporary improvement. Usually, relapses occur in the presence of a chronic infectious or inflammatory process in the body.

By the nature of inflammation:

• Purulent. It is characterized by the formation of pus inside the lymph node. It occurs as a result of an infection caused by bacteria, fungi, or other microorganisms. As a rule, purulent lymphadenitis is accompanied by severe pain, swelling, redness of the skin and fever.
• Serous. It differs in the formation of serous fluid inside the affected lymph node, and the inflammatory process does not go beyond its capsule. Often found in children.

Localization:

• submandibular – usually occurs against the background of diseases of the oral cavity, teeth or pharynx;
• axillary – associated with infectious or oncological diseases of the breast;
• inguinal – occurs against the background of skin infections and skin lesions;
• cervical – develops when the pharynx, mouth, nose or ears are affected. Source:
  Diagnosis and management of cervical lymphadenitis. Skorlyakov V.V., Babiev V.F., Keshchyan S.S., Stagnieva I.V., Boyko N.V. Young scientist. 2017. No. 16. pp. 75-78;
• parotid – caused by infectious diseases of the ear or mouth;
• occipital – occurs against the background of pathologies of the skin or upper respiratory tract.

Symptoms

Symptoms of lymphadenitis depend on its type, location and cause. The most common signs of inflammation of the lymph node:

• swelling and soreness of the affected lymph node;
• redness of the skin in the affected area;
• general weakness, fatigue and fever;
• pain and discomfort when touching an affected lymph node;
• headache;
• sometimes – nausea, vomiting and loss of appetite;
• excessive sweating, especially at night;
• change in color and texture of the skin in the area of ​​an inflamed lymph node;
• appearance of spots on the skin or other rashes.

Ways of infection

The primary cause of secondary lymphadenitis can be:

• trophic ulcer;
• caries;
• otitis;
• influenza;
• tonsillitis;
• angina;
• herpes;
• tumor;
• tuberculosis and more.

Lymphadenitis sometimes develops due to skin lesions such as scratches, wounds, or insect bites, which can become entry gates for bacteria.

Possible complications

Many people don’t even realize the danger of lymphadenitis. Without timely treatment, the disease leads to various, including dangerous consequences. Most often, the following complications develop:

• abscess – a limited accumulation of pus in the tissues, surrounded by a membrane;
• sepsis is a severe infectious disease in which the infection spreads throughout the body through the bloodstream;
• compression of surrounding tissues – enlarged lymph nodes cause discomfort and put pressure on neighboring tissues;
• thrombophlebitis – inflammation of the venous wall with the formation of blood clots that can clog the lumen of the vein;
• fistula – the formation of a pathological channel as a result of the accumulation of purulent fluid.

When to see a doctor

Lymphadenitis is diagnosed and treated by a vascular surgeon. It is necessary to consult a doctor at the first signs of the disease. The specialist will prescribe a diagnosis to identify the cause of inflammation and tell the patient what to do. Timely access to a doctor prevents the development of dangerous complications.

Diagnosis

Diagnosis of lymphadenitis is aimed at finding the cause of the inflammatory process, assessing the current state of the lymph node and the body as a whole. For this, a comprehensive examination is used:

• Inspection. The doctor examines the skin at the site of the affected lymph node, evaluates its size, shape, texture, temperature and sensitivity of the skin.
• General and biochemical blood test. Analyzes confirm the inflammatory and infectious process.
• Biopsy. Taking a sample of a lymph node for histological examination allows you to determine the cellular composition of the tissue and differentiate the tumor. Source:
  Differential diagnosis of bacterial and viral lymphadenitis in children. Antonova S.S., Botvin’eva V.V., Sitnikov I.G. VSP. 2008. No. 3. pp.76-78.
• ultrasound. Ultrasound examination helps to determine the size and structure of the lymph node, as well as to identify the neoplasm.
• CT and MRI. The procedures are used for layer-by-layer study of the lymph node and surrounding soft tissues.
• Culture study. If lymphadenitis is caused by a bacterial infection, a bacterial culture is performed to determine the type of bacteria and select the most effective antibiotic.

Methods of treatment

The doctor chooses the method of treatment individually for each clinical case. It depends on the etiology of inflammation, the current state of the patient and associated complications. In most cases, conservative therapy is used, including medication, including:

• antibiotics if there is a bacterial infection;
• antiviral drugs – in the presence of a viral infection;
• antifungals – in the presence of a fungal infection;
• non-steroidal anti-inflammatory drugs – for the relief of inflammation and pain.

In addition, physiotherapy, compresses and massage are used. In the presence of abscesses, surgical intervention is indicated – removal of purulent contents and sanitation of the affected tissues.

Forecast and prevention of the disease

With timely visit to the doctor, lymphadenitis of the lymph node has a favorable prognosis. Early initiation of treatment allows you to achieve complete recovery, prevent the development of complications and the transition of the disease to a chronic form.

Due to the lack of a single etiology, there is no specific prevention of lymphadenitis. The following recommendations will help prevent infection:

• Maintain good personal hygiene. Wash your hands regularly with soap and water, especially after handling animals and visiting public places.
• Minimize contact with infected patients and visits to crowded places. If there is a sick person in the family, it is necessary to limit contact with him.
• Using only your own hygiene items. Do not use other people’s towels, razors, toothbrushes, etc.
• Strengthening immunity: giving up bad habits, maintaining physical activity, proper nutrition and regular walks in the fresh air.
• Timely treatment of diseases. When the first symptoms appear, you should immediately consult a doctor and do not self-medicate.
• Vaccination. Timely vaccination helps prevent infections that can cause lymphadenitis. You need to be vaccinated both in childhood and in adulthood.

• Differential diagnosis of bacterial and viral lymphadenitis in children. Antonova S.S., Botvin’eva V.V., Sitnikov I.G. VSP. 2008. No. 3. pp.76-78
• The role of lymph nodes in human life. Okunyaka O.M., Tumasyan T.I. Bulletin of science. 2019. №3. p.60-62
• Diagnosis and treatment of cervical lymphadenitis. Skorlyakov V.V., Babiev V.F., Keshchyan S.S., Stagnieva I.V., Boyko N.V. Young scientist. 2017. No. 16. pp.75-78
• Treatment of chronic tonsillitis and acute lymphadenitis. Pavlova K.V. Medicines and rational pharmacotherapy. 2022. No. 5-2. p.90-91
• Lymphadenopathy. Melikyan A.L., Egorova E.K., Kovrigina A.M. Clinical guidelines. 2018. p.5-30

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Article published : 15/02/2018
Last updated : 15/06/2023

See also

Chickenpox (chickenpox)

Scarlet fever in adults

Acute bronchitis

symptoms, causes, classification, what to do with inflammation of the lymph nodes

Therapist deals with the treatment of this disease

The information provided on this page should not be used for self-treatment or self-diagnosis. If you suspect a disease, you should seek help from a qualified specialist. Only your doctor can diagnose and prescribe treatment.

Article content:

• What is the lymphatic system
• Functions of the lymph nodes
• What is lymphadenitis
• Causes
• Disease classification
• Symptoms
• Routes of infection
• Possible complications
• When to see a doctor
• Diagnostics
• Methods of treatment
• Prognosis and prevention of disease

What is inflammation of the lymph nodes?

The lymphatic system ensures the normal functioning of the immune system, internal organs and tissues. One of the most common diseases of the lymphatic system is lymphadenitis of the lymph nodes. The disease has a different etiology, symptoms and degree of danger to health. In the article we will talk about how to recognize pathology and what methods of treatment exist.

What is the lymphatic system

The lymphatic system is a network of lymphatic vessels and nodes. These vessels transport a special liquid – lymph. It is responsible for the transport of proteins, salts and metabolites into the blood.

Lymph nodes act as a filter. They purify the lymph from pathogenic microorganisms and foreign substances, due to which purified and safe lymphatic fluid enters the bloodstream. Source:
The role of lymph nodes in human life. Okunyaka O.M., Tumasyan T.I. Bulletin of science. 2019. No. 3. pp.60-62.

The lymphatic system performs three main functions:

1. Participates in immune defense. Together with the flow of lymph, pathogenic microorganisms enter the lymph nodes, where they are recognized and destroyed.
2. Maintains proper fluid levels in tissues. With an excessive amount of fluid, the lymphatic vessels “drain” organs and tissues.
3. Produces fat metabolism. Lymphatic vessels transport lipids, which are involved in almost all metabolic processes.

Functions of the lymph nodes

There are about 500 lymph nodes in the human body. They play the role of a barrier and a pump, perform several important functions:

• Hematopoietic. Lymph nodes are involved in the development of white blood cells – lymphocytes. Lymphocytes are cells of the immune system responsible for fighting various infections and diseases.
• Drainage, or transport. Lymph nodes play an important role in the transport of lymph, which enters the lymphatic vessels from the intercellular spaces of tissues. Due to this, exudate and metabolic products are utilized from the tissues.
• Barrier. Lymph nodes serve as a barrier to infected cells and microorganisms, preventing them from spreading throughout the body. They can also form antibodies that help neutralize and destroy infectious agents.

What is lymphadenitis

Lymphadenitis is an inflammation of the lymph nodes. In most cases, this is not an independent disease, but a complication of the primary pathology. It is most often a sign of a bacterial, viral, fungal, or protozoal infection. Source:
Lymphadenopathy. Melikyan A.L., Egorova E.K., Kovrigina A.M. Clinical guidelines. 2018. p.5-30. Therefore, to find the cause of the inflammatory process, complex diagnostics are needed.

Depending on the etiology, one or more lymph nodes may become inflamed. With lymphadenitis, the following types of lymph nodes are usually affected:

• cervical;
• elbow;
• submandibular;
• popliteal;
• inguinal;
• axillary.

In lymphadenitis, the lymph node becomes enlarged and painful. This is due to an increase in the number of lymphocytes and other cells of the immune system that collect inside it. If an infectious agent has entered the lymph node and caused the formation of an abscess or abscess, purulent inflammation may develop.

In the absence of timely treatment, lymphadenitis provokes the development of dangerous complications: the spread of infection to other tissues and organs, the formation of fistulas, sepsis. Therefore, it is important to consult a doctor at the first sign of illness.

Causes

Most common causes:

• Infections. In most cases, inflammation in the area of ​​the lymph node occurs precisely against the background of infection: tonsillitis, scarlet fever, stomatitis, SARS, influenza, tuberculosis, brucellosis, chicken pox, etc.
• Injuries and operations. Any injury, surgery and other damage to the lymph node can cause inflammation.
• Allergic reactions. Some allergens activate a cascade of inflammatory responses.
• Oncological diseases. Lymphadenitis sometimes becomes one of the signs of malignant tumors of the lymphatic system, especially lymphoma.
• Autoimmune diseases. Lymph node inflammation can accompany systemic lupus erythematosus and rheumatoid arthritis.

In some cases, it is not possible to determine the etiology of inflammation of the lymph node. Then a diagnosis of “lymphadenitis, unspecified” is established.

Clinical recommendations of the Ministry of Health of the Russian Federation offer several classifications of lymphadenitis.

Origin:

• Primary. Occurs when an infection or other cause of inflammation occurs directly in the lymph node. This most commonly occurs when bacteria or other pathogens enter the body through a skin wound, or when certain viruses, such as the Epstein-Barr virus, infect the lymphatic system.
• Secondary. Occurs when an infection or other cause of inflammation is localized not in the lymph node itself, but elsewhere in the body. In this case, the inflammatory process spreads from the primary focus to the lymph nodes through the lymphatic vessels. For example, secondary lymphadenitis can occur with an infection of the pharynx or teeth, as well as in the presence of cancer or blood diseases.

Intensity and duration of inflammation:

• Acute. It is characterized by an abrupt onset, rapid progression, and an acute inflammatory response. Usually acute lymphadenitis is accompanied by pain, swelling, redness of the skin, fever and other signs of inflammation Source:
  Treatment of chronic tonsillitis and acute lymphadenitis. Pavlova K.V. Medicines and rational pharmacotherapy. 2022. No. 5-2. pp. 90-91.
• Chronic. It is characterized by a sluggish long course and a low intensity of the inflammatory process. Most often it develops against the background of untreated acute lymphadenitis. The chronic form is characterized by two periods: exacerbation and remission. In the first case, clinical manifestations are pronounced, in the second – weakly or completely absent, an imaginary recovery occurs.
• Recurrent. It is characterized by periodic exacerbations of inflammation after a temporary improvement. Usually, relapses occur in the presence of a chronic infectious or inflammatory process in the body.

By the nature of inflammation:

• Purulent. It is characterized by the formation of pus inside the lymph node. It occurs as a result of an infection caused by bacteria, fungi, or other microorganisms. As a rule, purulent lymphadenitis is accompanied by severe pain, swelling, redness of the skin and fever.
• Serous. It differs in the formation of serous fluid inside the affected lymph node, and the inflammatory process does not go beyond its capsule. Often found in children.

Localization:

• submandibular – usually occurs against the background of diseases of the oral cavity, teeth or pharynx;
• axillary – associated with infectious or oncological diseases of the breast;
• inguinal – occurs against the background of skin infections and skin lesions;
• cervical – develops when the pharynx, mouth, nose or ears are affected. Source:
  Diagnosis and management of cervical lymphadenitis. Skorlyakov V.V., Babiev V.F., Keshchyan S.S., Stagnieva I.V., Boyko N.V. Young scientist. 2017. No. 16. pp. 75-78;
• parotid – caused by infectious diseases of the ear or mouth;
• occipital – occurs against the background of pathologies of the skin or upper respiratory tract.

Symptoms

Symptoms of lymphadenitis depend on its type, location and cause. The most common signs of inflammation of the lymph node:

• swelling and soreness of the affected lymph node;
• redness of the skin in the affected area;
• general weakness, fatigue and fever;
• pain and discomfort when touching an affected lymph node;
• headache;
• sometimes – nausea, vomiting and loss of appetite;
• excessive sweating, especially at night;
• change in color and texture of the skin in the area of ​​an inflamed lymph node;
• appearance of spots on the skin or other rashes.

Routes of infection

The primary cause of secondary lymphadenitis may be:

• trophic ulcer;
• caries;
• otitis;
• influenza;
• tonsillitis;
• angina;
• herpes;
• tumor;
• tuberculosis and more.

Lymphadenitis sometimes develops due to skin lesions such as scratches, wounds, or insect bites, which can become entry gates for bacteria.

Possible complications

Many people don’t even realize the danger of lymphadenitis. Without timely treatment, the disease leads to various, including dangerous consequences. Most often, the following complications develop:

• abscess – a limited accumulation of pus in the tissues, surrounded by a membrane;
• sepsis is a severe infectious disease in which the infection spreads throughout the body through the bloodstream;
• compression of surrounding tissues – enlarged lymph nodes cause discomfort and put pressure on neighboring tissues;
• thrombophlebitis – inflammation of the venous wall with the formation of blood clots that can clog the lumen of the vein;
• fistula – the formation of a pathological channel as a result of the accumulation of purulent fluid.

When to see a doctor

Lymphadenitis is diagnosed and treated by a vascular surgeon. It is necessary to consult a doctor at the first signs of the disease. The specialist will prescribe a diagnosis to identify the cause of inflammation and tell the patient what to do. Timely access to a doctor prevents the development of dangerous complications.

Diagnosis

Diagnosis of lymphadenitis is aimed at finding the cause of the inflammatory process, assessing the current state of the lymph node and the body as a whole. For this, a comprehensive examination is used:

• Inspection. The doctor examines the skin at the site of the affected lymph node, evaluates its size, shape, texture, temperature and sensitivity of the skin.
• General and biochemical blood test. Analyzes confirm the inflammatory and infectious process.
• Biopsy. Taking a sample of a lymph node for histological examination allows you to determine the cellular composition of the tissue and differentiate the tumor. Source:
  Differential diagnosis of bacterial and viral lymphadenitis in children. Antonova S.S., Botvin’eva V.V., Sitnikov I.G. VSP. 2008. No. 3. pp.76-78.
• ultrasound. Ultrasound examination helps to determine the size and structure of the lymph node, as well as to identify the neoplasm.
• CT and MRI. The procedures are used for layer-by-layer study of the lymph node and surrounding soft tissues.
• Culture study. If lymphadenitis is caused by a bacterial infection, a bacterial culture is performed to determine the type of bacteria and select the most effective antibiotic.

Methods of treatment

The doctor chooses the method of treatment individually for each clinical case. It depends on the etiology of inflammation, the current state of the patient and associated complications. In most cases, conservative therapy is used, including medication, including:

• antibiotics if there is a bacterial infection;
• antiviral drugs – in the presence of a viral infection;
• antifungals – in the presence of a fungal infection;
• non-steroidal anti-inflammatory drugs – for the relief of inflammation and pain.

In addition, physiotherapy, compresses and massage are used. In the presence of abscesses, surgical intervention is indicated – removal of purulent contents and sanitation of the affected tissues.

Forecast and prevention of the disease

With timely visit to the doctor, lymphadenitis of the lymph node has a favorable prognosis. Early initiation of treatment allows you to achieve complete recovery, prevent the development of complications and the transition of the disease to a chronic form.

Due to the lack of a single etiology, there is no specific prevention of lymphadenitis. The following recommendations will help prevent infection:

• Maintain good personal hygiene. Wash your hands regularly with soap and water, especially after handling animals and visiting public places.
• Minimize contact with infected patients and visits to crowded places. If there is a sick person in the family, it is necessary to limit contact with him.
• Using only your own hygiene items. Do not use other people’s towels, razors, toothbrushes, etc.
• Strengthening immunity: giving up bad habits, maintaining physical activity, proper nutrition and regular walks in the fresh air.
• Timely treatment of diseases. When the first symptoms appear, you should immediately consult a doctor and do not self-medicate.
• Vaccination. Timely vaccination helps prevent infections that can cause lymphadenitis. You need to be vaccinated both in childhood and in adulthood.

• Differential diagnosis of bacterial and viral lymphadenitis in children. Antonova S.S., Botvin’eva V.V., Sitnikov I.G. VSP. 2008. No. 3. pp.76-78
• The role of lymph nodes in human life. Okunyaka O.M., Tumasyan T.I. Bulletin of science. 2019. №3. p.60-62
• Diagnosis and treatment of cervical lymphadenitis. Skorlyakov V.V., Babiev V.F., Keshchyan S.S., Stagnieva I.V., Boyko N.V. Young scientist. 2017. No. 16. pp.75-78
• Treatment of chronic tonsillitis and acute lymphadenitis. Pavlova K.V. Medicines and rational pharmacotherapy. 2022. No. 5-2. p.90-91
• Lymphadenopathy. Melikyan A.L., Egorova E.K., Kovrigina A.M. Clinical guidelines. 2018. p.5-30

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