Lymphadenitis

Definition

Lymphadenitis is an infection of the lymph nodes (also called lymph glands). It is a common complication of certain bacterial infections.

Causes, incidence, and risk factors

The lymph system is a network of organs, lymph nodes, lymph ducts, and lymph vessels (or channels) that produce and move a fluid called lymph from tissues to the bloodstream. For more information on this part of the body, see lymph system.

The lymph glands, or nodes, are small structures that filter the lymph fluid. There are many white blood cells in the lymph nodes to help fight infection.

Lymphadenitis occurs when the glands become enlarged by inflammation, usually in response to bacteria, viruses, or fungi. The swollen glands are usually found near the site of an underlying infection, tumor, or inflammation.

Lymphadenitis may occur after skin infections or other bacterial infections, particularly those due to streptococcus or staphylococcus. Sometimes it is caused by rare infections such as tuberculosis or cat scratch disease (Bartonella).

Symptoms

• Swollen, tender, or hard lymph nodes
• Red, tender skin over lymph node

Lymph nodes may feel rubbery if an abscess has formed.

Signs and tests

The health care provider will perform a physical exam, which includes feeling your lymph nodes and looking for signs of injury or infection around any swollen lymph nodes.

A biopsy and culture of the affected area or node may reveal the cause of the inflammation. Blood cultures may reveal spread of infection to the bloodstream.

Treatment

Lymphadenitis may spread within hours. Treatment should begin promptly.

Treatment may include:

• Antibiotics to treat any underlying infection
• Analgesics (pain killers) to control pain
• Anti-inflammatory medications to reduce inflammation and swelling
• Cool compresses to reduce inflammation and pain

Surgery may be needed to drain any abscess.

Expectations (prognosis)

Prompt treatment with antibiotics usually results in complete recovery, though it may take weeks, or even months, for swelling to disappear. The amount of time until recovery occurs will vary depending on the underlying cause.

Complications

• Abscess formation
• Cellulitis (a skin infection)
• Sepsis (generalized or bloodstream infection)
• Fistulas (seen in lymphadenitis that is due to tuberculosis)

Calling your health care provider

Call your health care provider or go to the emergency room if you have symptoms of lymphadenitis.

Prevention

Good general health and hygiene are helpful in the prevention of any infection.

References

Armitage JO. Approach to the patient with lymphadenopathy and splenomegaly. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier. 2007: chap 174.