| ICD-9-CM: |
| 289.1 - | Lymphadenitis, Chronic; Adenitis Any Lymph Node, except Mesenteric, Chronic; Lymphadenitis Any Lymph Node, except Mesenteric, Chronic |
| 289.2 - | Lymphadenitis, Nonspecific Mesenteric; Mesenteric Lymphadenitis, Acute, Chronic |
| 289.3 - | Lymphadenitis, Unspecified, except Mesenteric |
| 683 - | Lymphadenitis, Acute; Abscess (Acute) Lymph Gland or Node, except mesenteric; Adenitis (Acute) Lymph Gland or Node, except mesenteric; Lymphadenitis (Acute) Lymph Gland or Node, except Mesenteric |
| 785.6 - | Enlargement of Lymph Nodes; Lymphadenopathy, "Swollen Glands" |
| A lymph node disorder is a condition in which the lymph nodes are enlarged in response to an underlying disease process. The lymph nodes (glands) in the human body are small, rounded masses of tissue that cluster in certain areas of the human body, especially in the neck (cervical), arm pits (axillary), above the groin (inguinal), and near various organs and large vessels. The lymphatic drainage system collects lymph from all parts of the body and returns it to the blood. As highly organized centers of immune cells, the lymph nodes filter lymph fluid to trap infectious agents and prevent them from entering the bloodstream. Active lymph nodes enlarge as they attempt to destroy the infective material. Lymph node enlargement may occur as an immune response to viral, bacterial, or fungal infection; as an accumulation of localized proliferation of cancer cells (lymphoma, leukemia); and as a reaction to infiltrative cancer cells in the lymphatic or blood circulation (metastatic cancer). Lymph node disorders include inflammation of the lymph nodes (lymphadenitis), abnormalities of the lymph nodes (lymphadenopathy), and cancer.
Lymphadenitis is an inflammation of the lymph nodes that usually occurs as a response to a bacterium, virus, fungi, or other organism affecting the body. Common bacterial infections that produce this response are from tonsillitis, infected cuts or wounds, and abscesses. Circulating cancer cells or other inflammatory conditions may also cause lymphadenitis. The location of the affected nodes is usually associated with the site of the underlying infection, tumor, or inflammation; when infection occurs, the lymph node(s) and the area adjacent to the infection become swollen and inflamed. The enlarged node(s) tend to be tender to the touch and mobile, meaning that each individual node moves freely when touched.
Lymphadenopathy is a related condition, referring to lymph nodes that are abnormal either in size, consistency, or number; enlargement is due to infection, inflammation or other reasons, such as cancer. The enlarged nodes tend to be firm, rubbery, and nontender to the touch.
Some of the causes of lymphadenopathy are obvious, as in the case of the individual who presents with a sore throat, tender lymph nodes in the neck area (cervical nodes), and a positive strep test. In other cases, the etiology is less clear, as in the case of the individual who only presents with symptoms of swollen lymph nodes in the groin (inguinal nodes). Such presentation often raises the specter of serious illnesses like Castleman's disease, lymphomatoid granulomatosis, cancer of the lymphatic system (lymphoma), acquired immunodeficiency syndrome (AIDS), or cancer that has spread from some other primary source (metastatic cancer). Etiology has also been associated with exposure to industrial chemicals or certain anti-seizure medications that have been associated with enlarged nodes. In addition, certain drugs, such as cephalosporins, penicillins, or sulfonamides, have been associated with enlarged lymph nodes and other symptoms, including fever and rash, that may resemble Hodgkin's disease. |
Source: Medical Disability Advisor
| History: Individuals with lymph node disorders may report lymph nodes that are tender, swollen, and hard. If an abscess in the lymph node has formed, it may feel rubbery. The individual may report fever, malaise, sore throat, or cough. There may be history of recent travel. Physical exam: On examination, affected lymph nodes and/or vessels are palpable. There may be evidence of trauma around the node. Acutely infected lymph nodes may be warm, tender, and swollen upon palpation. A single or multiple lymph nodes may be affected. Tests: As a lymph node disorder is a sign of underlying disease, the diagnosis is made by the history and physical examination to determine the source of infection and determine appropriate diagnostic testing if necessary. Lymph node aspiration, culture, or open/closed biopsy may be necessary. Blood tests (complete blood count, or CBC) and blood culture may be useful in identifying the cause of the inflammation. Rarely, chest x-ray, diagnostic ultrasound, or CT scans may be required to determine which disease is causing the lymph node disorder, such as tuberculosis, pneumonia, or malignancies. |
Source: Medical Disability Advisor
| Treatment for lymph node disorders should begin promptly. When an infection is diagnosed as the underlying cause, specific antibiotics should be administered. Anti-inflammatory medications may be used to reduce inflammation and swelling. Aspirin may be recommended as a fever-reducing (antipyretic) medication. When the cause of swollen lymph nodes is viral, treatment is usually not required. When swollen nodes cause tissue degeneration, infection, and the formation of a localized collection of pus buried within the nodes (abscess), surgical drainage of abscesses may be required. |
Source: Medical Disability Advisor
| With prompt antibiotic treatment, complete recovery may be expected. Recovery time will vary, depending on the underlying cause. It may take a period of time for swelling to completely disappear. |
Source: Medical Disability Advisor
| Complications include abscess formation, cellulitis, fistula formation, or sepsis. |
Source: Medical Disability Advisor
| Restriction of work activities (usually temporary) may be indicated depending on the degree of weakness, the general ill health experienced, and degree of recovery expected. If the individual is especially fatigued, he or she may need less strenuous or part-time work. If the individual experiences pain, he or she may benefit from avoiding aggravating movements or positions. Accommodations at work may temporarily include an allotment of time and space for quiet rest periods. |
Source: Medical Disability Advisor
| If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case. Regarding diagnosis:
- Has underlying cause of condition been identified and confirmed?
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Is condition due to infection as a result of bacteria, viruses, fungi, or other organisms?
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Are conditions present, such as the following: lymphoma, HIV infection, mononucleosis, toxoplasmosis, non-Hodgkin's lymphoma, Epstein-Barr virus, cytomegalovirus, cat-scratch disease, tuberculosis lymphadenitis, secondary syphilis, hepatitis B, lymphogranuloma venereum, chancroid, lupus erythematosus, rheumatoid arthritis, leukemia, sarcoidosis, Kawasaki disease, and pelvic and head-and-neck malignancies?
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Is it being effectively resolved or managed?
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Has individual experienced any complications such as abscesses, cellulitis, or sepsis?
Regarding treatment:
- If treatment was delayed, what was the criteria?
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Did individual undergo a period of observation if clinical signs were reassuring?
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Is a biopsy now appropriate?
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Has infection and inflammation been effectively resolved?
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Has a culture and sensitivity been done to determine the most effective antibiotic to be used?
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Was causative agent antibiotic-resistant?
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If condition has persisted past what is expected for viral resolution, does diagnosis need to be revisited?
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If infected nodes caused an abscess, was surgical drainage required?
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Was surgical drainage effective?
Regarding prognosis:
- Is delayed recovery due to complication by abscess formation, cellulitis, or sepsis?
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If treatment has not been as effective as expected, has a culture and sensitivity been done to determine the most effective antibiotic to be used?
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Have antibiotic-resistant organisms been ruled-out?
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Is the etiology of generalized lymphadenopathy a malignant or systemic disease, such as lymphoma, AIDS, or leukemia?
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What is prognosis for the underlying condition?
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Is underlying cause due to environmental substances, medications, or drugs that can be avoided?
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Can alternate medications be used instead?
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Would protective clothing or change in occupational environment be beneficial?
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Source: Medical Disability Advisor
| Levy, Daniel, ed. "Lymphadenitis and Lymphangitis." MedlinePlus. Ed. Daniel Levy. 15 Aug. 2003. National Library of Medicine. 21 May 2005 <http://www.nlm.nih.gov/medlineplus/ency/article/001301.htm#top>. |
Source: Medical Disability Advisor
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