Cervical lymphadenitis: Etiology, diagnosis, and management

Abstract

Cervical lymphadenopathy is a common problem in children. The condition most commonly represents a transient response to a benign local or generalized infection. Acute bilateral cervical lymphadenitis is usually caused by a viral upper respiratory tract infection or streptococcal pharyngitis. Acute unilateral cervical lymphadenitis is caused by streptococcal or staphylococcal infection in 40% to 80% of cases. Common causes of subacute or chronic lymphadenitis include cat-scratch disease and mycobacterial infection. Generalized lymphadenopathy is often caused by a viral infection, and less frequently by malignancies, collagen vascular diseases, and medications. Laboratory tests are not necessary in most children with cervical lymphadenopathy. Most cases of cervical lymphadenitis are self-limited and require no treatment. The treatment of acute bacterial cervical lymphadenitis without a known primary source should provide adequate coverage for both Staphylococcus aureus and Streptococcus pyogenes.

Peripheral Lymph Glands; Are We Justified in Taking These Out for Histopathology in Our Patients?

“…This is a retrospective descriptive study which was conducted at the south surgical ward, Mayo 2 Hospital, Lahore and the Pathology Department of King Edward Medical University. The study period duration was one year from April 2016 to April 2017.…”

“…This may be due to a localized inflammatory process or a generalized disorder that may be infective or malignant in nature. 2 The most common cause of peripheral lymphadenopathy is tuberculosis in our country. 3 The other common causes include reactive hyperplasia, lympho-proliferative disorders and metastatic malignancies.…”

Cervical Lymphadenitis

“…1 In subacute infections, serologic testing for B. henselae, cytomegalovirus, Epstein-Barr virus, and human immunodefi ciency virus should be considered as well as skin tuberculin testing, which can be positive in both M. tuberculosis as well as nontuberculous mycobacteria (NTM) infection. 2,16 Ultrasonography has proven to be an effective modality to facilitate diagnosis and track clinical improvement in cases of nonsurgical management. 16 In cases in which therapy is not effective, biopsy, fi ne-needle aspiration, or excision is warranted.…”

“…17 For any surgical specimens, testing should include cultures for bacteria, fungi, and AFB as well as Gram and tissue staining for fungi, B. henslae (Warthin-Starry stain), and AFB. 2 For NTM, excisional biopsy may be both diagnostic and curative, 18 but the surgery carries some risk of nerve damage. 19 However, many providers prefer surgical excision over incision and drainage of lymph nodes infected with NTM, 20,21 likely because of risks of chronic draining fi stulas and poor cosmetic outcome associated with incomplete removal of infected tissue.…”

Clinicopathological Profile of Patients with Cervical Lymphadenopathy in a Tertiary Care Centre

“…The causes of lymphadenopathy implicated depend on the age of the patient. In small children, the causes can be head lice or other cutaneous infections of drainage area [15][16][17][18] . In older children and young adults, it can be due to tuberculosis or lymphoma, where as in elderly the commonest cause is secondary metastasis.…”