What is lymphadenitis?

Lymphadenitis is inflammation in the lymph nodes. It usually presents as one or more swollen or enlarged lymph nodes under the neck, in the armpits, or in the groin. Lymphadenitis is relatively common, and most often indicates the presence of bacterial or viral infection. Fungal and parasitic infection can also lead to lymphadenitis. Very occasionally, a lymph node can also become swollen as a result of cancer cells invading the node. This is less common, but can be tried if all other symptoms are ruled out.

The most common symptoms of lymphadenitis are swelling of one or more lymph nodes. Swollen lymph nodes may feel slightly hardened and may be painful when touched. The skin covering the lymph node may sometimes feel warm to the touch or may appear slightly red.

A swollen lymph node usually means that a doctor will want to look for the cause, especially if the lymphadenitis is painful. Doctors may do blood tests to check for infection and, in some cases, may do a small biopsy of the lymph node. If the suspected cause of lymphadenitis is viral, a biopsy is rarely done. Lymphadenitis usually only indicates the need for a biopsy if cancer is suspected.

Sometimes in children, chronic swelling of a lymph node occurs and is not associated with discomfort, warmth, or redness of the skin. This is actually not uncommon, and unless there is discomfort, doctors usually diagnose this as viral and do not treat it. Recent studies on cat scratch fever disease suggest that it may be responsible for most cases of chronic lymphadenitis in children. Since bacteria cause cat scratch fever, antibiotics can resolve lymphadenitis.

The normal treatment for lymphadenitis of bacterial origin is a course of antibiotics. In all cases, doctors treat the underlying causes when possible. You can also relieve minor discomfort from swollen lymph nodes by taking anti-inflammatory medications such as ibuprofen.

A more serious form of lymphadenitis is lymphangitis, which almost always indicates the presence of a bacterial infection. Its symptoms include high fever, red streaks around the swollen lymph node, throbbing pain in the lymph nodes, and flu-like symptoms such as poor appetite, fatigue, and muscle pain. Lymphangitis is most associated with streptococcal and staphylococcal bacterial infections. Cellulitis, a blood infection, is a fairly common cause. Since lymphangitis is often bacterial, a doctor should promptly evaluate these symptoms.

Even with antibiotic treatment, it may take several months for the lymph nodes to return to normal. Some people have almost constant symptoms of lymphadenitis, which do not resolve, despite treatment. This may be especially true in people with compromised immune systems. People with autoimmune disorders or with HIV may experience chronic lymphadenitis. Some children, due to constant exposure to viruses, also have lymphadenitis that can last from several months to a year or more.

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