Swelling in the neck lymph nodes

Cervical Adenitis

Located between the deep and superficial fasyalar neck tonsiler, submandibuler, submental, occipital, superficial and deep jugular, nukkal, spinal accessory and transverse cervical lymph nodes is the infection. Factors typically viruses, S. aureus, group A streptococci, other streptococci, anaerobic bacteria, Bartonella henseleae, atypical mycobacteria and Gram-negative bacilli are. Acute bilateral and group A streptococcal adenitis viruslara to produce more acute unilateral adenitis S. aureus, group A streptococci, anaerobic bacteria and viruslara, subacute and chronic adenitis while atypical mycobacteria, tuberculosis, toxoplasmosis and cat scratch disease (Bartonella henseleae) 'na is optional. Rarely M. tuberculosis, fungi, T. gondii, F. tularencis, Y. pestis, HIV and C. diphtheriae as a factor in our face may occur. Microorganisms usually upper respiratory tract, tonsils and teeth through trauma, or, rarely comes to the blood via the lymph glands.

Clinic: Lymph gland growth and one-or two-sided time varies depending on that. No or mild systemic symptoms usually are. If you have cellulitis, or bacteremia in the surrounding tissue with a high fever may occur. Especially in the upper respiratory tract infection, streptococcal adenitis of the initial symptoms may be. Size can be up to 2-6 cm lymph nodes, submandibular most frequently (50-60%) and upper cervical glands (25-30%) are affected. Glands on the skin and local temperature increments are usually hiperemiktir. Approximately ¼ of the cases at the rate of fluktuasyon is taken. More S. aureus and mycobacterium infections may süpürasyon. Of lymph nodes found to be busy the other regions (above clavicle, axilla and inguinal region) must be checked, spleen and liver size should be investigated. In the body if there is widespread lymphadenopathy and hepatosplenomegaly, cervical lymphadenopathy usually a systemic disease (EBV, CMV, such as viral infections, toxoplasmosis, tuberculosis, connective tissue disease, leukemia, ...) have evolved in response. Mouth cavity, pharynx, nose, ears, neck, scalp, such as lymph drainage from the last region with the likely primary source of information about the examination are obtained.

Complications: abscess formation, cellulitis, bacteremia, internal jugular vein thrombosis, factors related complications (acute rheumatic fever, glomerulonephritis, scalded skin syndrome ...)

Diagnosis: Mild cases clinical diagnosis is sufficient. However, the response to antibiotic treatment can not be retrieved, with the exemplary needle aspiration or incision and Gram, Wright, and Ziehl-Nielsen stained with paint and should be reviewed, if necessary, should be evaluated from cytological and pathological aspects. In severe cases received treatment before the sample is appropriate. Persistent, diagnosed at 8-12 weeks did not have findings consistent with adenitis and neoplasia (lower cervical and supraklavikular lenfadenopatiler, weight loss, fever does not fall, adhesion to the skin and deep tissues)

Differential Diagnosis: mumps, bacterial parotitis, dental abscesses, congenital neck masses (cyst Thyroglossal Duct, brankial cleft cyst, cystic hygroma, epidermoid cysts), neck tumors (lymphoma, neurogenic tumors, thyroid tumors, parotid tumors, Kawasaki disease, drug reactions, connective tissue diseases, sarcoidosis, retiküloendotelyozlar, storage diseases.

Treatment: Lymph gland overgrowth did not, sensitivity and primary infection focus was not found to be less mild cases do not need antibiotic treatment, lymph glands begin to shrink until the weekly monitoring of controls is sufficient.

Growth persists, contact the patients when lymph nodes or large (but smaller than 3 cm), tender, reddened skin infections and primary focus of empirical oral antibiotic therapy or can be started, until shrinkage is observed. In these patients the antibiotic flucloxacillin, cephalexin, clindamycin, or amoxicillin / clavulanate may be used.

Lymph node 3 cm or greater, is inflamed, if the cellulitis and / or systemic symptoms and findings have since not respond to antibiotic therapy, and patients were hospitalized or dreya incision and drainage with exemplary study is convenient. Factors identified, or while waiting for results of parenteral clindamycin, cefazolin + metronidazole, sulbactam / ampicillin or vankomycin (or teicoplanin) + metronidazole treatment can be started one.