Internal Medicine

Inflammation of the Lymph Nodes - How Dangerous Is It?

synonym

Lymphadenitis

definition

A Lymphadenitis is the swelling from Lymph nodes owing to inflammatory processes, mostly in the context of Infections. The swelling one or more lymph nodes is called Lymphadenopathy designated.

The terms lymphadenitis (in the narrower sense inflammation of the lymph nodes) and lymphadenopathy (in the narrower sense swelling of the lymph nodes) are often used synonymously. Lymphadenitis can numerous causes to have. Some do not have far-reaching health relevance and the inflammation of the Lymph nodes is spontaneously regressive within a few days, in others the lymphadenitis can be an indication of a serious illness so that a visit to the doctor with further diagnostics can be useful.

Anatomy and pathophysiology

Lymph nodes are part of the Immune system. They are used to filter Lymph fluid and contribute to Defense against pathogens at. They also play a role in non-pathogen-related diseases.
Lymph nodes are usually 0.2 to a maximum of 2 cm in size and slidable against the surrounding tissue as well not tender on pressure.

Important Lymph node regions lie in the area of the head, neck, chest, abdomen and groin. If there is an activation of lymph nodes due to a confrontation with a pathogen - of whatever kind - this usually leads to an enlargement of the lymph nodes, which turns out to be swelling can make noticeable. A swelling of the lymph nodes can thus indicate a inflammation but also one malignant (malignant) disease deliver. Swelling of the lymph nodes is called lymphadenopathy. Lymphadenitis is more specific and means swelling of the lymph nodes as part of an inflammation.

Symptoms

Depending on the cause of the Swelling of the lymph nodes there may be other symptoms in addition to this. So can swollen lymph nodes tender on pressure be or it can become one overheat and Redness come to the affected region. Other possible accompanying symptoms are fever, chills and general malaise. Depending on the cause of the lymph node swelling, numerous other symptoms can occur (see causes).

Read more on this topic at: Swelling of the lymph nodes

Risk potential of an inflamed lymph node

The risk of permanent damage to health from an inflamed lymph node is very low.
Most lymph node inflammation occurs as part of an infection of neighboring tissue, for example swelling of the cervical lymph nodes as part of a common cold. This lymph node swelling usually disappears within a few days or weeks.

If an inflammation of the lymph node is due to a specific bacterial inflammation, complete healing within a few weeks is the rule. It should be noted, however, that this is only possible with adequate and timely therapy.

Only in rare cases, such as the manifestation of tuberculosis in the lymph nodes, can a chronic inflammation develop, which can be swollen for months or years.

examination

Swelling of the lymph nodes and increased tenderness to pressure are typical of inflammation of the lymph nodes in the neck region caused by an infection.

The clinical examination of the Lymph nodes can provide important clues to the Type of swelling give. So, at least as a rough rule, with one pressure painful and swelling sliding well against the surrounding tissue from one infection can be assumed as the cause.

Are the swollen lymph nodes not tender on pressure and does not slide well against the surrounding tissue, this may indicate a malignant (malignant) tumor give. Therefore, as with most non-acute complaints, you can generally wait a few days to see how the swelling develops and whether further symptoms appear. If it persists or if there are additional symptoms that go beyond the extent of an unproblematic cold, a doctor should be consulted.

Most of the time he can Family doctor determine more precisely how the lymph node swelling should be classified and which further examinations could be useful. In addition to the clinical examination, the anamnesis is always important. Questions about the time of occurrence (is it a acute swelling of the lymph nodes or is it chronic?) and the temporal connection with other events (for example the appearance of the swelling shortly before a cold breaks out). Also the question of Pre-existing illness (e.g. a history of cancer) and most recently undertaken to travel (Possibility of infection with pathogens that are common in certain countries) is important.

In addition to the clinical examination and the anamnesis, the Imaging a role. Here come procedures like Ultrasonic (Sonography), Computed Tomography (CT) and Magnetic resonance imaging (MRT) are used. Nuclear medicine procedures such as scintigraphy also play an important role in the precise examination of lymph nodes. However, they are not used as a routine procedure.

causes

The possible causes of lymph node swelling can be roughly divided into two categories: infections and malignant processes.

If an infection is the cause of the swelling, then we are talking about the lymphadenitis discussed in this article in the narrower sense, i.e. inflammation of the lymph nodes. Numerous bacterial and viral pathogens can penetrate the body and be filtered and "discovered" in the lymph nodes, resulting in increased activity of the lymph nodes and thus their swelling.

Here are a few examples in more detail: The cat scratch disease is a disease whose bacterial pathogen - Bartonella henselae - is transmitted by cats. It occurs more often in children than in adults and manifests itself as swelling of the lymph nodes, especially around the neck and / or armpits (lymph node swelling in the armpit).
Other symptoms such as fever, feeling tired, headache, chills and sore throat can occur. In addition, at the beginning, shortly after infection with the pathogen, a small, brownish skin lesion often appears, which recedes within a few days and often goes unnoticed.

The disease is often bland, but it can also lead to complicated courses which then mainly affect the central nervous system (for example encephalitis, paralysis). But the heart (endocarditis), the lungs (pneumonia), the eye (retinitis) or the liver can also be affected. The blood may show a breakdown of red blood cells (haemolysis) and a lack of platelets (thrombocytopenia). To confirm the diagnosis, an antibody detection against the bacterium in the blood and the detection of the bacterium in a molecular biological test, the PCR, must be carried out.

The disease often heals without specific therapeutic measures, sometimes antibiotics are used. Another bacterial infectious disease that can manifest itself as swelling of the lymph nodes is lymph granuloma venerum, also known as lymph granuloma inguinale.
The disease is caused by the bacterium Chlamydia trachomatis and is one of the sexually transmitted diseases (STD for short). Lymph node swellings in the area of the groin near the genital area are characteristic. The swelling is clearly painful, and there is sometimes a reddish-bluish discoloration of the skin in the area of the swollen lymph nodes.

Treatment with certain antibiotics (macrolides or tetracyclines) should always be carried out, otherwise the disease can become chronic. The sexual partner should always be treated with antibiotics, otherwise the disease can always be transmitted from one to the other.

The disease known as yersiniosis in humans can also lead to swelling of the lymph nodes. Children and young people are particularly affected. Typically, there is swelling of the lymph nodes in the abdomen (mesenteric lymph nodes), symptoms that are similar to appendicitis (pseudoappendicitis) often occur, which can lead to misdiagnosis.

Chronic inflammation of the lymph nodes can result from lymph node tuberculosis. Viral pathogens can also be filtered out by the lymph nodes, causing them to swell. For example, the Epstein-Barr virus (EBV), which can lead to the clinical picture of mononucleosis, also known as Pfeiffer's glandular fever (colloquially known as the kissing disease). Almost 100% of Europeans are infected, but only a few show symptoms.

In adults, the disease manifests itself as a flu-like condition while in adolescents it can lead to swelling of the lymph nodes, sore throat, tonsillitis, fever and swelling of the spleen (splenomegaly). The pathogen is mainly transmitted via the saliva, hence the term kiss disease. The diagnosis is made by the detection of antibodies against the viral pathogen; the number of white blood cells (leukocytes) is often increased.

There is no specific therapy; fever-lowering drugs may be prescribed. Infection with the measles virus and rubella virus can also lead to swelling of the lymph nodes. With rubella infection, the lymph nodes behind the ears and on the back of the head are typically affected, while with measles infection, numerous lymph nodes in various parts of the body can be swollen (generalized lymphadenopathy).

You may also be interested in this article: Abscess on the head

It should be mentioned here briefly that another important cause of the swelling of lymph nodes - in addition to inflammation due to infection with pathogens - can be the presence of a malignant (malignant) process, i.e. a tumor disease. The term here is not lymphadenitis but lymphadenopathy (i.e. swelling of the lymph nodes without their inflammation), but these two terms are often used synonymously. The tumor diseases that are typically associated with swelling of the lymph nodes include Hodgkin's lymphoma and the group of non-Hodgkin's lymphomas (NHL), which also include chronic lymphocytic leukemia (CLL).

therapy

The therapy one inflammation of the Lymph nodes depends crucially on the triggering cause. Lymph node swelling can be a cold or flu occur for only a few days; no specific therapy is required here. Are the lymph nodes inflamed from a bacterial infection such as the Lymph granuloma venerum (Lymph granuloma inguinale) so is one antibiotic therapy mandatory. At Lymphadenitis in the context of viral diseases like the Pfeiffer's glandular fever such as measles or rubella Medicinal therapy may also be necessary, but this is less aimed at the lymph nodes or the elimination of the pathogens, but is used to lower the fever.

forecast

The prognosis of a Inflammation of the lymph nodes depends largely on the cause of the inflammation. This is what inflammation and associated swelling of the lymph nodes sound like as part of a banal infection mostly within less days or Weeks off again. Also Lymphadenitis in the context of bacterial and viral inflammation tend to decline within a few weeks. However, this can also depend heavily on whether treatment has taken place in good time (for example in the case of lymph granuloma venerum). However, there is also chronic lymph node swelling in infectious diseases, an example of this is one tuberculosis with involvement of the lymph nodes. Here the swellings exist as an expression of chronic inflammation for years and decades.