Cervical Lymphadenopathy


Cervical lymphadenopathy

Description, Causes and Risk Factors:

Abbreviation: CL.

Everyone has lymph nodes; they act as filters of the blood and lymph. When lymph nodes swell, it is in reaction to something; this is called lymphadenopathy. Neck lymph nodes are referred to as “cervical lymph nodes.” When the cervical lymph nodes swell the condition is called cervical lymphadenopathy. Cervical lymphadenopathy is a common problem in children. The condition most commonly represents a transient response to a benign local or generalized infection, but occasionally it might herald the presence of a more serious disorder.

Cervical Lymphadenopathy

The most common cause for swollen cervical lymph nodes is an infection. While most incidents of cervical lymph node enlargement is self-limiting and resolves quickly, some may persist for a longer time and may need more active management. Acute bilateral cervical lymphadenopathy usually is 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. The most common causes of subacute or chronic lymphadenitis are cat scratch disease, mycobacterial infection, and toxoplasmosis. Amongst this group, the supraclavicular lymph nodes are of special significance. Their enlargement may be an ominous sign since it is most often associated with malignancy and careful assessment and investigation.

Risk Factors may include:

    Ailments like common cold, sore throat, strep throat, tuberculosis and tonsillitis may trigger the disorder of swollen lymph nodes in neck.

  • Viral Infections (e.g. Mumps, glandular fever, rubella, toxoplasmosis and peritonsillar abscess).

  • Fungal infections.

  • Parasitic infections.

  • Sexually transmitted disease such as syphilis, HIV.

  • Cervical lymphadenitis.

  • Epiglottis.

  • Tuberculosis.

  • Sarcoidosis.

  • Strep throat.

  • Thyroiditis.

  • Cat scratch disease.

  • Dental infection.

  • Kawasaki disease.

  • Leukemia.

  • Lymphoma.

  • Tonsillitis.

  • Viral pharyngitis.

  • Viral syndrome.

  • Swollen lymph nodes in the neck have been associated with known mercury toxicity.

  • Certain drugs too causes cervical lymph node swelling.

Other causes may include:

    Scalp infection: Skin abscess, Tinea capitis, cellulitis, wound infection.

  • Infected external ear: Infected pierced earring site, erysipelas, otitis externa.

Symptoms:

Symptoms may include:

    Swollen lymph nodes in the neck.

  • Swollen lymph nodes under the jaw.

  • Neck swelling.

  • Lumps under the skin.

  • Neck pain.

  • Facial swelling.

  • Fever.

  • Chills.

  • Weight loss.

  • Night sweats.

  • Sore throat.

  • Red throat.

  • Muscle aches and stiffness.

Less common symptoms may include:

    Fatigue.

  • Difficulty swallowing.

  • Malaise.

  • Headache.

  • Nausea and vomiting.

Diagnosis:

Physical exam may include:

    All vital signs (temperature, respiratory rate, pulse, blood pressure, and heart rate).

  • Look in the pharynx for exudate.

  • Note the lymph node distribution and size, and whether they are fixed, tender, or fixed.

  • Have the patient bend the head forward and palpate along the trapezius.

  • Have the patient lift their chin and palpate under the mandible.

Imaging Tests:

Ultrasonography:

    Ultrasound is a useful imaging modality in assessment of cervical lymph nodes. Distribution of nodes, grey scale and power Doppler sonographic features are useful to identify the cause of cervical lymphadenopathy. Useful grey scale features include size, shape, status of echogenic hilus, echogenicity, micronodular appearance, intranodal necrosis and calcification. Adjacent soft tissue edema and matting are particularly useful to identify tuberculosis. Useful power Doppler features include vascular pattern and displacement of vascularity.

  • Ultrasonography can be combined with fine needle aspiration cytology in which a sample of cells from the lymph node is aspirated using a needle and examined under the microscope.

  • Ultrasound is a useful imaging modality in evaluation of cervical lymphadenopathy because of its high sensitivity (98%) and specificity (95%) when combined with fine-needle aspiration cytology (FNAC).

CT scan:CT scans can detect the presence of enlarged cervical lymph nodes with a short-axis diameter of 5 mm or greater.

Treatment:

    Treating cervical lymphadenopathy depends on the cause. If the nodes are inflamed, you do not have to be concerned. However, if you have symptoms of some other condition together with enlarged cervical lymph nodes, you should seek immediate medical assessment.

  • If the swelling is caused by infection, antibiotics medications may be prescribed.

  • Applying warm compresses and elevating the affected area may also help to reduce swelling.

  • People with immune disorders may also be prescribed medication to reduce swelling. A localized abscess may need to be drained by cutting the skin open and removing the infected material and careful examination under microscope. More severe episodes of swelling are often due to malignancy require appropriate treatment.

Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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