Inguinal lymphadenitis, ICD code 10. Nonspecific lymphadenitis, unspecified (I88.9)

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Nonspecific lymphadenitis, unspecified (I88.9)

general information

Short description

Lymphadenitis (from lymph and Greek aden - iron) - inflammation of the lymph nodes, often purulent. It is often caused by staphylo- and streptococci, which, with lymphangitis, enter the regional The lymph nodes. Localization mostly in the groin and armpit.

Classification

Classification of lymphadenitis.

By etiology:

    Specific. It is caused by some infectious disease, which is characterized by a lesion lymph nodes(tuberculosis, syphilis, actinomycosis, Infectious mononucleosis, tularemia, plague, etc.)

    Non-specific. It is most often caused by staphylococci and streptococci, less often by other pathogenic microorganisms or mixed microflora.

According to the duration of the disease:

  • Acute (up to 2 weeks)
  • Subacute (2 weeks to 1 month)
  • Chronic (over 1 month)

By the nature of the exudate:

  • Serous
  • Hemorrhagic
  • fibrinous
  • Purulent

By the nature of morphological changes:

  • Infiltrative (serous)
  • Purulent
  • Purulent-necrotic
  • Necrotic
  • Adenophlegmon

Etiology and pathogenesis

The causative agents of lymphadenitis are pyogenic microorganisms that penetrate into the lymph nodes through the lymphatic vessels from the foci of acute or chronic purulent inflammation (phlegmon, panaritium, etc.), with the flow of lymph, blood or by direct contact.

The infection enters the regional lymph nodes with the flow of lymph flowing from the primary purulent foci. Lymphadenitis can also occur without previous lymphangitis, and the primary focus is so insignificant and heals so quickly that by the time lymphadenitis occurs, it is not always possible to detect the site of infection. In rare cases, infection may enter the lymph nodes along with the bloodstream. Lymphadenitis sometimes also occurs due to the direct transition of the inflammatory process from the tissues surrounding the node.

Lymphadenitis should be considered as a manifestation of the barrier function of the lymphatic system, which limits the further spread of the infection and its toxins. However, lymphadenitis itself can be the starting point for the development of a severe purulent process (adenophlegmon, sepsis).

In acute lymphadenitis, in the initial phase, structural changes are reduced to reddening of the skin over an enlarged lymph node, expansion of the sinuses and desquamation of their endothelium. This is followed by increasing serous impregnation of the parenchyma of the node, the growth of elements of the lymphoid tissue and leukocyte infiltration. IN further development the inflammatory process, the liquid can take on a purulent character. Depending on the intensity of the factor that caused lymphadenitis, on the duration of its exposure and on the body's own reaction, the process quickly passes through all these phases or is limited to any. In accordance with the phase reached, there are forms of acute lymphadenitis:

simple or catarrhal,

hyperplastic,

Purulent.

Some features of the pathoanatomical picture cause the occurrence of other forms of lymphadenitis: with a process that has stopped at the stage of exudation, but with abundant sweating of fibrin - fibrinous lymphadenitis; with rapid and extensive necrosis of the lymph node - necrotic lymphadenitis.

Hemorrhagic lymphadenitis is distinguished as a special form, in which a significant violation of capillary permeability leads to imbibition (impregnation) of the lymph node with blood (anthrax, plague lymphadenitis).

In the initial phases, i.e., in less severe forms (simple and hyperplastic lymphadenitis), the inflammatory process contributes to the reverse development, but it can also take a chronic course. In forms characterized by a predominance of damage phenomena (purulent, necrotic lymphadenitis), the death of the lymph node and its purulent fusion or, depending on the nature of the infection, putrefaction occurs. The resulting purulent accumulation can remain within the capsule of the lymph node for quite a long time and be limited by the purulent membrane, forming an abscess. In other cases, there is a rapid destruction of the capsule of the lymph node and the infected content breaks into the surrounding tissue. In the initial forms of lymphadenitis, the inflammatory process often does not go beyond the capsule of the lymph node, being limited to its serous infiltration. With purulent lymphadenitis, periadenitis usually also develops - inflammation of the tissue surrounding the node, in which hyperemia (redness), edema, and leukocyte infiltration are observed. Purulent periadenitis occurs mainly as a result of a breakthrough of pus from the lymph node. Depending on the long course of lymphadenitis, purulent periadenitis takes the form of either an abscess surrounding the remnants of the lymph node, or phlegmon, the so-called adenophlegmon.

Clinical picture

Clinical Criteria for Diagnosis

Enlargement and soreness of regional lymph nodes, local hyperemia and edema, symptoms of intoxication.

Symptoms, course

Acute lymphadenitis

Acute lymphadenitis begins with pain in the area of ​​the affected regional nodes and their increase. With serous and hyperplastic forms, enlarged lymph nodes are well palpable, their pain is insignificant, general phenomena may be absent or mild. When the process turns into suppuration, the pain increases, a dense, painful induration appears in the region of the regional lymph node, the body temperature rises, and appetite disappears. Hardly noticeable at the beginning of the disease, redness and swelling in this area increase sharply, the contours of the lymph node lose their clarity, the node becomes inactive (periadenitis).
The patient spares the affected area, because movements intensify pain (inguinal gonorrheal lymphadenitis is especially painful). Soon, in the area of ​​infiltrate (inflammatory formation), fluctuation begins due to purulent fusion of the lymph node. If the abscess of the lymph node is not opened in time, the pus breaks out or seeps into the depth and around the circumference, the surrounding tissues are involved in the process. Adenophlegmon appears, the signs of which are a rapidly growing dense and painful infiltrate in the subcutaneous and intercellular tissue, sometimes with separate foci of softening, and in putrefactive forms - with gaseous crepitus (crunching). The transition of the suppurative process to neighboring lymph nodes is possible. High temperature, rapid pulse, chills indicate a progressive purulent inflammation. General phenomena are especially expressed in streptococcal and putrefactive infections.

Chronic lymphadenitis

Chronic nonspecific lymphadenitis develops with an infection caused by pathogens with a weak ability to infect with infected (impetiginized) eczema in children, with skin manifestations of exudative diathesis, pyoderma, etc. The cause of the development of the disease can also be repeated weak infectious irritations of the regional lymphatic apparatus due to frequent superficial lesions skin due to occupational injury. Often, chronic lymphadenitis is associated with chronic inflammation nasal mucosa or chronic otitis media. Chronic lymphadenitis of a specific origin usually has a tuberculous origin and affects more often the cervical lymph nodes; less often there is a universal lesion of the lymph nodes of various areas of the body, including bronchial and retroperitoneal. Chronic enlargement of the lymph nodes is observed in congenital and acquired syphilis. Clinical picture chronic lymphadenitis is characterized by an increase in lymph nodes of various consistency and mobility. With a nonspecific infection, isolated, clearly palpable mobile enlarged lymph nodes predominate, usually painless when palpated. With tuberculosis, packages of average density of nodes are more often probed; with syphilis, enlarged lymph nodes due to sclerosis are more dense.

Diagnostics

Recognition of acute nonspecific lymphadenitis of superficial localization is not difficult. This takes into account the anamnesis and the totality of clinical manifestations. Complicated forms of lymphadenitis are more difficult to diagnose, occurring with periadenitis and adenophlegmon, involvement of mediastinal and retroperitoneal tissue. In all cases, it is necessary to establish a primary purulent focus.

Chronic lymphadenitis usually requires puncture biopsy of the lymph node or its excision with histological analysis. This is necessary to distinguish between the chronic form of lymphadenitis and systemic diseases (sarcoidosis), lymphogranulomatosis, leukemia, metastatic lesions of the lymph nodes with cancerous tumors and etc.

If necessary, patients with lymphadenitis undergo ultrasound examination of the lymphatic vessels, CT, MRI of the affected segments, lymphoscintigraphy, radiopaque lymphography.

Differential Diagnosis

Differential diagnosis nonspecific lymphadenitis should be carried out with specific lymphadenitis, systemic blood diseases (leukemia, lymphogranulomatosis), accumulation diseases (Gaucher, Niemann-Pick), immunopathological diseases (chronic granulomatous disease, juvenile rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis, etc.), tumor metastases. Sometimes it is necessary to make a differential diagnosis between lymphadenitis and other surgical diseases, for example:

    In young children with damage to the inguinal nodes, the tumor is often mistaken for a strangulated inguinal hernia. Sudden onset, absence of stool, vomiting, indication of inguinal hernia in the anamnesis allow to distinguish a hernia from lymphadenitis.

    Epiphyseal osteomyelitis of the femur sometimes has to be differentiated from inflammation of the deep pelvic lymph nodes (high temperature, pain, flexion-adductor contracture of the thigh). When examining a child, it is possible to establish that a painful infiltrate is determined in the pelvis above the pupart ligament, and movements are preserved in the joint, albeit in a limited volume. Helps Diagnosis ultrasound procedure small pelvis.

    Ileocecal mesadenitis often has to be differentiated from acute appendicitis. Connection with viral infection, regression of clinical and laboratory data during dynamic observation of the patient against the background of the use of antispasmodics, detoxification infusion therapy. In doubtful cases, ultrasound, diagnostic laparoscopy is used.

Complications

Complications of purulent lymphadenitis can be thrombophlebitis, lymphatic fistulas, septicopyemia. A breakthrough of pus from the tracheobronchial lymph nodes into the bronchi or esophagus leads to the formation of bronchopulmonary or esophageal fistulas, mediastinitis. The outcome of chronic lymphadenitis is wrinkling of the nodes due to the replacement of the lymphoid tissue with connective tissue. Sometimes overgrowth connective tissue causes a disorder of lymphatic circulation: edema, lymphostasis, elephantiasis.

Of the complications of acute purulent lymphadenitis, in addition to periadenitis, abscess and adenophlegmon, it is possible to develop a general infection, the formation of thrombophlebitis of adjacent veins, erosion of the walls of blood vessels, followed by bleeding.

Treatment abroad

The World Health Organization in 2007 carried out the 10th revision of the classification of diseases in order to subordinate them to the international coding of diagnoses, and as a result, 22 subsections were obtained. According to the generally accepted standard for ICD 10, the lymphadenitis code is L04, with the exception of some diseases, which we will discuss below.

What is lymphadenitis

Lymphadenitis is a disease of the lymph nodes associated with their inflammation, reaching an infectious-purulent form. Pathology is unpleasant not only with painful sensations, discomfort, but also with what affects appearance. Most often you can find inflammatory processes in the neck, jaw, armpits.

The trigger signal is the ingress of an infection or pyogenic microorganism into the lymph node. They enter the system from the blood or lymph fluid. The first symptoms are most often pain accompanied by weakness, malaise, fever, headache, enlargement of the lymph nodes in size.

Kinds

There are several classifications of this disease, which are also reflected in ICD 10. Depending on the duration of the course, there is an acute and chronic form.. Depending on the location, there are:

  • submandibular lymphadenitis;
  • pathology in the neck;
  • inflammation of the nodes of the armpits;
  • inguinal lymphadenitis.

Patients with similar diagnoses are subject to hospitalization. The doctor prescribes drug treatment, physiotherapy, rest.

By the nature of the infection, a purulent stage can be distinguished, accompanied by constant, throbbing pain, induration, redness of the skin in the area of ​​​​inflammation. This type can lead to serious complications, sepsis, as it quickly spreads to neighboring lymph nodes, penetrates into nearby tissues and cells. Purulent pathology requires mandatory surgical intervention, drainage. In the absence of pus, the disease is much easier, does not require surgical intervention, does not change the condition of the skin.

Classification according to ICD10

Lymphadenitis in ICD 10 can be found in three sections:

  • Diseases of the circulatory system include in their composition a chronic form of the disease under the number I1, nonspecific mesenteric in acute or chronic form - I88.0, nonspecific unspecified - I88.9, as well as other forms of nonspecific pathology - I88.8.
  • Diseases of the skin and subcutaneous tissue L04 include an acute form of pathology, numbered according to the location: 0 - face, head and neck, 1 - trunk, 2 - upper limbs(including armpits, shoulder), 3 - lower limbs, pelvic area, 8 - other localizations, 9 - unspecified.
  • Enlargement of lymph nodes can be attributed to symptoms rather than diagnosis, however, it also has a separate classification: R59.0 well-defined localization R59.1 generalized enlargement, lymphadenopathy NOS (except HIV, which is included in B23.1), R59.9 Unspecified form.

Based on the above classification, it is possible to clearly determine where this or that diagnosis belongs. For example, cervical lymphadenitis in ICD 10 refers to L04.0. This approach makes it possible to standardize medical documents around the world.

Submandibular lymphadenitis can develop in both adults and children. It is important to understand that this disease is rarely primary. What does it mean? This means that the cause of lymphadenitis is an inflammatory process in some other organ, and only then the infection spreads to the lymph nodes.

In general, there are several hundred lymph nodes in the human body, which are part of the body's protective immune system. But most often it is the nodes located in the head and neck that become inflamed. These are submandibular, cervical or occipital lymph nodes.

ICD-10 code

Over the centuries of existence and development modern medicine doctors and scientists have repeatedly tried to create a description and classification of various diseases. The first such attempt, which entered the annals of history, belonged to Sauvage, who lived in the sixteenth century.

In our time, such a classification of diseases was created by the WHO and is called the ICD or the International Classification of Diseases. This classification also included submandibular lymphadenitis.

At present, the ICD is used by many countries of the world. This regulatory document gives a description and rules for the treatment of various diseases. As new scientific data in the field of medicine and pharmacology become available, this document is revised by WHO and improved.

ICD-10 code

L04 Acute lymphadenitis

L04.0 Acute lymphadenitis of face, head and neck

Causes of submandibular lymphadenitis

Although in most cases submandibular lymphadenitis is a secondary disease, there are cases when this disease develops separately. Then the cause of submandibular lymphadenitis is the trauma of the node itself with the ingress of pathogenic microflora into it.

As a rule, there are two pathogenic bacteria that most often cause submandibular lymphadenitis. These are streptococci and staphylococci. How do bacteria get into the lymph node? It is clear that with a direct injury to the node, they are brought there through damaged skin.

But if there was no injury, then these bacteria can enter the node through the lymph. The foci of bacterial growth can be found in the teeth and gums. Diseases such as caries, gingivitis or periodontitis are foci of infection from which bacteria can enter the lymph nodes through the lymph flow and cause inflammation.

Another cause of submandibular lymphadenitis is chronic diseases of the mucous membranes of the nasopharynx and tonsils. For example, chronic tonsillitis can cause submandibular lymphadenitis. Another cause of lymphadenitis may be chronic sinusitis. That is why lymphadenitis is called a secondary disease. Of course, it is necessary to treat such a disease in combination with the primary focus of infection.

In addition to streptococci and staphylococci, submandibular lymphadenitis can also be caused by other pathogens. For example, the causative agent of tuberculosis, Koch's bacillus, can also cause concomitant damage to the nodes. Another possible causative agent of infection is the bacterium that causes syphilis.

Symptoms of submandibular lymphadenitis

As a rule, submandibular lymphadenitis can be quite simply diagnosed by its symptoms. When an infection enters the node, it becomes inflamed, which is accompanied by pain, redness of the skin in the area of ​​the node. The skin may also become hot because locally the body temperature rises.

In some cases, the lymph node greatly increases in size. This is due to swelling of the tissues, or due to the accumulation of pus in the node itself and in the tissues around it. After all, submandibular lymphadenitis is of two types: non-purulent and purulent.

In addition to pain and other symptoms of submandibular lymphadenitis, it can be detected by a general blood test. The level of leukocytes in the blood in this disease rises sharply.

A local increase in temperature, that is, hot skin in the area of ​​\u200b\u200bthe node, may be accompanied by a general deterioration in well-being and an increase in the temperature of the whole body. In the acute course of processes and suppuration, body temperature can rise sharply and strongly.

The patient may experience weakness, chills and show signs of general intoxication, namely, pallor of the skin, lethargy, lack of appetite.

Acute submandibular lymphadenitis

Submandibular lymphadenitis is of two types - acute and chronic. In the first case of the disease, it always proceeds in acute form, but if the patient is not given adequate treatment, the disease can become chronic.

In acute submandibular lymphadenitis, only one or several nodes can become inflamed at once. Although the acute course of the disease can also be with a non-purulent form of lymphadenitis, it is most often caused by suppuration.

In this case, pus can collect in the node and fluctuate. This means that the pus "overflows" and "fluctuates" in the node, which can lead to a breakthrough and further infection of the tissues. In addition, in the acute course of the disease, the infection can affect not only the node itself, but also other tissues around it, they swell, redden and hurt.

Acute lymphadenitis can interfere with the full use of that part of the body where the node is located. With submandibular lymphadenitis, the neck and jaw can hurt. Pain may also appear when opening or closing the mouth.

Chronic submandibular lymphadenitis

Chronic submandibular lymphadenitis may appear as a result of improper treatment of the acute form of this disease. While in the acute form the lymph node swells, increases in size, and the skin around it turns red, in the chronic form, the nodes may harden.

Also, in the chronic form, infection and inflammation can spread from the node itself to the tissues around it. The patient has the same symptoms as in the acute form of the disease. Both the body temperature and the temperature of the skin around the nodes rise. The skin turns red. A person feels severe malaise, chills and lethargy.

If lymphadenitis becomes chronic, a more radical method of its treatment may be needed - removal of the node. While acute lymphadenitis can be treated by removing pus from the node and using antibiotic therapy.

Submandibular lymphadenitis in children

Submandibular lymphadenitis in children is as common as in adults. The infection can get into the nodes through the lymph from different foci of inflammation. It can be an infection of the teeth and gums, chronic infections in the nasopharynx, and so on.

It should be noted that in children of the first years of life, lymphadenitis cannot develop, because the lymph nodes are formed during the first three years of life.

If this disease is not treated in a timely manner, then surgical intervention and even removal of the inflamed node may be necessary. Therefore, it is important to consult a doctor in time, because the inflammation of some nodes is more difficult to notice. Many parents are unaware of the existence of lymph nodes in the back of the head. Although submandibular lymphadenitis in children is quite easy to diagnose.

The child may complain of pain in the neck or under the jaw. The parent can probe the nodes. If they are healthy, this will not cause any pain in the child. In addition, healthy knots will be soft and movable to the touch.

Diagnosis of submandibular lymphadenitis

There are several methods for diagnosing submandibular lymphadenitis. Firstly, the doctor can make a diagnosis, so to speak, "by eye". After all, this disease has a pronounced symptomatology. When inflamed, the nodes hurt and increase in size.

The skin above and around the nodule may be red and feel much warmer than the patient's other skin. In addition, the general body temperature can rise greatly and is difficult to bring down.

If pus has collected in the node, the node greatly increases in size, the skin around it turns red and even turns purple. Pus is palpable through the texture of the skin and node. It fluctuates there or "shimmers".

In addition to visual, symptomatic and palpar diagnostic methods, there are also clinical methods. For example, a doctor may order a patient to take general analysis blood. With submandibular lymphadenitis, the level of leukocytes in the blood will be significantly increased.

Ultrasound is another diagnostic method for submandibular lymphadenitis. Using ultrasound, you can accurately determine whether there is pus inside the node. In addition, the doctor may prescribe a puncture to take fluid from the node for bacteriological analysis. This analysis will help determine which bacteria is causing the inflammation and which antibiotic these bacteria are most sensitive to.

Treatment of submandibular lymphadenitis

There are two main ways to treat submandibular lymphadenitis. Unfortunately, the main treatment is surgery. It comes in different types. If pus has collected in the node during the acute course of the disease, then the doctor makes an incision and releases the pus.

Thus, it is possible to avoid spontaneous breakthrough of the node and infection of the tissues around it. With an uncontrolled breakthrough, sepsis can occur.

Therefore, the knot is opened and pus is removed from it. This reduces inflammation and speeds up the healing process. The second treatment is antibiotics. Often these drugs are prescribed as concomitant treatment for surgery.

There are also folk remedies for the treatment of submandibular lymphadenitis. And also in some cases, physiotherapy, electrophoresis and so on are used. But these treatments are most often used after the pus has been surgically removed from the node.

Antibiotic treatment

Not every antibiotic is suitable for the treatment of submandibular lymphadenitis. Most often, this disease is caused by pathogens such as streptococci or staphylococci. Therefore, antibiotics of the penicillin group are used for treatment.

In most cases, you need to administer the medicine through injections and the duration of the course should not be less than seven days. This course is enough to completely destroy the infection in the lymph nodes.

At the same time, it is very important to understand even before treatment how effective this or that drug will be in the fight against bacteria. For this purpose, the doctor may prescribe a puncture. The taken fluid is sown for the presence of pathogens and tested which antibiotic most effectively kills bacteria.

Treatment of submandibular lymphadenitis in children

When treating submandibular lymphadenitis in children, it is very important to first identify the primary source of infection. These can be chronic inflammatory processes on the mucous membranes of the throat or nasopharynx. Or maybe tooth decay or gum disease.

It is very important to cure and eliminate the primary infection. As a rule, submandibular lymphadenitis is closely related to the oral cavity and nasopharynx. Therefore, in its treatment, it is important to carefully observe the cleanliness of the teeth, mouth and throat strips. You can rinse your mouth and throat and brush your teeth regularly.

Purulent lymphadenitis definitely needs to be treated with antibiotics. Sometimes it may be necessary to open the node to remove pus from it. The doctor can put drainage so that further pus does not accumulate in the node, does not cause severe pain, and the inflammation does not disperse to the tissues around the lymph node.

In some cases, the doctor may prescribe compresses or lotions on the skin around the knot. But in no case should you do them without a doctor's prescription. It is especially necessary to avoid heating the area of ​​​​the nodes until the diagnosis is made. Heat increases the rate of bacterial growth and can only increase the child's pain.

Treatment with folk remedies

It is important to understand that it is impossible to treat purulent submandibular lymphadenitis with folk remedies. So you can only waste time and out acute infection, it will become chronic. Therefore, folk remedies are best used as an additional therapy or for early stages diseases.

Usually, ethnoscience uses medicinal herbs. They can be consumed internally in the form of tinctures or teas, or you can make lotions from them. In the treatment of submandibular lymphadenitis, you can use such a natural "antibiotic" as echinacea.

From it you need to make a tincture of alcohol. But you can not apply a compress from a pure or undiluted tincture to the skin. Before use, one part of the tincture must be diluted with two parts of water. Do not use hot water, so as not to overheat the inflamed node. Take warm water.

The compress is put on the whole night. The diluted tincture is applied to cotton wool and fixed with a bandage. The same tincture, only not diluted, can be taken orally. You can do this three times a day and drink no more than 40 drops at a time.

Another folk remedy treatment of submandibular lymphadenitis is onions. It has long been famous for its bactericidal properties. It can be used for compress. In addition to onions, you need to stock up on tar from the pharmacy.

Onions are baked whole (with peel) in the oven. The oven needs about 20 minutes. The husk is removed and the onion is kneaded. Add a tablespoon of tar. The mixture should be warm, but not hot. A compress from this mixture is applied to the inflamed node and left overnight.

Blueberries are suitable as a natural immunostimulant. These berries are rich in vitamins and useful microelements, which are so necessary for the body during illness. You can make a strong fruit drink from blueberries and drink this drink several times during the day. Just do not forget that blueberries have a laxative effect, so you should not eat too much of them.

Prevention of submandibular lymphadenitis

Basically, submandibular lymphadenitis is reduced to the prevention of chronic infections in the body. Since lymphadenitis is a secondary disease, any inflammatory process can become its cause. Especially if such inflammation is caused by streptococci or staphylococci, to which the lymph nodes are very susceptible.

It is important to understand that the primary infection itself may not cause acute pain or discomfort. For example, it can be caries, in which there is no acute toothache. Or a chronic runny nose that does not cause fever or other pronounced symptoms.

With the flow of lymph, the infection of their other organs can migrate to the lymph nodes and cause acute inflammatory processes there. To prevent submandibular lymphadenitis, you need to treat your teeth in time, maintain hygiene oral cavity and timely visit the dentist for preventive examination.

The same is true for ENT organs. It is necessary to visit an otolaryngologist several times a year for a preventive examination and not to trigger acute or chronic diseases of the nasopharynx.

Prognosis of submandibular lymphadenitis

There are several undesirable complications of submandibular lymphadenitis. If this disease is not treated, then the prognosis can be disappointing. The acute form can become chronic, in which the nodes harden, and their complete removal by surgery may be necessary.

Non-purulent lymphadenitis can turn into a purulent form. Then you will need antibiotic treatment and you may have to do an autopsy of the node to remove pus.

If lymphadenitis is not treated in a timely manner, then pus can break out and infect other tissues around the node. The rapid spread of infection in the body can lead to blood poisoning, general sepsis and death of the patient.

The consequences of submandibular lymphadenitis can be unpredictable, because pus can go from these nodes in almost any direction. They are close to the brain, and infection can even get there.

Therefore, it is very important to consult a doctor in time if you notice an increase in lymph nodes or pain in the area of ​​​​the nodes in yourself or your child. In addition, it is necessary to heal wounds, calluses and eliminate other permanent foci of infection in the body in time, because it can migrate to the lymph nodes from any organ or part of the body.

In chronic or acute form. Cervical localization almost immediately manifests itself in the form of typical symptoms, which makes it possible to start therapy in a timely manner and, accordingly, a quick recovery.

Most often, cervical lymphadenitis occurs against the background of a disease of the oral cavity, which can be caused by infection with microorganisms, viruses or bacteria. A distant purulent focus can also become a prerequisite for lymphadenitis.

Causes of lymphadenitis

Quite often, inflammation of the lymph nodes is preceded by the process of suppuration in the face area. Staphylococci and streptococci are the most common pathogens. Depending on the cause of the occurrence, lymphadenitis is divided into specific and nonspecific.

The cause of specific lymphadenitis can be severe infectious diseases such as diphtheria, tuberculosis and others. The non-specific form of the disease occurs due to direct infection in the lymph node. This can happen through a wound in the neck.

The risk group for cervical lymphadenitis (ICD 10 - L04) includes patients with weakened immune system children who often suffer from infectious diseases, adults who work with animals, land and dirty water. Most cases occur in patients over 18 years of age.

Provoking factors

There are several factors that determine the risk of the disease:

  • infectious disease of the nasopharynx and oral cavity;
  • disorders of the endocrine system, including the thyroid gland;
  • AIDS virus;
  • allergic reaction with complications;
  • pathology of the metabolic process;
  • excessive consumption of alcoholic beverages.

Cervical lymphadenitis (ICD 10 - L04) is not contagious, it is a secondary process that occurs as a complication of a viral or bacterial infection. Depending on concomitant diseases, lymphadenitis therapy is carried out by an otolaryngologist, an infectious disease specialist, a surgeon, etc.

On the initial stage lymphadenitis manifests itself in an acute form, gradually turning into a chronic stage. Sometimes at the introductory stage they do not appear. It depends on the patient's immune status.

Kinds

Types of cervical lymphadenitis (ICD 10 - L04) are presented below:

  • nonspecific inflammation occurs against the background of getting into the lymph node fungal or viral infection, easier to treat, less likely to lead to complications;
  • specific inflammation is a sign of severe pathology, including tuberculosis, syphilis, typhoid fever and plague

In this case, the diagnosis takes place already at the stage of the chronic course. There are several stages of the disease in acute form:

  1. Serous. Does not cause intoxication and severe fever. initial stage penetration of a harmful microorganism into the lymph node.
  2. Purulent. Denotes bacterial infection. Accompanied high temperature and requires prompt intervention.
  3. Complicated. Requires emergency surgery, as it can lead to infection of the entire body.

The course of a nonspecific form of cervical lymphadenitis (ICD code 10 - L04) is characterized by the spread of viruses and fungi through the lymph node. This form responds well to therapy and rarely causes complications. The spread of the disease to other lymph nodes can lead to the development of a severe pathology called generalized lymphadenitis.

Signs of cervical lymphadenitis

Common symptoms indicating lymphadenitis are:

  • an increase in temperature in the acute stage of the course of the disease;
  • sleep disturbance, loss of appetite, weakness;
  • neurological disorders, apathy, dizziness, migraines;
  • intoxication.

At the beginning of acute cervical lymphadenitis (ICD code 10 - L04), there is a thickening and enlargement of the lymph nodes. Palpation is painful. This is considered a serous stage and requires medical attention. Otherwise, the disease will progress and become chronic.

Signs that characterize the chronic form of lymphadenitis are:

  • swelling of the lymph nodes;
  • increase in body temperature;
  • drowsiness, general malaise, sleep disturbance;
  • slight pain on palpation.

At the stage of the chronic course of lymphadenitis of the cervical lymph nodes (ICD 10 - L04), the symptoms become unexpressed. This is due to the fact that the body reduces the amount of resources that is spent on fighting the disease and gets used to the existing state. As a result, the body is intoxicated with decay products and areas that have undergone necrosis.

Purulent tissue damage leads to an increase in the external manifestations of the disease and, as a result, quickly worsens. A pulsation will indicate the purulent stage and strong pain and severe swelling of the lymph nodes. This condition is considered life-threatening and requires immediate attention.

Diagnostic methods

How is cervical lymphadenitis detected (ICD 10 - L04)? During the examination, the specialist palpates the affected lymph nodes, as well as the tissues surrounding them, to determine the cause of the disease. A general blood test will provide information about the presence of an inflammatory process, accompanied by an increase in the number of lymphocytes.

If lymphadenitis is diagnosed without concomitant complications, then immediate treatment will be required. If the doctor observes changes in other organs and systems, an additional examination is required, including the following tests:

  • general and biochemical blood test;
  • a study on the histology of the material of the lymph node through a puncture;
  • x-ray examination chest(performed in cases of suspected tuberculosis);
  • Ultrasound of the abdominal cavity, if the cause of the inflammatory process has not been established;
  • blood test for immunodeficiency virus and hepatitis.

Regardless of the stage of the disease, a visit to the doctor is a strictly mandatory procedure. Exacerbation of lymphadenitis can occur at any time.

Treatment

Purulent cervical lymphadenitis (ICD 10 - L04) is treated exclusively by surgery. The focus is opened, the contents are removed, the wound is treated and drained. After that, symptomatic therapy is carried out. Conservative treatment is carried out depending on the factor that caused the disease. Most often, analgesics, restorative drugs and anti-inflammatory drugs are prescribed. During the period of remission, physiotherapy is allowed.

Preventive measures

As for prevention, it is necessary to immediately treat purulent and inflammatory diseases that occur in the chest and face. Since the disease can occur against the background of infection of the oral cavity, you should regularly visit the dentist for preventive purposes.

In addition, the prevention of lymphadenitis involves taking vitamin and mineral complexes, timely treatment of scratches and wounds on the skin, as well as the treatment of abscesses, boils, etc. It is unacceptable to treat lymphadenitis at home. Inflamed lymph nodes should not be warmed up or applied to them with compresses!

Inguinal lymphadenitis appears against the background of infection of the body with bacteria or a virus, as well as as a result of autoimmune processes and excessive exposure to ultraviolet radiation. The main symptom of pathology is an increase in the size of the lymph nodes. The diagnosis is always preceded by an inflammatory process due to the activation of the infection and a decrease in the level of immunity.

There are several options for separating lymphadenitis in the inguinal zone. According to the type of course, the disease is divided into acute and chronic. Inguinal lymphadenitis in acute form was assigned the ICD code 10 - L04.

The main classification provides for the division of the disease into specific and non-specific types. The latter is amenable to therapy faster and has virtually no complications against the backdrop of favorable prognosis.

Specific lymphadenitis in the groin occurs in the following forms:

  • indurative, which is characterized by a long period of development with a weak symptomatic picture, the formation of scar tissue, followed by atrophy of the node and slight pain when pressed;
  • infiltrated, in which the node increases in size and thickens due to the active growth of lymphocytes, but does not fuse with neighboring tissues;
  • caseous - it is characterized by necrosis and suppuration in the area of ​​​​inflammation, the nodes thicken, are painful, solder with nearby tissues. Difficult to treat.

Similar forms of lymphadenitis in the inguinal zone are more often manifested in tuberculosis and are accompanied by additional symptoms in the form of fever and general weakness.

Reasons for the appearance

Lymphadenitis of the inguinal region is diagnosed against the background of entering pathogenic microorganisms directly inside the nodes. As a result, an inflammatory process occurs in this part of the body. In medicine, it is customary to distinguish between 2 types of diseases:

  1. Primary, when pathogenic bacteria enter the lymph node due to external skin lesions. Considered the most common.
  2. Secondary, in which infection occurs from an already existing focus of the pathological inflammatory process.

Causes of groin lymphadenitis:

  1. Inflammatory foci in the genital area - colpitis, chronic vulvitis, progressive balanoposthitis, bartholinitis, urethritis and others.
  2. Sexually transmitted diseases - gonorrhea, syphilis, chlamydia and others.
  3. Inflammation in the area lower extremities and perineum, these include various abscesses, progressive trophic ulcers, boils, cuts, and bacterial-infected skin lesions.
  4. Viral infections of the systemic type - cytomegalovirus, adenovirus, HIV, mononucleosis.
  5. Neoplasms on lymph tissue - and.
  6. Feliniasis, the development of which occurs after bites or scratches inflicted by a cat.

Lymphadenitis of the perineum can occur due to oncological tumors of the small pelvis, in which metastases appear in the lymph nodes. Most often, the disease manifests itself as a consequence of another diagnosis. Sometimes, by the presence of lymphadenitis, a tumor of the lymphoid or nearby tissues is determined.

signs

In the normal state, the lymph nodes in the groin are not visualized and are not palpated. The presence of the following symptoms indicates the onset of the inflammatory process, as a result of which lymphadenitis is diagnosed:

  • discomfort in the groin area, especially after physical activity;
  • visual enlargement of nodes that look like bumps of various sizes, depending on the stage;
  • pain in the area of ​​​​inflammation, even with a slight touch;
  • dense consistency of inflamed nodes, but at the same time, the “bumps” are elastic. A solid structure indicates a malignant tumor;
  • lymph nodes are often not soldered to neighboring tissues and are characterized by mobility. On this basis, it is determined infectious nature lymphadenitis in the groin. Oncology with developing metastases is characterized by dense and motionless "bumps";
  • with purulent lymphadenitis in the inguinal region, there is redness in the focus of inflammation, severe soreness, an increase in the temperature of the skin covering the lymph node.

With a tumor process occurring in the lymphatic tissues, the symptomatic picture is less pronounced. Redness of the skin is mild, and pain is insignificant.

Diagnostic measures

To confirm lymphadenitis, it is necessary to conduct the following studies in a medical institution:

  1. A blood test of a biochemical type, which will determine the concentration of the C-type reactive protein.
  2. A simple (general analysis) blood test in a laboratory that will determine an increase in leukocytes, a change in color indicators and an acceleration of the erythrocyte sedimentation rate.
  3. PCR or ELISA examination, which will confirm the presence of the pathogen.
  4. To determine the type of pathogen, to understand its sensitivity to various types of antibacterial medicines, bacteriological culture is used.
  5. Examination under a microscope to detect the presence of cancer cells. The contents of the lymph node are studied and the severity of the situation is assessed.
  6. Ultrasound diagnostics, through which not only the size and structure of the lymph node is determined, but also general state adjacent tissues.
  7. X-ray to identify a potential cause of a specific type of lymphadenitis.
  8. Biopsy of the composition of the lymph nodes.

If there is suspicion of the development of oncological metastases, PET is performed using computed tomography.

Treatment and prevention

Therapy of inguinal lymphadenitis is not directed, the symptoms of the disease disappear after the elimination of the true cause of its appearance. If, after curing the main pathological focus, the lymph nodes do not return to their primary state, medical support, physiotherapy and surgical intervention are necessary.