95 - Lymphadenitis and Lymphangitis

Abstract

Lymphadenitis is acute (suppurative), or chronic (often granulomatous) inflammation of the lymph nodes. Suppurative lymphadenitis is most common in young children; granulomatous lymphadenitis occurs at all ages. Suppurative lymphadenitis is caused primarily by Staphylococcus aureus (methicillin sensitive or methicillin resistant) and group A streptococci in normal hosts. Multiple other pathogens cause suppurative lymphadenitis in immunocompromised hosts. Granulomatous lymphadenitis is caused primarily by nontuberculous mycobacteria in healthy children. Mycobacterium tuberculosis is the most important etiology in older individuals, but it may also be caused by a variety of other pathogens in immunocompromised hosts. Diagnosis is usually by needle aspiration or incisional or excisional biopsy. Therapy of suppurative abscesses is by drainage and antimicrobial therapy directed at identified pathogens. Identification of causes of granulomatous lymphadenitis may require more extensive microbiologic and histologic investigation.