Lymphadenopathy (patient information)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

Lymphadenopathy is a disease of the lymph nodes. It is, however, almost synonymously used with “swollen/ enlarged lymph nodes”. When the infection is of the lymph nodes themselves, it is called lymphadenitis.

Most of the time lymphadenopathy is an incidental finding in physical examination. Sometimes they present as lump in the neck (e.g in tumors, sarcoidosis). Lymphadenitis presents as:

• Red, tender skin over lymph node.
• Swollen, tender, or hard lymph nodes.

Lymph nodes may feel rubbery if an abscess has formed.

The most common causes of lymphadenopathy include:

• Acute infections (e.g. bacterial, or viral)
• Chronic infections (e.g. tuberculous lymphadenitis, cat-scratch disease). Infectious mononucleosis is an acute viral infection, the hallmark of which is marked enlargement of the cervical lymph nodes.
• Toxoplasmosis, a parasitic disease, gives a generalized lymphadenopathy
• Hodgkin lymphoma, non-Hodgkin lymphoma, hairy cell leukemia, give lymphadenopathy in all or a few lymph nodes
• Metastasis
• Sarcoidosis
• Systemic lupus erythematosus (SLE)
• Rheumatoid arthritis
• AIDS– generalized lymphadenopathy is an early sign of infection with human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS). “Lymphadenopathy syndrome” has been used to describe the first symptomatic stage of HIV progression, preceding AIDS-related complex and full-blown AIDS.

The health care provider will perform a physical exam, which includes feeling your lymph nodes and looking for signs of injury or infection around any swollen lymph nodes. A biopsy and culture of the affected area or node may reveal the cause of the inflammation. Blood cultures may reveal spread of infection to the bloodstream.

Call your health care provider or go to the emergency room if you have symptoms of lymphadenitis or lymphadenopathy.

Lymphadenitis may spread within hours. Treatment should begin promptly. Treatment may include:

• Analgesics (painkillers) to control pain
• Antibiotics to treat any infection
• Anti-inflammatory medications to reduce inflammation
• Cool compresses to reduce inflammation and pain
• Surgery may be needed to drain an [abscess]].

Treatment of lymphadenopathy depends on the underlying cause (e.g chemotherapy for lymphomas and leukemias, antibiotics for tuberculosis).

Directions to Hospitals Treating Lymphadenopathy

Good general health and hygiene are helpful in the prevention of any infection.

Prompt treatment with antibiotics usually leads to a complete recovery. However, it may take weeks, or even months, for swelling to disappear. The amount of time to recovery depends on the cause. Prognosis is poor for malignant tumors.

• Abscess formation
• Cellulitis (a skin infection)
• Fistulas (seen in lymphadenitis that is due to tuberculosis)
• Sepsis (bloodstream infection)