Axillary lymphadenitis: what is this disease? What causes axillary lymphadenitis

Axillary lymphadenitis is an inflammation of the lymph nodes caused by staphylococcus and streptococcus bacteria that enter them from soft tissue phlegmon or panaritium. Much less often, inflammation occurs due to the direct entry of bacteria directly into the lymph nodes through trauma to the skin.

Lymph nodes located in the armpits are a filter lymphatic vessels shoulder girdle, arms, abdominal organs (those located above the navel) and chest organs, which are sources of infection spreading through them to the armpits.

Causes of axillary lymphadenitis

The main causes of axillary lymphadenitis are such sources of infections in the body as:

• Phlegmon;
• · Infected abrasions and wounds;
• · Osteomyelitis;
• · Trophic ulcers;
• · Erysipelas;
• Furuncles.

Also, inflammation of the lymphatic vessels can be the cause of inflammation of the lymph nodes. The causative agents of axillary lymphadenitis in most cases are:

• · coli;
• · Proteus;
• Streptococci and their toxins;
• · Enterococci and their toxins;
• · Staphylococci and their toxins;
• Decomposition products of tissues of the primary focus of inflammation.

Symptoms of axillary lymphadenitis

Symptoms of axillary lymphadenitis are expressed differently depending on the form of the course of the disease. In acute axillary lymphadenitis, the symptoms are severe pain syndrome, fever body and enlarged lymph nodes. In cases of destructive forms of axillary lymphadenitis (purulent inflammation), symptoms of intoxication appear.

In the chronic form of the disease, only an increase and cohesion between the lymph nodes is observed. simple form inflammation, which is not accompanied by a purulent process, proceeds with a limited focus of inflammation within the boundaries of the formation capsule. The development of destruction leads to the fact that the inflammation begins to spread to the surrounding tissues.

Severe forms of axillary lymphadenitis lead to the development of a purulent-inflammatory process of cellular tissue (adenophlegmon) with softening foci, which, with ineffective or untimely treatment, spread further with the development of septicopyemia or thrombophlebitis. A breakthrough of pus outer part can eventually lead to the formation of lymphatic fistulas.

Treatment of axillary lymphadenitis

After confirming the diagnosis of axillary lymphadenitis and determining the cause of inflammation, the doctor determines the stage at which the disease is located and selects the type of treatment.

Axillary lymphadenitis in the initial stage of development can be treated with conservative treatment, with parallel general strengthening procedures, physiotherapy and the use of broad-spectrum antibiotics, and cold compresses are applied to the inflamed nodes.

In the treatment of axillary lymphadenitis with purulent inflammation, surgical intervention is necessary. The operation consists of opening the lymph node and removing purulent masses from it, after which drainage is performed. The operation is followed by a therapeutic treatment based on the principles used in the treatment of purulent wounds.

When treating specific axillary lymphadenitis, the doctor takes into account whether there are foci of inflammation in other organs, and traces the general tuberculous process. Treatment of axillary lymphadenitis of this type can last several months and, in addition to antibiotic therapy, includes chipping the affected node and applying ointment dressings. If a purulent infection occurs, then the doctor prescribes additional application broad spectrum antibiotics.

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Lymphadenitis in children is an inflammatory process that attacks the lymph nodes in the child's body. Recovery occurs quickly at the beginning of the disease, as the inflammation spreads, it becomes more difficult to cure.

The most common cause of lymphadenitis in the neck, groin, under the arm, behind the ear or other area is a disease of the body. In young children, lymph nodes are palpated near the ear, groin, and on the back of the head. Lymph nodes under the ear are often inflamed and infectious processes acute or chronic.

When the infection enters the lymph node, it enlarges and becomes inflamed due to the large concentration of cells that respond to the inflammatory response exactly where the bacterium ended up. Several nodes can become inflamed, or one even in infants in the first year of life.

cervical

Submandibular

Submandibular lymphadenitis occurs in oral cavity due to diseases such as caries, or gum disease. Therefore, in order to avoid submandibular lymphadenitis it is necessary to carefully monitor the oral cavity.

inguinal

Inguinal lymphadenitis is also common in children, but it is much less common than in adults due to infection sexually transmitted diseases. In this case, the nodes located in the groin become inflamed. The child has inguinal lymphadenitis occurs in case of injury or if the immune system is weakened.

axillary

disease under the arm occurs as a result of inflammation of the tonsils or caries. AT axillary node, bacteria that are carried by lymph enter from the chest, shoulder, and those on the neck, under the ear, eventually forming lymphadenitis in children under the arm.

parotid

Near the ear, parotid lymphadenitis may form. The disease can be caused by trauma to the ear, which subsequently turns into a purulent process. Also, the cause of enlarged knots under the ear can be the extrusion of an eel on the neck or on the face with dirt entering the wound. Lymphadenitis under the ear is considered the most dangerous, as it leads to meningitis.

mesenteric

Mesenteric lymphadenitis is formed in the mesenteric nodes. This disease is common in children in the upper respiratory tract. At the same time, the tonsils become inflamed, as with lymphadenitis in the area under the arm.

Symptoms

Before starting the treatment of lymphadenitis in children, it is necessary to undergo a diagnosis, take a blood test and determine the stage of the disease, as well as its type. The level of intoxication is also determined. Based on this, treatment is aimed at stopping infectious and inflammatory processes in the lymph nodes eliminated the primary foci of infectious disease.

Usually, with lymphadenitis in a child, the lymph nodes in the neck, near the ear and in the face area suffer. Most often, the submandibular region is affected and rarely the inguinal region.

In the process of acute lymphadenitis, it can form chronic form diseases, in the event that weakly virulent microorganisms are the cause. Symptoms chronic disease- enlarged lymph nodes, dense to the touch, inactive, elastic, pain symptoms missing. Purulent process does not develop. If the patient has a focus chronic infection which supports for a long time sluggish disease, lymph nodes gradually disintegrate and are replaced by granulation tissue.

Symptoms associated with tuberculous lymphadenitis are marked by inflamed lymph nodes in the neck. As a rule, the lymph nodes are collected in one bag, which is dense and painless, similar to a collar. Such symptoms are complicated by caseous decay, the formation of fistulas, scars appear on the skin.

Reactive lymphadenitis associated with TB vaccination has symptoms in the form of enlarged lymph nodes under the arms.

1-3 days after illness

On the third day after the disease, lymphadenitis is very painful, and the lymph nodes increase in size and become dense to the touch. General well-being is not violated.

3-5 days after illness

On the 3-5th day of the disease, acute lymphadenitis turns into purulent. The main signs of this stage are the deterioration of the general condition of the child, intoxication is noticed, the body is shivering, the temperature rises to 40 ° C, the head hurts, general malaise, weakness. There may also be symptoms of loss of appetite, insomnia. At the site of the affected nodes, there is a pulling and shooting pain, the skin swells. In this case, adenophlegmons can develop and a purulent process begins outside the lymph node. Adenophlegmons in the submandibular zone or ear area are complicated by thrombosis of the cavernous sinus and sepsis.

Treatment

Treat acute and chronic lymphadenitis necessary using conservative therapy, which includes antibiotics, including Sumamed, semi-synthetic penicillins and cephalosporins. Vishnevsky ointment, various compresses, dry heat are also prescribed. Intended for use and vitamins, medicines strengthening immune system sick.

Ointment Vishnevsky

Vishnevsky's ointment contains in its composition special components that have antiseptic properties, as a result of which they are destroyed harmful microorganisms. Treatment can provide irritant effect on receptors, the regeneration process will be quick and efficient.

Ointment is used together with other medical events, how additional treatment inflamed lymph nodes. As a rule, Vishnevsky's ointment is used for long non-healing wounds if there are abrasions or ulcers, as well as with bedsores.

Vishnevsky ointment is applied to the inflamed skin surface with visible wounds and lesions.

Antibiotics Sumamed

Sumamed is a broad-spectrum antibiotic. Usually, the drug is used for infection in the body of a child, which was caused by pathogenic microflora. Apply sumamed once a day one hour before eating. In addition, Vishnevsky's ointment is used. Sumamed should be used daily at the same time. Treatment takes place during three days however, the ointment needs to be used longer.

Sumamed should be used with caution in those patients who are susceptible to or have either hepatic impairment.

Before treating inguinal lymphadenitis, enlarged nodes on the neck, behind the ear or in another area of ​​the body, it is necessary to consult a doctor, take a blood test. It should also be taken into account side effects that may occur after taking the drug Sumamed: punctate rash on the body, abdominal pain or dyspeptic disorders.

Effects

Properly prescribed treatment after a blood test has been taken and a thorough diagnosis of the lymph nodes near the ear or on another part of the body has been completed leads to a complete recovery. The patient will recover completely and the body will not feel any further negative consequences.

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If you start to treat the child untimely, the disease can lead to the appearance of purulent foci in individual tissues and organs. You may even need surgery.

In addition, if the disease is strongly started and the lymph nodes near the ear, groin or under the back of the head begin to increase, then thrombophlebitis with pus may develop, in which the veins in the affected area of ​​​​the body become inflamed. Disease complicated by clogging of the pulmonary vessels with parts of blood clots and pus, which entered through the blood stream.

- this is inflammatory response lymph nodes in response to local or general pathological processes in the body. Serous lymphadenitis in children, it proceeds with an increase, compaction, soreness of the lymph nodes; purulent lymphadenitis is accompanied by local (hyperemia, edema) and common symptoms (sharp deterioration feeling, fever). The diagnosis of lymphadenitis in children is established on the basis of a clinical examination, general analysis blood, ultrasound and puncture of the lymph nodes. In the treatment of lymphadenitis in children, conservative tactics are used (antibacterial, desensitizing, detoxification therapy, local applications, UHF) or surgical opening and drainage of a purulent focus with the obligatory elimination of the primary source of infection.

In some cases, lymphadenitis in children may be associated with blood diseases (acute and chronic leukemia), tumors of the lymphoid tissue (lymphosarcoma, lymphogranulomatosis), as well as traumatic injury the lymph nodes themselves. Lymphadenitis is usually observed in children with lymphatic-hypoplastic diathesis, often suffering from acute respiratory viral infections, with a history of concomitant herpesvirus infections (CMV, Epstein-Barr virus) and chronic diseases GIT.

Classification

Depending on the type of pathogen, nonspecific and specific lymphadenitis is isolated in children, which can have an acute (up to 2 weeks), subacute (from 2 to 4 weeks) or chronic (more than a month) course. The nature inflammatory changes lymphatic glands in children distinguish between serous (infiltration), purulent, necrotic (with melting nodes) lymphadenitis and adenophlegmon.

According to the focus of the lesion, lymphadenitis in children is divided into regional (cervical, submandibular, axillary, inguinal, etc.) and generalized; on etiological factor- odontogenic (associated with the pathology of the dentoalveolar system) and non-odontogenic.

Symptoms

As a rule, lymphadenitis in children affects the lymph nodes in the face and neck (most often - submandibular and cervical on one or both sides, less often - parotid, buccal, occipital, behind the ear), in some cases - axillary, inguinal.

The serous stage of acute nonspecific lymphadenitis in children (1-3 days of the disease) is manifested by painful, noticeably enlarged and tightly elastic to the touch regional lymph nodes, without loss of their mobility and development of local skin reaction. The general condition of the child is not disturbed, the temperature ranges from normal to subfebrile values.

Transition of acute lymphadenitis to purulent stage(3-6 days of the disease) proceeds with pronounced local features and a sharp deterioration in the well-being of children. Signs of intoxication are observed: chills, heat(up to 40ºС), headache, great weakness, lack of appetite and sleep disturbance. In the area of ​​the affected lymph nodes, intense pulling or shooting pains, periadenitis, local hyperemia and swelling of the skin occur. Perhaps the development of adenophlegmon with the appearance of foci of fluctuation and the release of purulent inflammation outside the lymph node. Adenophlegmons maxillofacial region may be complicated by cavernous sinus thrombosis, mediastinitis, sepsis.

The chronic form of lymphadenitis in children may develop primarily if the pathogens are weakly virulent microorganisms, or become a continuation acute form diseases. At chronic course without exacerbation, the lymph nodes are enlarged, limited in mobility, rather dense, but painless; the child's health is not disturbed; suppuration rarely develops. If a child has a focus of chronic infection that maintains sluggish lymphadenitis for a long time, the lymph nodes are gradually destroyed and replaced by granulation tissue.

Tuberculous lymphadenitis in children has a long course, usually limited to the cervical group of lymph nodes, collected in a dense, painless, significant package, similar to a collar. Tuberculous lymphadenitis in children can be complicated by caseous decay, the formation of fistulous tracts, cicatricial changes in the skin.

Specific lymphadenitis associated with vaccination against tuberculosis (“becezhite”) may develop in children with low and altered general reactivity, manifesting as a chronic calcific caseous lesion. axillary lymph nodes. Generalized lymphadenitis in children is observed with disseminated pulmonary tuberculosis and chronic tuberculous intoxication; accompanied by characteristic fibrosis of the nodes ("glands-pebbles").

Diagnostics

Diagnosis of lymphadenitis in children includes a thorough physical examination, assessment clinical picture and anamnesis of the disease, research clinical analysis blood, ultrasound of the lymph nodes and a number of additional differential diagnostic studies. Identification of lymphadenitis in children may require examination by doctors of various specialties: pediatrician, infectious disease specialist, pediatric otolaryngologist, hematologist, surgeon, phthisiatrician.

During the diagnosis, it is necessary to establish the etiology of lymphadenitis in children, to identify primary focus purulent inflammation. Helper Methods tuberculous lymphadenitis in children are tuberculin tests, chest x-ray, diagnostic puncture and bacteriological culture material. If you suspect oncological process biopsy of lymph nodes with cytological and histological examination fabrics.

Differential diagnosis of lymphadenitis different localization in children is carried out with UHF). General strengthening drugs are shown - calcium gluconate, ascorutin, vitamins, immunostimulants.

In the absence of the effect of therapy or the transition of lymphadenitis to a purulent stage, the child is hospitalized and an emergency opening, drainage and sanitation of the purulent focus is performed. In the case of necrotic lymphadenitis in children, a thorough curettage of the cavity is performed, if necessary, the lymph node is removed. AT postoperative period shows complex anti-inflammatory and detoxification therapy. Treatment of specific tuberculous lymphadenitis in children is carried out in specialized medical institutions.

Forecast and prevention

Forecast of lymphadenitis in children with timely adequate treatment- favorable, with a long chronic course, it is possible to replace lymphoid tissue with connective tissue; sometimes in the area of ​​the affected lymph nodes, a violation of the lymph outflow develops (lymphostasis

Purulent inflammation of the lymph nodes, localized directly in armpit and causes axillary lymphadenitis. Feature disease concludes that axillary lymphadenitis is a typical complication of various purulent-inflammatory diseases, and does not develop as a pathology on its own.

AT rare cases when a lymph node is infected, for example due to injury or trauma, the disease can be considered primary. Literally from ancient Greek, axillary lymphadenitis has the following meaning: lymph - liquid, aden - gland, itis - inflammatory process. Thus, axillary lymphadenitis is inflamed lymph nodes in the armpit. Localization of inflamed lymph nodes in the groin area is possible.

According to the structure of the disease, axillary lymphadenitis is divided into two subspecies: catarrhal or serous and purulent. The development of nonspecific lymphadenitis is possible during various inflammatory processes. The course of inflammatory processes is determined by characteristic changes in the lymph nodes, namely, an increase in size, pain when touched, easy mobility, plastic consistency, isolated state of the lymph nodes.

Usually, serous inflammation lymph nodes is accompanied by their increase, their sensitivity and soreness increase, despite the fact that the general condition of the patient is outward signs practically does not change. The skin does not change and is not soldered to the seals of the nodes. In the case when the disease lasts for a long time, it is likely that the patient will find inflamed areas of the lymph nodes, in the form of "packages".

The purulent form of axillary lymphadenitis is characterized by pronounced painful sensations in the area of armpit, its color changes skin, redness and swelling appear, hyperthermia is also possible. Lymph nodes have a blurred outline and adhesions to the surrounding tissue, as well as to each other. The general condition of the patient worsens significantly, against the background of general malaise tachycardia, fever, severe headache, chills, fast fatiguability. Delayed treatment, in most cases, entails the development of an advanced form of the disease, possible complications, for example, thrombophlebitis, abscess, adenophlegmon, in more severe cases generalized infection - sepsis.