Lymphadenitis in children
Lymph nodes are essential for the human body. They contain lymphocytes, which form the basis of the immune system. Vessels depart from the lymph nodes that extend to the glands, spleen, and thymus. Together, they provide the body's immune response.
The blood lymph flows to the lymph nodes. In them, she is cleared of infection and receives a set of antigens. This allows the body to start the process of producing antibodies against a specific pathogenic flora. When a person is faced with this infection again, his body will be ready to resist it. Therefore, almost all diseases of an infectious nature lead to an increase in lymph nodes in size.
- Features of lymphadenitis in children
- Causes of lymphadenitis in children
- Treatment of lymphadenitis in children
- Tips from Dr. Komarovsky
- What can not be done with lymphadenitis?
Features of lymphadenitis in children
In a newborn baby, it is impossible to palpate the lymph nodes. Their structure begins to change as the child grows up and encounters pathogenic flora. The lymph nodes located in the armpits and on the neck increase up to 10 mm. The knots in the groin reach 15 mm. If they do not exceed the indicated sizes, then they do not talk about lymphadenitis. Other lymph nodes cannot be felt (provided that the person is healthy).
In children, lymphadenitis develops against the background of infection of the body. Also, cancers and autoimmune processes can lead to inflammation.
With acute lymphadenitis, the patient's condition worsens. The nodes begin to ache, the dermis that covers them turns red. If you touch it, you can feel the heat. Purulent inflammation will be indicated by pulsation in the area of the lymph node.
If a cancer neoplasm grows in a person's body, then the lymph nodes will not hurt. However, they become unnaturally tough. It is difficult to move them as they will be soldered to the dermis. In some cases, several nodes merge into one large conglomerate.
Causes of lymphadenitis in children
Infectious diseases can lead to lymphadenitis, including:
- Infectious mononucleosis
- Tonsillitis and pharyngitis. Ingestion of staphylococci and streptococci. These microorganisms often cause tonsillitis, against which a person develops lymphadenitis.
- Felinosis or cat scratch disease
- Human immunodeficiency virus as well as AIDS
- SLE (systemic lupus erythematosus)
- Rheumatoid arthritis
- Kawasaki disease
- Malignant Granuloma (Hodgkin's Lymphoma)
- Non-Hodgkin's lymphoma
Sometimes lymphadenitis develops while undergoing therapy with certain drugs.
Infectious mononucleosis as a cause of lymphadenitis in children
In childhood and adolescence, a viral disease such as infectious mononucleosis is often diagnosed. It is provoked by the Epstein-Barr virus.
You can recognize an infection by swollen lymph nodes, liver, and spleen. Sometimes a plaque appears on the tonsils, a person develops tonsillitis. In some cases, the disease is accompanied by skin rashes.
If there are no obvious symptoms of the disease, then for the diagnosis it is necessary to donate blood for the determination of antibodies in the disease.
Mononucleosis is a benign blood tumor. With disease, monocytes begin to divide at a high rate. There is scientific evidence that this infection can lead to cancerous tumors (nasopharyngeal tumor, lymphogranulomatosis, Burkitt's lymphoma). In this regard, patients with mononucleosis and persistent lymphadenitis are subject to high-quality examination.
Rubella is a viral disease that develops in children. It will be indicated by a slight increase in body temperature, enlarged lymph nodes (in the neck and at the back of the head), as well as a pink rash on the face. Rubella is insidious in that it takes up to 21 days from the moment of infection to the onset of the first symptoms. During this period, the child is already contagious and transmits the viral infection to other children.
Often the rash and fever are mild, so they go unnoticed by the parents. Attention is drawn to the enlarged lymph nodes. The patient is not given therapy, he is simply observed. To prevent the child from contracting rubella, he is vaccinated against this disease.
Read more: Rubella symptoms and treatment
This disease develops during childhood. Measles is rare today, as there is an effective vaccine for it. However, unvaccinated children remain at risk. The infection spreads rapidly through the air with particles of mucus and saliva. If the child has not been vaccinated, then he will definitely get sick.
After infection, it takes 12 days until the first symptoms of the disease appear. During this period, a person is already contagious to others. Then his body temperature rises, cough, rhinitis, conjunctivitis develops. On the 2nd day from the manifestation of the first symptoms, the child's cheeks are covered with a rash. The spots are whitish, bordered with a red rim. After a day, they disappear. The body temperature rises to extremely high levels (up to 40 ° C). At the same time, new spots and papules appear on the face. The next day, a rash can be found on the trunk, and after 3 days even on the feet. The rash then becomes pale. After it disappears, bruises remain on the skin.
Lymph nodes with measles increase in size. They protrude under the jaw, around the neck, and elsewhere.
Therapy is reduced to taking medications to lower body temperature. To prevent the development of the disease, the child must be vaccinated. Measles can cause serious complications and even death.
Read more: Causes and symptoms of measles
Tonsillitis and pharyngitis
Group A streptococci can provoke inflammation of the oropharynx and tonsils. They cause not only angina, but also rheumatism, glomerulonephritis, scarlet fever. Outbreaks of infection are observed in organized children's groups. The bacterium spreads quickly, transmitted by airborne droplets and by contact. However, if a child begins to receive antibacterial drugs on time, then in a day he becomes not dangerous to the people around him.
Streptococcal pharyngitis will be indicated by an intense sore throat, its redness, an increase in body temperature and an increase in cervical lymph nodes in size. The diagnosis can be confirmed with the Seeding Tank. Mucus is taken from the throat. The study is carried out with a massive outbreak of infection in kindergarten. Pediatricians have compact tests available to quickly detect bacteria. It is enough to apply mucus from the child's throat to the reagent.
Streptococcal infections are treated with antibiotics. In this case, drugs of the penicillin group are used.
Staphylococci and streptococci can cause inflammation of the ears, eyes, gums. In this case, the patient may develop lymphadenitis of the corresponding localization.
Read more: Tonsillitis in adults - causes, symptoms and treatment
Felinosis is called cat scratch disease. It is provoked by bacteria. The disease leads to prolonged inflammation of the lymph nodes. It lasts for 3 weeks. Most often, it is children who are scratched or bitten by a kitten who are sick. The first symptoms of infection develop after 1–2 weeks. Papules appear in the wound area. In size, they reach 5 mm. After 7-30 days, the lymph nodes begin to become inflamed. They hurt, the skin over them turns red, sometimes they suppuration. Body temperature rises in 1/3 of patients.
An infection can be detected by a laboratory method, but in practice it is not often used. As a rule, the disease disappears after a few months without any treatment. Antibacterial drugs do not affect the recovery time. It is not recommended to sanitize lymph nodes with an operative method, since wounds heal for a long time. Therefore, when other infectious and tumor processes are excluded, you just need to be patient and wait for the body to recover on its own. In rare cases, this can take up to a year.
HIV and AIDS
The immunodeficiency virus infects human immune cells. Any illness will be difficult, since the defenses of such people are reduced. Children are most often infected from sick mothers during childbirth. Sometimes infection occurs through a transfusion of infected blood.
HIV develops rapidly in childhood. A child who does not receive treatment dies within 2-4 years.
Adolescents who become sexually active or who inject drugs can become infected with HIV.
In this regard, the age of 14-19 is dangerous. Mild manifestations of HIV in children:
- Inflammation of the salivary glands.
- An increase in the size of the liver and spleen.
- Otitis, skin diseases, sinusitis.
Moderate HIV symptoms:
- Oral thrush, which cannot be eliminated for a long time.
- Persistent diarrhea.
- A persistent increase in body temperature that lasts more than a month.
The severe course of the disease is manifested by such disorders as:
- Severe infections that recur 2 times in 2 years (meningitis, blood poisoning).
- Bronchial and esophageal candidiasis.
- Toxoplasmosis of the brain.
If a child has long-term inflammation of the lymph nodes in combination with other symptoms described above, it is necessary to donate blood for HIV. The study is carried out by ELISA (detection of antibodies to the virus) and PCR (detection of the virus itself).
It will not be possible to get rid of HIV. However, all sick children should receive special drugs that reduce the activity of the virus and prolong life. Children should receive routine vaccines against other diseases without fail. However, it is forbidden to vaccinate patients with drugs that contain live components.
Toxoplasmas are the simplest microorganisms that can enter the human body through the mouth, through the blood, or be transmitted to a child from a sick mother. Cats carry the infection. You can also get infected by eating meat that has not been sufficiently heat-treated. If the child is healthy, then his illness proceeds without any symptoms. The only way to get rid of the infection is by ELISA. Minor lymphadenopathy is sometimes observed.
Other symptoms of toxoplasmosis include:
- Increased body temperature.
- Skin rashes.
- Muscle pain.
- Enlargement of lymph nodes and liver in size.
- Brain damage.
The illness can last for several months. If her symptoms are mild, then therapy is not carried out. A severe course of infection is observed with reduced human immunity. In this case, the patient is prescribed drugs. Therapy should be given to children with HIV and congenital toxoplasmosis.
Tuberculosis is widespread in Russia. Therefore, the likelihood of infection remains high.
Symptoms of pulmonary tuberculosis:
- Excretion of sputum with blood during coughing.
Pain in the chest area.
Tuberculosis can have extrapulmonary localization.
In this case, his symptoms will be as follows:
- Lymphadenopathy of many lymph nodes. Most often, they increase in the upper body.
- Bone pain.
- The appearance of nodules on the skin.
- Ulceration of mucous membranes.
When mycobacterium tuberculosis enters the child's respiratory system, there are no symptoms of infection. The disease develops gradually. In the early stages, it cannot be detected even with an x-ray. Tuberculosis can be detected using the Mantoux test. The chance of infection in infants is 40%. At an older age, latent tuberculosis does not often turn into a disease.
To reduce the likelihood of infection, you need to vaccinate the child with the BCG vaccine. It allows you to prevent the development of a severe form of pathology. Disease therapy is extended in time. In this case, several drugs can be used at once (Rifampicin, Isoniazid, etc.). In a truncated form, treatment is carried out for children with a bend.
Tumors such as non-Hodgkin's lymphoma, Hodgkin's lymphoma, leukemia can lead to lymphadenitis. These are the most common cancers that occur in childhood. However, inflammation of the lymph nodes is observed in any cancerous tumor (neuroblastoma, Wilms' tumor, tumors of the bone tissue, thyroid glands, genitals). Therefore, if an enlarged lymph node is found, it is necessary to consult a doctor and undergo a diagnosis.
Lymphogranulomatosis. Hodgkin's lymphoma is one of the most common cancers in children under 15 years of age. Until now, it has not been possible to find out the reason for its development, but the Epstein-Barr virus plays a definite role in this regard. Cancer cells form in lymphoid tissue. Then they spread to the lymph nodes located in the immediate vicinity. This leads to their pathological changes. The prognosis with the timely start of treatment is quite favorable.
The main symptoms of Hodgkin's lymphoma include:
- An increase in lymph nodes in size. However, they do not respond to pain.
- On palpation, the nodes are dense, sometimes they can become very large. Lymph nodes located on the neck and above the collarbone are primarily affected.
- An increase in the size of the liver and spleen is possible.
- The patient's body temperature rises, general symptoms of intoxication occur.
- The child sweats a lot at night.
- Complications of lymphogranulomatosis include respiratory failure, heaviness in the chest, deterioration in liver performance, and impaired renal function. Sometimes the patient develops serious illnesses such as tuberculosis.
If the child has enlarged lymph nodes for a long time, but the connection with infectious diseases cannot be traced, then he must be examined for Hodgkin's lymphoma. The patient is prescribed a chest x-ray. In the picture, it will be possible to visualize a volumetric formation, which disappears after undergoing therapy.
Lymph node biopsy and examination of the biopsy specimen are also indicated.
Therapy for Hodgkin's lymphoma depends on the stage of the disease. It is determined by the number of affected lymph nodes, as well as the intensity of other symptoms (fever, exhaustion, etc.). Treatment involves several courses of chemotherapy. If the disease recurs, then drugs with enhanced action are used. They also resort to blood stem cell transplantation.
The forecast is quite favorable. After the first course of treatment, recovery occurs in 60% of children.
Non-Hodgkin's lymphoma. The disease develops due to the fact that the body loses control over the division of lymphocytes. In African countries, it is the Epstein-Barr virus that leads to blood disease in 50% of cases. On other continents, this pattern is not observed.
There are many non-Hodgkin lymphomas. The most common of these is Burkitt's lymphoma, as well as lymphoblastic and large cell lymphomas.
Burkitt's lymphoma symptoms:
- Abdominal pain.
- Intestinal obstruction.
- Diarrhea or stool retention.
- Intestinal bleeding.
- Damage to the brain and spinal cord.
The following symptoms will indicate lymphoblastic lymphoma:
- Increased shortness of breath.
- Chest pain.
- Problems swallowing food.
- Cervical and axillary lymphadenitis.
- Damage to the brain and spinal cord.
With large cell lymphoma, symptoms of Burkitt's lymphoma and lymphoblastic lymphoma appear, but the brain and spinal cord are not affected.
To detect the disease, a puncture of the lymph nodes, tumor neoplasms, and the dermis is required. In parallel, the patient is prescribed CT and MRI, a puncture of the spinal cord.
Treatment is reduced to a chemotherapy course. If the disease progresses over a long time, then treatment can last up to 2 years. The survival rate varies between 50-95%.
Leukemia. Leukemia is the most common neoplastic pathology diagnosed in children. There are many types of leukemia, but all of them are characterized by uncontrolled division of blood cells. Cells undergo mutations, therefore they are not able to perform their functions normally. If the disease is not treated, then soon all blood cells will undergo pathological changes.
Symptoms of leukemia developing in a child:
- Increased fatigue.
- Lack of desire to eat.
- Pain in the limbs.
- Swelling of the joints.
- Pale skin.
- Bleeding from the nose. It happens often.
- Bruising on the skin without prior soft tissue injury.
- Enlargement of the liver and spleen in size.
To detect leukemia, the child is prescribed blood and bone marrow tests. This will reveal a decrease in the level of erythrocytes and platelets, a change in the number of leukocytes, the detection of leukemic cells.
You can cope with the disease with a course of chemotherapy. The prognosis depends on the stage of development of the disease and the age of the child. The probability of a full recovery is equal to 60-90%.
Autoimmune diseases, vasculitis
Systemic lupus erythematosus. It is an autoimmune disease, the nature of which remains unclear. In the patient's body, a restructuring of the immune system takes place and his cells begin to attack their internal structures. Aggression manifests itself in relation to the kidneys, skin, and the central nervous system. The disease can have a long course and not manifest itself for a long time. Sometimes it aggravates, which can lead to the death of the patient.
The symptoms of lupus erythematosus are as follows:
- An increase in lymph nodes in size.
- Increased body temperature.
- Joint pain due to inflammatory response.
- Kidney dysfunction.
- The appearance of red spots on the face, which merge and begin to resemble a butterfly.
- Inflammation of the brain, seizures, stroke.
- Chest pain.
- Pale skin.
- Increased fragility of blood vessels.
To determine the diagnosis, you will need to donate blood for antinuclear bodies, LE cells, antibodies to DNA. Therapy is reduced to taking corticosteroid hormones. These drugs can help slow the progression of the disease. If the pathology has a severe course, then the patient is prescribed cytostatics.
The prognosis is determined by the aggressiveness of immune cells and the degree of damage to internal organs.
Kawasaki disease. The disease occurs throughout the world, but most often it is recorded in Asian countries. In past years, this pathology was called mucocutaneous lymph node syndrome. Scientists failed to find out the cause of its occurrence, but there are suggestions that the disease has an infectious etiology.
Children under the age of 5 suffer from Kawasaki disease. It is extremely rare that it develops in adolescents and adults. The lesion is primarily the blood vessels, which are responsible for nourishing the heart muscle.
Symptoms of a developing pathology:
- Increase in body temperature to febrile levels. Antibacterial drugs do not have the desired effect. This temperature lasts for several weeks. The longer the period of the hyperthermic reaction, the higher the likelihood of damage to the cardiac collaterals.
- The mucous membranes of the mouth and organs of vision turn red.
- The tongue resembles strawberries.
- A rash appears on the body.
- Legs and arms swell, redden.
- The lymph nodes on the child's neck reach 15 mm in size.
- After the extinction of the main symptoms, there is a pronounced dryness of the skin.
When the acute phase of the disease has passed, complications begin to pose a danger. They are manifested by arthritis, meningitis, hepatitis, otitis media, thrombosis and heart attack.
The diagnosis must be thorough, as the symptoms of the disease resemble scarlet fever, measles and other less dangerous infections. Blood biochemistry and ultrasound of the heart are required.
To prevent myocardial infarction, the patient is prescribed aspirin and drugs to destroy blood clots. If the damage to the cardiovascular system is serious, then the child is referred for surgery.
Other autoimmune diseases, for example, scleroderma, rheumatoid arthritis, etc., can provoke lymphadenitis in children.
Lymphadenopathy while taking medications
Sometimes lymphadenitis in children develops while undergoing therapy with certain drugs. The following drugs can provoke such a side effect: Penicillin, Captopril, Phenytoin, Carbamazepine, etc. In some cases, lymphadenitis is a symptom of an allergic reaction of the body to a particular drug.
Many parents, noticing their child's enlarged and inflamed lymph nodes, as well as his tendency to frequent acute respiratory viral infections, suggest that the baby is developing immunodeficiency. They start taking him to hospitals and giving him various drugs. You should not do this.
If a child really develops an immunodeficiency, then it will manifest itself with the following symptoms:
- Bacterial infections that are severe and occur at least 2 times a year. In this case, we are talking about meningitis, blood poisoning, osteomyelitis.
- The defeat of the respiratory system by the bacterial flora, as well as bacterial tissue infections, which occur more often 3 times a year.
- Localization of the focus of infection in the brain and liver.
- Diseases caused by rare pathogens, for example, aspergillus.
- Any diseases are difficult for a child.
Treatment of lymphadenitis in children
Lymphadenitis does not require treatment. If the child's lymph nodes are slightly inflamed, then this is not a reason for taking antibiotics. When the infection that led to lymphadenitis has passed, the nodes will repair themselves. If they remain enlarged for a long time, then the child should be checked for oncopathology.
With suppuration of the lymph node, its surgical opening is required. In parallel, the patient is prescribed anti-inflammatory drugs. Suppuration is indicated by pulsation in the area of inflammation, increased body temperature, hyperemia of the skin over the node. If such symptoms appear, you should consult a surgeon.
Lymphadenitis can indicate various pathologies of both infectious and non-infectious nature. A physical examination will allow you to determine the cause of the inflammation of the lymph nodes and begin treatment, if necessary.
Tips from Dr. Komarovsky
Komarovsky EO is of the opinion that there is no need to treat lymphadenitis in childhood. He points out that the lymph nodes from time to time become inflamed in every child. You should not worry about this.
It is important to donate blood for analysis 2 times a year in order to exclude the possibility of any pathological processes in the body.
What can not be done with lymphadenitis?
With lymphadenitis, it is forbidden to perform the following manipulations:
- Lymph nodes should not be heated. This can lead to serious complications, up to and including suppuration of the node and sepsis.
- You can not take a hot bath, visit the sauna or bath.
- Do not take medicines without medical advice.
- You can not use folk remedies.
- It is forbidden to take vitamin complexes and immunomodulators, unless prescribed by a doctor.
- You cannot resort to non-traditional methods of treatment.
To avoid serious health complications, you should not self-medicate.
To prevent the development of lymphadenitis, the following recommendations must be observed:
- Eliminate all situations in which the child could be injured.
- Treat wounds and abrasions efficiently using antiseptic compounds.
- If the child is scratched, an antiseptic patch should be applied to the wound.
- It is necessary to visit the dentist once every 6 months.
- You need to brush your teeth 2 times a day.
- It is important to strengthen the immune system: take vitamins, temper, play sports and walk in the fresh air as often as possible.
Compliance with hygiene rules will reduce the likelihood of lymphadenitis to a minimum. Therefore, they need to be vaccinated in a child from childhood.
The author of the article: Sokolova Praskovya Fedorovna | Pediatrician
Education: Diploma in the specialty "General Medicine" received at the Volgograd State Medical University. A specialist certificate was immediately received in 2014.
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