Lymph Node Disorders

Treatment

The treatment of chronic osteomyelitis in children is somewhat easier in that the child's periosteum is capable of bone regeneration. The basic principle is the same, of eradicating the avascular bone (sequestrum), and providing a means for the limb to regenerate a replacement.

Note!

· Surgical debridement is the mainstay of treatment (it removes the necrotic tissue and provides an infection-free scaffold for future healing).

· It is usually appropriate to delay treatment until culture and sensitivity results are obtained, unless the infection is severe, in which case empirical treatment is started as above.

Inflammation of a lymph node is called lymphadenitis.

Lymphadenopathy is a term meaning "disease of the lymph nodes". Lymphadenopathy is defined as an enlargement or a change in the character of a lymph node.

In practice, the distinction between lymphadenopathy and lymphadenitis is rarely made.

Inflammation of lymph channels is called lymphangitis.

Pathologic lymphadenopathy is usually a symptom of infectious, noninfectious conditions, or, in rare cases, malignant disease.

Lymphadenopathy, especially cervical lymphadenopathy, is quite common in childhood, with a reported prevalence of 28% to 55% in otherwise normal infants and children. In addition, children have palpable nodes in most of the superficial lymphatic basins, including cervical, axillary, and inguinal regions that are non-pathologic; there is progressive increase in lymphoid mass from birth until early adolescence. This lymphoid tissue then normally diminishes throughout puberty.

Many lymph nodes are palpable in children, and generally, cervical nodes less than 2 cm, axillary nodes less than 1 cm, and inguinal nodes less than 1.5 cm are considered physiologic in young children.

Classification / Cause

According to H.L. Ioachim, H. Ratech, 2002 (USA)

¤ Lymphadenitides (acute and chronic inflammatory processes of lymph nodes that occur in response to a variety of pathogenic agents)

Inflammatory pseudotumor of lymph nodes

Viral lymphadenitides

• Infectious mononucleosis lymphadenitis
• Cytomegalovirus (CMV) lymphadenitis
• Herpes simplex virus lymphadenitis
• Varicella-herpes zoster lymphadenitis
• Vaccinia lymphadenitis
• Measles lymphadenitis
• Human immunodeficiency virus (HIV) lymphadnitis, with and without salivary gland invovlvement
• Human immunodeficiency virus (HIV) lymphadnitis of salivary gland invovlvement

Bacterial lymphadenitides

• Non-specific bacterial lymphadenitis (common, non-specific species)
• Cat-scratch lymphadenitis (Afipia felis)
• Bacillary angiomatosis of lymph nodes (Bartonella henselae and B. quintana)
• Lymphogranuloma venereum lymphadenitis (Chlamydia trachomatis)
• Syphilitic lymphadenitis (Trapenosoma pallidum)
• Lymphadenitis of Whipple disease

Mycobacterial lymphadenitides

• Mycobacterium tuberculosis lymphadenitis (TB)
• Atypical mycobacterial lymphadenitis
• Mycobacterium avium-intracellulare lymphadenitis
• Mycobacterium leprae lymphadenitis
• Miscellaneous mycobacterial lymphadenitis

Fungal lymphadenitides

• Cryptococcus lymphadenitis
• Histoplasma lymphadenitis
• Coccidioidomycosis lymphadenitis
• Pneumocystis lymphadenitis

Protozoal lymphadenitides

• Toxoplasma lymphadenitis
• Leishmania lymphadenitis
• Filaria lymphadenitis

Others

• Malaioplakia (most common in the mesenteric lymph nodes)

¤ Lymphadenopathies (Reactive processes of lymph nodes in response to a variety of exogenous and endogenous stimulants)

Reactive lymphadenopathies

• Reactive lymphoid hyperplasia
• Atypical lymphoid hyperplasia
• Progressive transformation of germinal centers

Lymphadenopathies associated with clinical syndromes

• Kimura's lymphadenopathy
• Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease)
• Kikuchi-Fujimoto lymphadenopathy
• Sarcoidosis lymphadenopathy
• Systemic lupus (SLE) lymphadenopahty
• Rheumatoid lymphadenopathy
• Dermatopathic lymphadenopathy
• Angiofollicular lymph node hyperplasia (Castleman disease)
• Angioimmunoblastic lymphadenopahty
• Tumor-reactive lymphadenopathy

Vascular lymphadenopathies

• Lymph node infarction
• Vascular transformation of sinuses
• Nodular spindle cell vascular transformation of lymph node

Foreign body, iatrogenic or drug induced lymphadenopatheis

• Proteinaceous lymphadenopathy
• Lipid lymphadenopathy
• Lymphangiography-associated lymphadenopathy
• Silicone lymphadenopathy
• Gold lymphadenopathy
• Lymphadenopathy of metal debris associated with joint prostheses
• Methotrexate induced lymphadenopathy
• Anticonvulsants induced lymphadenopathy

Дата добавления: 2014-10-15