What Is Lymphadenitis? What Are Its Symptoms? Is It Cancer?

Lymphadenitis is an infection that occurs in one or more lymph nodes. These infections in the lymph nodes can cause swelling and severe pain, and symptoms may also include chills and fever.

What Is Lymphadenitis?

Lymphadenitis, generally caused by a bacterial, viral or fungal infection, means swelling of one or more lymph nodes. Swollen lymph nodes may be hard, tender and more noticeable than usual.

A person with swollen lymph nodes has lymphadenopathy, and swollen lymph glands are not always a disease, although they may cause symptoms. In contrast, lymphadenitis means that the lymph nodes have an infection that requires treatment. These are two different conditions.

Lymphadenitis can also mimic other diseases. For example, mesenteric lymphadenitis (inflammation of the lymph nodes in the abdomen) causes symptoms similar to those of appendicitis, and the two conditions may be confused.

Lymphadenitis is not cancer or a precancerous growth.

What Are the Types of Lymphadenitis?

Lymphadenitis can affect a single lymph node or multiple lymph nodes.

During an infection, a person is likely to develop lymphadenitis near the infection, either at that time or afterward. For example, a person with an ear infection or strep throat may have lymphadenitis in the lymph nodes of the neck.

If the infection enters the bloodstream, it can also affect other lymph nodes. Lymphadenitis can most commonly arise from the following causes:

• Ear infection
• Common cold
• Skin infection
• Tooth infection

Acute or Chronic Lymphadenitis

Lymphadenitis is classified as acute or chronic. Caused by an infection such as a sore throat, acute lymphadenitis lasts less than 2 weeks. Chronic lymphadenitis may be caused by a longer-lasting viral infection such as mononucleosis or, in rare cases, cancer, and may last 6 weeks or longer. Subacute lymphadenitis lasts 2-6 weeks and develops in a similar way to chronic lymphadenitis.

What Does Nonspecific Lymphadenitis Mean?

Nonspecific lymphadenitis is a condition with many possible causes that presents with swollen lymph nodes and sometimes pain. “Nonspecific” means that it cannot be attributed to a particular cause. It is most often described as “acute nonspecific lymphadenitis.” Bacterial and viral infections are among the most common causes.

What Is Acute Nonspecific Mesenteric Lymphadenitis?

Acute nonspecific mesenteric lymphadenitis is defined as inflammation of the mesenteric (intestinal) lymph glands. Because the mesenteric lymph glands defend against foreign substances or microbes in the intestines, lymphadenitis can often develop from causes such as food poisoning or intestinal infections. This condition generally causes symptoms such as fever, abdominal pain and fatigue and can usually be treated. However, if inflammation of the mesenteric lymph glands is a sign of a serious infection or another health problem, more intensive treatment may be needed.

What Causes Lymphadenitis?

Lymph nodes contain immune cells that help fight infections. Enlarged lymph nodes generally indicate the presence of an infection.

Anyone can develop lymphadenitis. However, children are more likely to experience an infection in their lymph nodes.

Lymphadenitis occurs when bacteria, viruses or fungi reach the lymph nodes and cause an infection. This may bring swelling and severe pain.

In addition, although not very common, tuberculosis and cat-scratch disease can also cause lymphadenitis.

In some cases, specialists may be unable to identify the infection that causes lymphadenitis.

What Are the Symptoms of Lymphadenitis?

The main symptom of lymphadenitis may be a swollen, very painful lymph node. Other symptoms include:

• Fever
• Chills
• Fatigue
• Redness of the skin over the lymph node
• Visible swelling over the lymph node

How Is Lymphadenitis Diagnosed?

Lymphadenitis may be suspected based on symptoms and the appearance of the lymph nodes. In some cases, treatment can be started based on appearance alone. However, the first step in diagnosis is generally superficial soft tissue ultrasound (USG) imaging. This can be useful in diagnosing cervical lymphadenitis or swollen lymph nodes in the neck.

Other diagnostic tests may include:

• Laboratory Tests: These include various tests that look for particular bacteria or viruses that may cause swollen lymph nodes. Examples include a complete blood count, CRP, liver function tests and other routine blood tests.
• Imaging Scans: CT (computed tomography) scans provide detailed images of the lymph nodes and surrounding structures, such as nerves or blood vessels. They can also provide information about the presence of any abscess before surgery.
• Fine Needle Aspiration: This is a procedure that involves inserting a needle into the lymph nodes and taking a fluid sample. It is useful for identifying the cause of infection.

How Is Lymphadenitis Treated?

Antibiotics are the most commonly prescribed treatment for lymphadenitis. An antibiotic may be given intravenously (IV) in the hospital, or a broad-spectrum antibiotic such as Augmentin may be prescribed as first-line treatment. If an MRSA (resistant) infection is suspected, clindamycin may be prescribed. People may also need pain medication.

In some cases, the infection may be severe or cause an abscess. Abscesses can spread, cause severe pain or lead to sepsis. An abscess may need to be drained surgically.

A 2019 study evaluated 567 cases of pediatric lymphadenitis:

• 86.9% of cases returned home after presenting to the clinic
• 29% of cases received IV antibiotics when they first presented to the emergency department
• 19.3% of cases returned to the emergency department
• In 7.4% of cases, the lymph nodes were drained surgically

Treatment for lymphadenitis generally begins on an outpatient basis with oral antibiotics. However, if there is no improvement or the condition worsens, it may be necessary to go to the hospital. If lymphadenitis becomes chronic, additional tests may be needed to identify the cause. Ongoing follow-up and different antibiotics may be required.

Can Lymphadenitis Heal on Its Own?

An incision (cut) and drainage (removal of fluid) are generally unnecessary unless there is a persistent abscess. After this procedure, the area may still feel somewhat hard and may take some time to resolve.

In contrast, in some cases lymphadenitis can improve without treatment. This usually occurs in swollen lymph nodes in the abdomen.

Complications of Lymphadenitis

Children are more likely to develop complications in the following circumstances:

• Fever
• Larger lymph nodes
• Previous antibiotic treatment
• Younger age (the younger the child, the higher the risk)

In addition, untreated lymphadenitis can cause complications:

• Abscess formation, a painful collection of pus
• Cellulitis, a serious infection in the deeper layers of the skin
• Sepsis, an infection affecting the bloodstream
• Other complications related to drainage surgery, such as another infection

These lists are not exhaustive, and other complications may occur with particular forms of the condition.

What Is the Difference Between Lymphadenitis and Lymphadenopathy?

Lymphadenopathy generally refers to swollen lymph nodes. Lymphadenitis means an infection that causes the lymph glands to swell.

Lymphadenopathy can occur for many reasons. It usually develops because the body is fighting an infection. Lymph nodes swell as part of the immune system's response. Reactive lymphadenopathy can also occur in response to inflammation. Inflammation may arise for various reasons, such as a response to dental treatment or hair dye.

Lymphadenitis means that the infection is in the lymph nodes. It can sometimes be difficult to distinguish it from lymphadenopathy. The skin over the lymph nodes becomes inflamed, which points to lymphadenitis. Lymphadenitis also causes more lymph node pain than lymphadenopathy.

Summary

Lymphadenitis is an infection in the lymph nodes and can be very painful. If left untreated, some infected lymph nodes may lead to abscess formation or develop infections that spread to other parts of the body. In most cases, lymphadenitis responds well to antibiotic treatment. Sometimes, however, the condition can become chronic. In this case, specialists may request additional tests to check for potentially serious conditions such as cancer and atypical infections.