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Lymphadenitis, Emergency Medicine

John Mahoney and Dolores Gonthier Reviewed 06/2017
 


Basics

Description

  • Lymph nodes may be swollen and tender as part of the systemic response to infection:

    • Become engorged with lymphocytes and macrophages

    • May be primarily infected

    • Infection in distal extre...

Diagnosis

Signs and Symptoms

  • Painful swelling, inflammation/infection of lymph nodes

  • Commonly presents simultaneously with acute cellulitis or abscess if pyogenic cause

  • Axillary lymphadenitis:

    • Fever, axil...

Treatment

Initial Stabilization/Therapy

Ensure airway, breathing, and circulation management and hemodynamic stability 

Ed Treatment/Procedures

  • General principles:

    • Antibiotics based on involved primary or...

Follow-Up

Disposition

Admission Criteria

  • Toxic appearing

  • History of immune suppression

  • Concurrent chronic medical illnesses

  • Unable to take oral medications

  • Unreliable patients

Discharge Criteria

  • Mild infectio...

Pearls and Pitfalls

  • Staph species are the most common cause of acute regional lymphadenitis due to pyogenic bacteria

  • Empiric antibiotic coverage must extend to include CA-MRSA, in addition to coverage ...

Additional Reading

  • Abrahamian  FM, Talan  DA, Moran  GJ. Management of skin and soft-tissue infections in the emergency department. Infect Dis Clin North Am.  2008;22:89–116.

  • Boyce  JM. Severe str...

Codes

ICD9

  • 289.1 Chronic lymphadenitis

  • 289.3 Lymphadenitis, unspecified, except mesenteric

  • 683 Acute lymphadenitis

ICD10

  • I88.9 Nonspecific lymphadenitis, unspecified

  • L04.0 Acute lymphadenitis of face, head ...

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