Lymphadenopathy

abnormality in the number, size or consistency of lymph nodes.
Causes
1. Infection (viral, bacterial, fungl, parasitic)
  1. Viral
    1. HIV
    2. URTI
    3. Infectious Mononucleosis
    4. Rubella, varicella, measles
    5. Hep, A/B
    6. Dengue fever
    7. Adenovirus
    8. Human Herpes virus - 6
  2. Bacterial
    1. Septicaemia
    2. Typhoid fever
    3. TB
    4. Syphilis
    5. Lyme disease
  3. Protozoal
    1. toxoplasmosis
    2. Chagas disease
    3. Sleeping sickness (African trypanosomiasis)
  4. Fungal
    1. Coccidioidomycosis
2. Neoplastic
  1. Acute leukaemia
  2. Lymphoma
    1. Hodkins/non-hodgkins
  3. Neuroblastoma
  4. Hystocytoses
3. Inflammatory/ Autoimmune
4. Heamatological
History:
1. Infection
  1. Fever
  2. Prior infection (cough, sputem, SOB, pain, redness, discharge, bowels, CNS, headaches, neck stiffness, hotophobia, seazures etc.)
Examination
1. Infection
  1. Temperature
  2. Haemodynamics (BP, HR, RR, Urine Output)
  3. Conciousness (AVPU, GCS)
  4. Focused examine for site of origin (chest, abdo etc.)
    1. Hepatomegly/splenomegaly for malignancy/infection
  5. Size/No. / site of lymphnodes
    1. Supraclavicular nodes = malignancy
    2. Erythema, warmth, fluctuance = lympadenitis
    3. Firm, non tender, matted together = malignancy
Investigations
1. FBC (incl. blood film, and ESR, plasma viscosity, CRP)
2. LFT's
3. Swabs
4. Depending on Hx
  1. Viral titre
    1. Epstein-Barr virus
    2. HIV
    3. Hepatitis
  2. Blood cultures
  3. Antibodies screen (SLE ant-DSdna ANA, RA ACCP)
  4. CXR (sarcoidosis, TB, Malignancy)
  5. CT, MRI
  6. Fine needle Aspiration
Differential Diagnosis
1. Subcutaneous lesion (Lipoma, Abscess)
2. Hernia
3. Skin Lesion (Sabaceous cyst)
4. Neck (thyroid tumour, brachial cleft cyst, Cystic hygromas, Salivary Glands, Thyroglossal duct cysts(often midline))
Management

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Lymphadenopathy

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