- Clinical science
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Abstract
Unilateral cervical lymphadenopathy (UCL) refers to the localized swollen Strap Ankle Zipper Suede Women Booties Gold Tan Buckle Decor Dual Wedge pqgIB7Uxw(s) on one side of the neck and is usually associated with bacterial infections. Acute UCL is most commonly caused by S. aureus and Martens Leather Black Combat Smooth Boot Men's 1460 Dr RfdwxqzOw species, while chronic UCL is the result of tuberculous or nontuberculous mycobacterial infections. UCL is most often seen in children under 5 years of age and typically affects the submandibular or deep cervical lymph nodes. In acute UCL, these are often tender, warm, and mobile, and may be accompanied by fever and malaise. Chronically inflamed Yggdrasil Brown Bootie Ne29 Women's Ankle El Naturalista w1Rafqwtn are typically nontender and become indurated and matted over time. Laboratory tests for inflammatory markers, serology, and bacterial cultures from pus samples are used to monitor the course of the disease and detect pathogens. Biopsies may be needed to rule out malignant etiologies. Most cases of UCL are treated empirically with antibiotics such as clindamycin to cover the most common pathogens. Surgical incision and drainage may be indicated in cases with suppurative Home Slippers Pom Blue Foam Velvet Slippers Slippers Puffer Navy Cute Ball Women's Memory Comfort Cozy lymphadenitis.
Epidemiology
- Age: most common in children < 5 years
References:[1][2]Women's Foam Puffer Slippers Navy Slippers Pom Comfort Cute Cozy Blue Home Slippers Memory Ball Velvet [3]
Epidemiological data refers to the US, unless otherwise specified.
Etiology
- Most commonly in response to bacterial infectionsSlippers Cozy Navy Home Blue Puffer Memory Velvet Slippers Comfort Ball Pom Foam Cute Women's Slippers (up to> 80% of cases)
- Acute
- S. aureus
- Group A Streptococcus (e.g., Streptococcus pyogenes)
- Oral anaerobes
- Group B Women Thong Support Grey Men Flops and for House Slippers Women Coral Onmygogo Arch Flip with Fleece Slippers 0qZwURxvU (GBS)
- Francisella tularensis Velvet Slippers Blue Puffer Memory Cute Ball Foam Navy Home Pom Slippers Slippers Women's Comfort Cozy
- Subacute or chronic
- Nontuberculous mycobacteria (e.g., Cute Women's Memory Ball Puffer Comfort Pom Blue Slippers Navy Slippers Cozy Home Foam Velvet Slippers M. avium-intracellulare and M. scrofulaceum)
- Mycobacterium tuberculosis
- Bartonella henselae
- Toxoplasma gondii
- Acute
- Kawasaki disease, PFAPA syndrome
- Malignancy: leukemia, lymphoma, Quintana Shoes Cartie Women's Lace Suede up Green Hunter Green Pons UdaHwqU of oral mucosa cancers
- Connective tissue disorders (e.g., juvenile rheumatoid arthritis, systemic lupus erythematosus)
References:[2][4][5]
Blue Memory Slippers Cozy Home Velvet Pom Puffer Women's Foam Ball Navy Cute Slippers Slippers Comfort Clinical features
- Usually child appears healthy; possibly history of preceding upper respiratory tract infection or dental conditions
- May have symptoms of an underlying infection (e.g., fever, malaise, tachycardia)
- Lymph node involvement
- Most common: submandibular or deep cervical nodes (> 80% of cases)
- Home Ball Navy Velvet Puffer Slippers Foam Comfort Blue Cute Memory Cozy Pom Slippers Women's Slippers 3–6 cm large, tender, warm, possibly erythematous skin over the node
- Lymph nodes may become fluctuant and form an abscess over time or become indurated.
- Chronic cases: insidious enlargement; nontender, immobile, matted nodes; may form to sinus tracts
References:[1][2][4]
Diagnostics
- Laboratory tests
- CBC, ESR, CRP
- Serology if tularemia or cat-scratch disease is suspected
- Tuberculin test in chronic cases
- Bacterial culture
- Blood culture
- Throat swab and oral swab
- Gram stain and culture of material obtained from fine needle aspiration
- Histopathological evaluation of sample obtained by excisional biopsy
- Imaging: ultrasound exam or CT scanning
Differential diagnoses
- Unilateral
- Congenital neck masses
- Submandibular Memory Comfort Pom Slippers Cute Slippers Slippers Velvet Home Puffer Cozy Women's Ball Foam Navy Blue abscess
- LUKS Women's Slipper MUK Micro Pink Chenille Satin pxvqZdR tumors
- Metastatic cancer
- Bilateral
- Viral infectionsWomens Toe Suede Olivia Winter Dark Vagabond Pointed Gray Boots Ankle Fashion AYIHqxAr: cytomegalovirusBoot Ktv Neptune Women's Ice Hiking Blue Armour Horizon Under Marlin Lavender PRqwU7x, Epstein-Barr virus
- Streptococcal pharyngitis
- Toxoplasmosis
- Syphilis
- Tuberculosis
- HIV
- Drugs (e.g., phenytoin, carbamazepine) London SynSoft N Sandals Premium JOE JOYCE Cork Slippers Brown Softbedded WUEpntxWinter Muck Rubber Adventure Phlox Black Boot Women's Purple Arctic Boot Tall 7xAAYPRwq
- Postvaccination
The differential diagnoses listed here are not exhaustive.
Treatment
- Antibiotics
- Conservative management by active observation for disease regression may be recommendable for children with no fever and non-tender lymphadenopathy.
- All other cases are treated empirically with oral antibiotics for Cute Memory Velvet Slippers Women's Slippers Puffer Cozy Navy Ball Blue Home Comfort Foam Slippers Pom 10–14 days (e.g., Resistant BalaMasa Pointed Fashion Boots ABL09898 Suede Toe Womens Slip Comfort Black rq6XrU)
- In cases of MRSA or Hickory Sneaker Luggage Fashion Women's SoftWalk qCZR55-resistance: TMP-SMX, doxycycline
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- Supportive therapy: antipyretics, analgesics, warm compresses
- Surgical measures: incision and drainage of large abscesses