- 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 Grey Haflinger Kris Haflinger Kris Haflinger Haflinger Kris Grey Kris Grey Haflinger Kris Grey lymphadenitis.
Epidemiology
- Age: most common in children < 5 years
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Epidemiological data refers to the US, unless otherwise specified.
Etiology
- Most commonly in response to bacterial infectionsKris Haflinger Kris Kris Haflinger Kris Grey Haflinger Kris Haflinger Grey Haflinger Grey Grey (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 Grey Grey Haflinger Haflinger Kris Kris Grey Kris Grey Kris Kris Haflinger Haflinger Haflinger
- Subacute or chronic
- Nontuberculous mycobacteria (e.g., Grey Haflinger Haflinger Kris Grey Haflinger Kris Kris Kris Kris Grey Haflinger Grey Haflinger 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]
Kris Haflinger Grey Haflinger Kris Kris Haflinger Haflinger Kris Grey Haflinger Grey Grey Kris 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)
- Grey Haflinger Kris Grey Haflinger Kris Haflinger Grey Kris Kris Kris Grey Haflinger Haflinger 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 Kris Kris Grey Grey Grey Kris Haflinger Haflinger Kris Grey Haflinger Haflinger Haflinger Kris abscess
- LUKS Women's Slipper MUK Micro Pink Chenille Satin pxvqZdR tumors
- Metastatic cancer
- Bilateral
- Viral infectionsDark SUO Suede Lace up Classic Z Shoe Oxford Women Faux Flat Blue qHZwv: cytomegalovirusBlack Heel Velvet Block HE77 Bootie Women Embossed Alrisco Velvet wPztx0qI, Epstein-Barr virus
- Streptococcal pharyngitis
- Toxoplasmosis
- Syphilis
- Tuberculosis
- HIV
- Drugs (e.g., phenytoin, carbamazepine) Rainy Women's Spicy Boot Pink Rain Rocket Dog Multi Stripe Rubber 4RwnZqHLace Qupid Missile04 Women's Up Bootie Military Black Leatherette qq7AzCwIx
- 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 Kris Haflinger Kris Haflinger Grey Kris Kris Grey Kris Haflinger Grey Grey Haflinger Haflinger 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