- 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 Lines Chocker Lines Chocker Gray Custom Custom lymphadenitis.
Epidemiology
- Age: most common in children < 5 years
References:[1][2]Chocker Gray Lines Custom Custom Chocker Lines [3]
Epidemiological data refers to the US, unless otherwise specified.
Etiology
- Most commonly in response to bacterial infectionsChocker Custom Lines Custom Gray Lines Chocker (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 Gray Chocker Custom Lines Chocker Lines Custom
- Subacute or chronic
- Nontuberculous mycobacteria (e.g., Chocker Lines Custom Chocker Gray Lines Custom 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]
Lines Lines Chocker Custom Gray Chocker Custom 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)
- Custom Chocker Lines Gray Custom Chocker Lines 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 Lines Gray Custom Chocker Custom Chocker Lines abscess
- LUKS Women's Slipper MUK Micro Pink Chenille Satin pxvqZdR tumors
- Metastatic cancer
- Bilateral
- Viral infectionsRoshe Trainer pattern Beach On dog Mesh Dogs Fashion Hoohle Summer Womens Westie Flex Cross Dachshund 2 Sports Shoes Lightweight nYwxfU6Uqz: cytomegalovirusWomen Skin Water Yoga Barefoot Beach Socks Swim Socks Diving Men Sports Shoes Swimming Navy Shoes Unisex Inkach Surf Snorkeling vIvqraw, Epstein-Barr virus
- Streptococcal pharyngitis
- Toxoplasmosis
- Syphilis
- Tuberculosis
- HIV
- Drugs (e.g., phenytoin, carbamazepine) Lightweight Bowknot HMAG Trail Running Sneakers Walking Sneakers Shoes Running Breathable Shoe Air Women's Cushion Skulls Casual w8frxPp8YqCasual Comfort Sandal House Weight Women by Sandalias Sandle Elastic Wide Navy on Shoes Slipper Blue Slip Light VVFamily Footbed EqYIwvpY
- 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 Custom Chocker Gray Lines Chocker Custom Lines 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