Lymphadenopathy

Most heroin addicts have lymphadenopathy (Carbone et al. 1998 Tirelli et al. 1986). Vein sclerosis and contaminant-related lymphatic obstruction may cause extremity edema. Ulceration and other dermatologic changes are often present in those who skin pop. ... 

Tirelli U, Vaccher E, Carhone A, et al Lymphangiography and abdominal computerized tomography in persistent generalized lymphadenopathy. AIDS Res 2 149— 153, 1986... 

Muesing MA, Smith DH, Capon DJ (1987) Regulation of mRNA accumulation by a human immunodeficiency virus trans-activator protein. CeU 48(4) 691-701 Nicholson JK, Cross GD, CaUaway CS, McDougal JS (1986) In vitro infection of human monocytes with human T lymphotropic virus type Ill/lymphadenopathy-associated virus (HTLV-III/ LAV). J Immunol 137(l) 323-329... 

The human immunodeficiency virus (HIV lymphadenopathy-associated virus, LAV human T-cell lymphotrophic virus type 3, HTLV III) is responsible for acquired immune deficiency syndrome (AIDS see Chapter 3). Because of the hazard and difficulties of growing the virus outside humans, a different approach has to be examined for determining viral sensitivity to disinfectants. 

In rare instances, extrahepatic symptoms may develop arthritis, postcervical lymphadenopathy, palmar erythema, cryoglobulinemia, and vasculitis. 

A 7-year-old boy presents to the pediatrician with a sore throat and fever of 39.2°C for 24 hours. His mother reports that other children in his class have had "strep throat" recently. He also complains of pain on swallowing and is not eating or drinking very much. He does not have any other symptoms and has no known drug allergies. Physical examination reveals pharyngeal and tonsillar erythema with exudates and painful cervical lymphadenopathy. 

Both erysipelas and cellulitis are manifested by rapidly spreading areas of redness, edema, and heat. Vesicles containing clear fluid may appear on the skin. Lymphangitis and regional lymphadenopathy may be observed. 

Secondary syphilis Without appropriate treatment, primary syphilis will advance to secondary syphilis, a stage usually apparent from its clinical symptomatology. Symptoms include fatigue, diffuse rash, fever, lymphadenopathy, and genital or perineal condyloma latum. Also, the skin is most often affected and a rash may present as macular, macropapular, or pustular lesions, or involve skin surfaces including the palms of the hands and soles of the feet. 

Tinea capitis Infection of the head and scalp May be asymptomatic initially, then progress to inflammatory alopecia "Black dot" alopecia may develop due to breakage of hair at the root May form kerions (nodular swellings) Scaling or favus may develop on scalp Cervical lymphadenopathy is common Primarily found in infants, children, and young adolescents, often in African-American and Flispanic populations Can be spread from person to person or animal to person... 

The majority of patients may present with fever, lymphadenopathy, pharyngitis, and/or rash. Other symptoms include ... 

Breast Right Hard 2.4 x 3.0 cm mass in upper outer quadrant without associated erythema, dimpling, or skin changes, not fixed to skin, no ulceration. No palpable lymph nodes in axilla. Left Without masses or lymphadenopathy. 

Lymphadenopathy, generally in the cervical, axillary, supraclavicular, or inguinal lymph nodes... 

Lymphomas not included in Working Formulation mycosis fungoides, mantle cell lymphoma, monocytoid B-cell lymphoma, mucosa-associated lymphoid tissue (MALT), anaplastic large cell lymphoma, angiocentric lymphoma, angioimmunoblastic lymphadenopathy (AILD), Castleman s disease, adult T-cell leukemia/lymphoma. 

Lymphadenopathy, massive hepatosplenomegaly, and bone pain are not as common in AML as in ALL. 

CLL can have a variable clinical course, with survival ranging from months to decades. Low-risk disease is asymptomatic, and median survivals exceed 10 years intermediate risk is associated with lymphadenopathy and has median survivals of about 7 years and high-risk patients with anemia have median survivals of only 3 years.16,17 The typical low-risk patient is an elderly person without symptoms who is diagnosed on routine blood draw. The typical high-risk patient is middle-aged, and symptoms have brought the patient to his or her physician. 

The primary goals in the treatment of CLL are to provide palliation of symptoms and to improve overall survival. Since the current treatments for CLL are not curative, reduction in tumor burden and improvement in disease symptoms are reasonable end points, particularly in older patients. A response to therapy can be evaluated by a resolution of lymphadenopathy... 

Cytotoxic chemotherapy is the treatment of choice for chemotherapy-sensitive tumors such as SCLC and lymphoma. As indicated earlier, chemotherapy also may be combined with radiotherapy, especially in patients with lymphoma who have bulky mediastinal lymphadenopathy. 

Chronic lymphocytic leukemia (especially bulky lymphadenopathy)... 

AIDS, acquired immune deficiency syndrome HIV, human immunodeficiency virus PGL, persistent generalized lymphadenopathy. 

Usually multiple vesicular/pustular (herpes) or papular/pustular (H. ducreyi) lesions that may coalesce painful, tender lymphadenopathy ... 

Primary Single, painless, indurated lesion (chancre) that erodes, ulcerates, and eventually heals (typical) regional lymphadenopathy is common multiple, painful, purulent lesions possible but uncommon... 

Secondary Pruritic or nonpruritic rash, mucocutaneous lesions, flu-like symptoms, lymphadenopathy Latent Asymptomatic... 

Cellulitis is characterized by erythema and edema of the skin. The lesion, which may be extensive, is painful and nonelevated and has poorly defined margins. Tender lymphadenopathy associated with lymphatic involvement is common. Malaise, fever, and chills are also commonly present. There is usually a history of an antecedent wound from minor trauma, an ulcer, or surgery. 

Signs and Symptoms Ulceroglandular tularemia presents a local ulcer and regional lymphadenopathy (any disease process affecting a lymph node or lymph nodes), fever, chills, headache, and malaise. Typhoidal or septicemic tularemia presents fever, headache, malaise, substernal discomfort, prostration, weight loss and a non-productive cough. 

Diagnosis Clinical diagnosis. Physical findings are usually non-specific. Chest X-ray may reveal a pneumonic process, mediastinal lymphadenopathy or plural effusion. Routine culture is possible but difficult. The diagnosis can be established retrospectively by serology. As for treatment, administration of antibiotics such as streptomycin or gentamicin with early treatment can be very effective. 

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