Acute cervical lymphadenitis commonly occurs in children and is often caused by infections such as upper respiratory tract infections, tonsillitis, dental caries, pharyngitis, stomatitis, and external otitis. These infections spread to cervical lymph nodes through lymphatic drainage pathways. The primary pathogens involved are Staphylococcus aureus and β-hemolytic Streptococcus.
Chronic lymphadenitis often develops as a result of incomplete treatment of acute lymphadenitis, unresolved primary infections, or weakened immune function in the patient.
Clinical Symptoms
Systemic Symptoms
Acute lymphadenitis is often accompanied by chills, fever, headache, fatigue, generalized discomfort, and loss of appetite.
Symptoms of Primary Infectious Sites
Symptoms such as sore throat, laryngeal pain, pain during swallowing, and dental pain may be present.
Local Symptoms
Enlargement of cervical lymph nodes may occur unilaterally or bilaterally, along with tenderness. The affected lymph nodes are usually of medium consistency, have smooth surfaces, and remain mobile. The number and size of the enlarged lymph nodes can vary. During acute exacerbations of chronic lymphadenitis, the symptoms resemble those of acute lymphadenitis. After anti-infective therapy, the lymph nodes may shrink but remain palpable, mobile, and non-tender.
Diagnosis and Differential Diagnosis
Diagnosis is typically based on the presence of enlarged painful cervical lymph nodes, acute inflammation in organs within the lymphatic drainage area, and systemic symptoms such as chills and fever. Laboratory findings often show elevated white blood cell counts with neutrophilia. Cervical ultrasound can help determine the size, location, number, and relationship of the lymph nodes to surrounding tissues.
Differential diagnosis is necessary to distinguish this condition from cervical tuberculous lymphadenitis, lymphoma, and malignant lymph node metastasis. Lymph node aspiration or excisional biopsy may be performed if necessary.
Treatment
Treatment involves addressing the primary infectious site, administering anti-infective therapy, improving nutrition, and enhancing the body's immunity.