0521779407-13 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:15
932 Lymphadenitis and Lymphangitis Lymphomasmanagement
■Careful exam to detect local site of infection
■Detailed history may reveal clues to underlying etiology: social his-
tory (sexual practices, partners), vocational exposures (animals, oth-
ers with illnesses), recreational history (camping, gardening), dietary
habits (unpasteurized dairy products), recent travel
specific therapy
■Therapy depends on etiologic agent; acute lymphadenitis and lym-
phangitis due to S. aureus or group A Streptococcus and empiric
therapy with cephalexin or dicloxacillin reasonable; if patient fails
to respond or chronic disease present, specific etiology should be
sought by blood tests (see above), aspiration of node or excisional
biopsy for culture and pathologic examination with therapy directed
at causative agent
follow-up
■Routine to ensure resolution of underlying process
complications and prognosis
■Bacteremia can occur with acute lymphadenitis and lymphangitis,
requiring hospitalization and parenteral antibiotic therapy.
■Suppuration may occur, but it usually resolves with appropriate ther-
apy.
■Prognosis depends on underlying etiology but overall is favorable.LYMPHOMAS
M.A. SHIPP, MD
REVISED BY ARNOLD S. FREEDMAN, MD
history & physical
■Approximately 57,000 new cases will be diagnosed in USA in 2006.
From 1992 to 2001, the rate has decreased 1% per year in men, and
remained stable in women.
■Associations
➣HD – EBV (mostly in developing countries, <20% elsewhere)
➣NHL
Inherited or acquired immunodeficiencies (severe combined
immunodeficiency, hypogammaglobulinemia, common vari-
able immunodeficiency, Wiskott-Aldrich syndrome, ataxia-
telangiectasia)