Lymphadenopathy Flashcards
Child with erythematous draining lymphnodes.
Most likely Diagnosis?/Ddx?
Most likely organisms?
Risk factors?
Management?
.
What percentage of lymphadenopathy in children is reactive?
60%
How long should a lymph node be observed prior to biopsy?
6 weeks or if there is enlargement on Abx.
When do you consider Kawasaki?
High fever, bilateral conjunctivitis, and strawberry tongue.
What medication frequently causes “Pseudolymphoma”?
Phenytoin.
Predictive features of malignant nodes?
Greater than 2-3 cm, rubbery, fixed, high CRP, LDH, no hilum on ultrasound, enlargement on follow up.
Common viral etiologies of lymphadenopathy?
Influenza - diffuse
EBV - cervical
HIV - diffuse
CMV - either
Features and treatment of toxoplasmosis?
Obtained from undercooked meat
Most commonly cervical
No treatment necessary - usually resolves.
May be diagnosed on serum PCR prior.
Organism and features causing cat scratch disease?
Bartonella henselae
Causes focal adenopathy usually in 5-9 yr old. Almost always in the submandibular nodes.
Usually does not require treatment but long course azithro may help.
Features and treatment of atypical mycobacterial infection?
M. Avium and M. Intracellulare.
Unilateral neck nodes - usually submandibular with characteristic blue color to under lying skin with draining sinuses.
Diagnose with node excision.
Surgery more effective than antibiotics to clear infection.
Features of TB causing adenopathy:
Consider in patients from endemic areas.
Excisional biopsy showing caseating Granulomas is diagnostic and further confirmed with ZN stain and PCR.
Requires long term treatment with ID.
Acute bacterial lymphadenitis - common pathogens and treatment?
Staph 80% and strep 15%
Acute red hot node most commmonly in the neck
Lack of improvement after 2-3 days of antibiotics requires drainage.
Continue Abx 10 days for MRSA
