Lymphadenopathy and Lymphadenitis
PATHOGENS
- Lists below are by no means comprehensive but list commonly considered pathogens causing lymphadenopathy, as well as some non-infectious considerations.
- Acute generalized LN (presenting in two or more regional groups): HIV, syphilis, EBV, CMV, Toxoplasma, Bartonella and Brucella
- Occasionally, lymphoma and hypersensitivity reactions.
- HAART-associated immune reconstitution syndrome in HIV+ pts (IRIS).
- Acute localized:
- Cervical: group A streptococci, EBV, TB, cat-scratch disease (Bartonella), lymphoma, temporal arteritis, chronic fatigue syndrome,
- Pre-auricular: adenovirus, conjunctivitis, tularemia, Bartonella (Parinauds syndrome).
- Epitrochlear: hand infection (medial 3 fingers), syphilis.
- Inguinal: syphilis, herpes, chancroid, LGV, chancroid, HIV, tularemia, plague.
- Mesenteric: Yersinia
- It may mimic appendicitis, especially right-sided.
- Chronic generalized: syphilis, TB, histoplasmosis, cryptococcosis, cat scratch disease (Bartonella), Stills disease, inflammatory bowel disease, Whipple’s disease, chronic granulomatous disease (CGD), lymphoma, HIV, sarcoid, hyperthyroidism, posttransplant lymphoproliferative disorder
- Chronic localized: TB, cryptococcus, histoplasmosis, cat scratch disease (Bartonella), lymphoma, metastatic cancer, Kikuchi-Fujimoto disease, Rosai-Dorman disease, Castleman’s disease (some HHV-8).
- Non-infectious: many conditions, but consider sarcoidosis, Kikuchi-Fujimoto disease (usually cervical LN), lymphoma, SLE, metastatic malignancy, Rosai-Dorman disease, Castleman’s disease (some HHV-8), reactive lymphoid hyperplasia (RLH), hemophagocytic lymphohistiocytosis HLH, dermatopathic lymphadenitis (DLN), Kimura disease, chronic granulomatous disease (CGD) and lymphadenopathy-associated with autoimmune and metabolic/storage disease.
- Other nodal entities could include lymph node infarction, foreign body reactions, drug reactions, and extramedullary hematopoiesis.
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Last updated: March 17, 2024
Citation
Auwaerter, Paul. "Lymphadenopathy and Lymphadenitis." Johns Hopkins ABX Guide, The Johns Hopkins University, 2024. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540326/all/Lymphadenopathy_and_Lymphadenitis.
Auwaerter P. Lymphadenopathy and Lymphadenitis. Johns Hopkins ABX Guide. The Johns Hopkins University; 2024. https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540326/all/Lymphadenopathy_and_Lymphadenitis. Accessed December 13, 2024.
Auwaerter, P. (2024). Lymphadenopathy and Lymphadenitis. In Johns Hopkins ABX Guide. The Johns Hopkins University. https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540326/all/Lymphadenopathy_and_Lymphadenitis
Auwaerter P. Lymphadenopathy and Lymphadenitis [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2024. [cited 2024 December 13]. Available from: https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540326/all/Lymphadenopathy_and_Lymphadenitis.
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