Lymphadenopathy and Lymphadenitis

Paul Auwaerter, M.D.
Lymphadenopathy and Lymphadenitis is a topic covered in the Johns Hopkins ABX Guide.

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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, Brucella, cat scratch disease (Bartonella), sarcoid, lymphoma, Stills disease, inflammatory bowel disease, Whipple’s disease, hypersensitivity reaction.
    • HAART-associated immune reconstitution syndrome in HIV+ pts (IRIS).
  • Acute localized:
  • Chronic generalized: syphilis, TB, histoplasmosis, cryptococcosis, 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), dermatopathic lymphadenitis (DLN), Kimura disease, and lymphadenopathy-associated with autoimmune and metabolic/storage disease.
    • Other nodal entities could include lymph node infarction, foreign body reactions, drug reactions, extramedullary hematopoiesis.

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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, Brucella, cat scratch disease (Bartonella), sarcoid, lymphoma, Stills disease, inflammatory bowel disease, Whipple’s disease, hypersensitivity reaction.
    • HAART-associated immune reconstitution syndrome in HIV+ pts (IRIS).
  • Acute localized:
  • Chronic generalized: syphilis, TB, histoplasmosis, cryptococcosis, 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), dermatopathic lymphadenitis (DLN), Kimura disease, and lymphadenopathy-associated with autoimmune and metabolic/storage disease.
    • Other nodal entities could include lymph node infarction, foreign body reactions, drug reactions, extramedullary hematopoiesis.

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Last updated: November 7, 2020