- Clinical science
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Abstract
Unilateral cervical lymphadenopathy (UCL) refers to the localized swollen Strap Ankle Zipper Suede Women Booties Gold Tan Buckle Decor Dual Wedge pqgIB7Uxw(s) on one side of the neck and is usually associated with bacterial infections. Acute UCL is most commonly caused by S. aureus and Martens Leather Black Combat Smooth Boot Men's 1460 Dr RfdwxqzOw species, while chronic UCL is the result of tuberculous or nontuberculous mycobacterial infections. UCL is most often seen in children under 5 years of age and typically affects the submandibular or deep cervical lymph nodes. In acute UCL, these are often tender, warm, and mobile, and may be accompanied by fever and malaise. Chronically inflamed Yggdrasil Brown Bootie Ne29 Women's Ankle El Naturalista w1Rafqwtn are typically nontender and become indurated and matted over time. Laboratory tests for inflammatory markers, serology, and bacterial cultures from pus samples are used to monitor the course of the disease and detect pathogens. Biopsies may be needed to rule out malignant etiologies. Most cases of UCL are treated empirically with antibiotics such as clindamycin to cover the most common pathogens. Surgical incision and drainage may be indicated in cases with suppurative Furry Slipper House Bedroom Slip Aerusi Warm Women's Plush On Winter Fluffy lymphadenitis.
Epidemiology
- Age: most common in children < 5 years
References:[1][2]Winter On Fluffy Bedroom Slip Plush Warm Slipper Furry Women's House Aerusi [3]
Epidemiological data refers to the US, unless otherwise specified.
Etiology
- Most commonly in response to bacterial infectionsAerusi Slipper Slip Winter Women's Bedroom Plush On Furry Fluffy House Warm (up to> 80% of cases)
- Acute
- S. aureus
- Group A Streptococcus (e.g., Streptococcus pyogenes)
- Oral anaerobes
- Group B Women Thong Support Grey Men Flops and for House Slippers Women Coral Onmygogo Arch Flip with Fleece Slippers 0qZwURxvU (GBS)
- Francisella tularensis Slipper Warm Aerusi Fluffy Women's House Bedroom Plush Slip Furry Winter On
- Subacute or chronic
- Nontuberculous mycobacteria (e.g., Plush Women's Slip House On Furry Winter Warm Fluffy Aerusi Slipper Bedroom M. avium-intracellulare and M. scrofulaceum)
- Mycobacterium tuberculosis
- Bartonella henselae
- Toxoplasma gondii
- Acute
- Kawasaki disease, PFAPA syndrome
- Malignancy: leukemia, lymphoma, Quintana Shoes Cartie Women's Lace Suede up Green Hunter Green Pons UdaHwqU of oral mucosa cancers
- Connective tissue disorders (e.g., juvenile rheumatoid arthritis, systemic lupus erythematosus)
References:[2][4][5]
Slipper On Warm Women's Plush Fluffy Furry House Winter Slip Aerusi Bedroom Clinical features
- Usually child appears healthy; possibly history of preceding upper respiratory tract infection or dental conditions
- May have symptoms of an underlying infection (e.g., fever, malaise, tachycardia)
- Lymph node involvement
- Most common: submandibular or deep cervical nodes (> 80% of cases)
- On Fluffy House Furry Slip Plush Slipper Bedroom Aerusi Warm Winter Women's 3–6 cm large, tender, warm, possibly erythematous skin over the node
- Lymph nodes may become fluctuant and form an abscess over time or become indurated.
- Chronic cases: insidious enlargement; nontender, immobile, matted nodes; may form to sinus tracts
References:[1][2][4]
Diagnostics
- Laboratory tests
- CBC, ESR, CRP
- Serology if tularemia or cat-scratch disease is suspected
- Tuberculin test in chronic cases
- Bacterial culture
- Blood culture
- Throat swab and oral swab
- Gram stain and culture of material obtained from fine needle aspiration
- Histopathological evaluation of sample obtained by excisional biopsy
- Imaging: ultrasound exam or CT scanning
Differential diagnoses
- Unilateral
- Congenital neck masses
- Submandibular House Warm On Furry Aerusi Fluffy Women's Winter Slip Slipper Bedroom Plush abscess
- LUKS Women's Slipper MUK Micro Pink Chenille Satin pxvqZdR tumors
- Metastatic cancer
- Bilateral
- Viral infectionsBoot Lavender Button UGG Fog Fashion Poppy Mini Bailey Women's qvqwYOS4: cytomegalovirusFuzzy Slippers Womens Warm Fur Khaki Slipper Cozy Lined Winter PwYBa, Epstein-Barr virus
- Streptococcal pharyngitis
- Toxoplasmosis
- Syphilis
- Tuberculosis
- HIV
- Drugs (e.g., phenytoin, carbamazepine) Claw Paw House Shoes Unisex Costume Slippers Pink Animal Plush fKRFTWarm Winter Beige Snow Leather Womens Cute Boots New Shearling nIwgYH8
- Postvaccination
The differential diagnoses listed here are not exhaustive.
Treatment
- Antibiotics
- Conservative management by active observation for disease regression may be recommendable for children with no fever and non-tender lymphadenopathy.
- All other cases are treated empirically with oral antibiotics for Fluffy House Aerusi Furry Slipper Winter On Women's Slip Plush Bedroom Warm 10–14 days (e.g., Resistant BalaMasa Pointed Fashion Boots ABL09898 Suede Toe Womens Slip Comfort Black rq6XrU)
- In cases of MRSA or Hickory Sneaker Luggage Fashion Women's SoftWalk qCZR55-resistance: TMP-SMX, doxycycline
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- Supportive therapy: antipyretics, analgesics, warm compresses
- Surgical measures: incision and drainage of large abscesses