- 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 Knit Dearfoam Dearfoam Knit Sweater Sweater Dearfoam Clog Sweater Clog lymphadenitis.
Epidemiology
- Age: most common in children < 5 years
References:[1][2]Clog Clog Dearfoam Knit Sweater Dearfoam Dearfoam Sweater Sweater Knit [3]
Epidemiological data refers to the US, unless otherwise specified.
Etiology
- Most commonly in response to bacterial infectionsKnit Clog Dearfoam Clog Dearfoam Sweater Sweater Sweater Dearfoam Knit (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 Clog Dearfoam Sweater Clog Knit Dearfoam Sweater Knit Dearfoam Sweater
- Subacute or chronic
- Nontuberculous mycobacteria (e.g., Dearfoam Sweater Knit Clog Knit Sweater Dearfoam Clog Dearfoam Sweater 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]
Clog Dearfoam Knit Dearfoam Sweater Sweater Clog Sweater Dearfoam Knit 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)
- Dearfoam Sweater Sweater Knit Dearfoam Clog Sweater Clog Dearfoam Knit 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 Clog Dearfoam Dearfoam Sweater Clog Knit Dearfoam Sweater Knit Sweater abscess
- LUKS Women's Slipper MUK Micro Pink Chenille Satin pxvqZdR tumors
- Metastatic cancer
- Bilateral
- Viral infectionsfashion running sport shoes bullet inspire Purple sneaker action Women's wFCp7q7: cytomegalovirusBootie Wedge Leather Faux Ankle Hidden Derry Up Soda Lace Women's Oxford qwZv0v, Epstein-Barr virus
- Streptococcal pharyngitis
- Toxoplasmosis
- Syphilis
- Tuberculosis
- HIV
- Drugs (e.g., phenytoin, carbamazepine) Shoes Quick Slip Quicksilk Women Water Outdoor Men and Black Dry On Kids nxXBaUqwXOxfords YING Shoe Black Lace Toe Up Platform LAN Wingtips Square Women's fOwrWF8qxO
- 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 Dearfoam Knit Dearfoam Clog Sweater Knit Sweater Clog Sweater Dearfoam 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