While many individuals are concerned about cervical lymphadenitis, it is not a disease. Instead, it is a symptom of a variety of health issues, including degenerative disorders, pathogenic infections, inflammatory conditions, metastases, and neoplastic tumors (McPherson, Pincus, & Henry, 2011).
Importance of Differential Diagnosis
Because there are numerous causes, differential diagnosis is critical in determining the etiopathophysiology of underlying variables. The most fundamental strategy is to create a full profile of the case by documenting the medical history and physical examination. A history is taken to determine the presence, duration, and size of a lump. The documentation also focuses on the nature of the lump, where the centrality is signs of discharge, and concurrence where lymphadenitis is also affecting inguinal canal, axillary, or supraclavicular region. Another aspect of history taking is recent medical and non-medical incidences including fever, URTI, TB, STIs, drug abuse, coughing, chest pains, hemoptysis, and international travel.
Documenting medical history is combined with physical examination, where techniques such as palpating the lumps are integrated. Both physical exam and medical history provide data that highlight the need for more sophisticated techniques. For instance, in the case of minors, palpation reveals a 1-cm lump. While it may not have any implication in case the lump is reactionary, there is a need for medical attention as cervical lymphadenopathy can also be infective (Lang & Kansy, 2014). The same situation applies to adults, where lymph nodes are palpable and measuring 2cm. When the person is above 50 years, persistent lumps should be given prompt attention because of the link between senescence and metastases. In the case of a rapidly enlarging lump that is more than 2cm among the adults and the elderly, cancer test should be considered. If the cervical lymphadenitis is accompanied by chest pain, TB is suspected and further confirmatory tests taken. Another important aspect of differential diagnosis is blood tests and imaging. Standard tests include monospot, CRP, FBC, LFTs, E&Es, and ESR. An ultrasound scan is employed to confirm hepatosplenomegaly, while sonographic imaging confirms the cancerous development (Ahuja & Ying, 2005).
Conclusion
In conclusion, lymphadenitis requires a differentials diagnosis with a consideration of patients' medical history since it may result from various causes. Moreover depending on the patient's age, the recommendations for diagnosis techniques may be different.
References
Ahuja, A. T., & Ying, M. (2005). Sonographic evaluation of cervical lymph nodes. American Journal of Roentgenology, 184(5), 1691-1699.
Lang S., & Kansy B.(2014). Cervical lymph node diseases in children. National Center for Biotechnology Information. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273169/
McPherson, R., Pincus, M., & Henry, J. (2011). Henry's clinical diagnosis and management by laboratory methods (1st ed.). Philadelphia, PA: Saunders Elsevier.
