Lymphadenopathy medical therapy

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Lymphadenopathy Microchapters

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Overview

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Pathophysiology

Causes

Differentiating Lymphadenopathy from other Diseases

Epidemiology and Demographics

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Natural History, Complications and Prognosis

Diagnosis

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History and Symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]; Vendhan Ramanujam M.B.B.S [3]

Overview

The optimal therapy for lymphadenopathy depends on the underlying cause. Antimicrobial therapy is administered for infections. Chemotherapy is instituted for those tumors that cannot be treated by surgery. Radiation therapy is indicated in refractory tumors and metastatic tumors.

Principles of Therapy

Medical management of lymphadenopathy depends on the underlying cause.

Therapy Based on Clinical Form

Generalized Lymphadenitis

Pathogen Based Therapy

▸ Click on the following categories to expand treatment regimens.

Bacteria

  ▸  Mycobacterium Tuberculosis

  ▸  Brucella

  ▸  Leptospira

  ▸  Treponema pallidum

  ▸  Burkholderia

  ▸  Salmonella Typhi

Chlamydia

  ▸  Chlamydia Trachomatis

Fungi

  ▸  Histoplasma

  ▸  Cryptococcus Neoformans

Viral

  ▸  Measles Virus

  ▸  Rubella Virus

  ▸  Epstein-Barr Virus

  ▸  Cytomegalovirus

  ▸  Herpes Simplex Virus

  ▸  Human Immunodeficiency Virus

Protozoans

  ▸  Leishmania

  ▸  Trypanosoma

  ▸  Toxoplasma Gondii

Helminths

  ▸  Brugia Malayi

  ▸  Wuchereria Bancrofti

Mycobacterium Tuberculosis
Preferred Regimen
Intensive Phase †
Isoniazid 5 mg/kg PO qd
OR
Isoniazid 10 mg/kg PO 3 times per week
PLUS
Rifampicin 10 mg/kg PO qd
OR
Rifampicin 10 mg/kg PO 3 times per week
PLUS
Pyrazinamide 25 mg/kg PO qd
OR
Pyrazinamide 35 mg/kg PO 3 times per week
PLUS
Ethambutol 14.5-21.1 mg/kg PO qd
OR
Ethambutol 36.4-52.6 mg/kg PO 3 times per week'
Continuation Phase ††
Isoniazid 5 mg/kg PO qd
OR
Isoniazid 10 mg/kg PO 3 times per week × 2 months
PLUS
Rifampicin 10 mg/kg PO qd
OR
Rifampicin 10 mg/kg PO 3 times per week × 2 months
For 2 months
†† For 4 months
Adapted from Treatment of Tuberculosis: Guidelines.[2]

Regional Lymphadenitis

Pathogen Based Therapy

▸ Click on the following categories to expand treatment regimens.

Cervical Lymphadentitis - Bacteria

  ▸  Group A Beta-Hemolytic Streptococci

  ▸  Staphylococcus Aureus

  ▸  Mycobacterium Tuberculosis

  ▸  Mycobacterium Scrofulaceum

  ▸  Mycobacterium Avium-Intracellulare

  ▸  Bartonella Henselae

  ▸  Francisella Tularensis

Cervical Lymphadentitis - Protozoans

  ▸  Toxoplasma gondii

Axillary Lymphadentitis - Bacteria

  ▸  Group A Beta-Hemolytic Streptococci

  ▸  Staphylococcus Aureus

  ▸  Bartonella Henselae

  ▸  Francisella Tularensis

  ▸  Yersinia Pestis

Axillary Lymphadentitis - Fungi

  ▸  Sporotrichosis

Inguinal Lymphadentitis - Bacteria

  ▸  Group A Beta-Hemolytic Streptococci

  ▸  Staphylococcus Aureus

  ▸  Bartonella Henselae

  ▸  Francisella Tularensis

  ▸  Yersinia Pestis

  ▸  Treponema Pallidum

  ▸  Haemophilus Ducreyi

Inguinal Lymphadentitis - Chlamydia

  ▸  Chlamydia Trachomatis

Inguinal Lymphadentitis - Viral

  ▸  Herpes Simplex Virus

Lymphadentitis of Extremities - Bacteria

  ▸  Francisella Tularensis

  ▸  Mycobacterium Marinum

  ▸  Mycobacterium Chelonae

  ▸  Nocardia Brasiliensis

Lymphadentitis of Extremities - Fungi

  ▸  Sporotrichosis

Lymphadentitis of Extremities - Protozoans

  ▸  Leishmania

Mycobacterium Tuberculosis
Preferred Regimen
Intensive Phase †
Isoniazid 5 mg/kg PO qd
OR
Isoniazid 10 mg/kg PO 3 times per week
PLUS
Rifampicin 10 mg/kg PO qd
OR
Rifampicin 10 mg/kg PO 3 times per week
PLUS
Pyrazinamide 25 mg/kg PO qd
OR
Pyrazinamide 35 mg/kg PO 3 times per week
PLUS
Ethambutol 14.5-21.1 mg/kg PO qd
OR
Ethambutol 36.4-52.6 mg/kg PO 3 times per week'
Continuation Phase ††
Isoniazid 5 mg/kg PO qd
OR
Isoniazid 10 mg/kg PO 3 times per week × 2 months
PLUS
Rifampicin 10 mg/kg PO qd
OR
Rifampicin 10 mg/kg PO 3 times per week × 2 months
For 2 months
†† For 4 months
Adapted from Treatment of Tuberculosis: Guidelines.[3]

References

  1. Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A (2014). "Peripheral lymphadenopathy: approach and diagnostic tools". Iran J Med Sci. 39 (2 Suppl): 158–70. PMC 3993046. PMID 24753638.
  2. Treatment of tuberculosis : guidelin. Geneva: World Health Organization. 2010. ISBN 978-92-4-154783-3.
  3. Treatment of tuberculosis : guidelin. Geneva: World Health Organization. 2010. ISBN 978-92-4-154783-3.

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