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Transcript
LECTURE
Lymphadenitis,
furuncle and
carbuncle of
maxillofacial area.
Lymphadenitis is the inflammation
of a lymph node.
Lymph nodes
The glandlike masses of tissue in the
lymphatic system that contain
lymphocytes. The lymph nodes also
filter lymph, which is a clear yellowish
tissue fluid that carries lymphocytes
and fats throughout the body.
Lymphoid system of maxillofacial area:
1 — glandula parotis; 2 — nodi lymphatici occtpitales; 3 — nodi lymphatici auriculares poster. 4 —
nodi lymphatici cervicales profundi superiores; 5 — v. jugutaris dextra; 6 — nodi lymphatici : cales
superficiales; 7 — nodi lymphatici cervicales profundi inferiores; 8 — nodi lymphatici auricu anteriorea;
9 — nodi lymphatici submaxillares; 10 — nodulus lymphaticus submentalis; 11 — a. ca communis
dextra; 12— truncus lymphaticus jugularis dexter.
THE MAINS WAYS OF FLOWING LYMPH FROM
LOWER AND APPER LIPS

Lymphadenitis is often a complication of
a bacterial infection of a wound, although
it can also be caused by viruses or other
disease agents. Lymphadenitis may be
either generalized, involving a number of
lymph nodes; or limited to a few nodes in
the area of a localized infection.
Lymphadenitis is sometimes accompanied
by lymphangitis, which is the inflammation
of the lymphatic vessels that connect the
lymph nodes.
Causes

Streptococcal and staphylococcal bacteria are the
most common causes of lymphadenitis, although
viruses, protozoa, rickettsiae, fungi, and the
tuberculosis bacillus can also infect the lymph
nodes. Diseases or disorders that involve lymph
nodes in specific areas of the body include rabbit
fever (tularemia), cat-scratch disease,
lymphogranuloma venereum, chancroid, genital
herpes, infected acne, dental abscesses, and
bubonic plague. In children, tonsillitis or bacterial
sore throats are the most common causes of
lymphadenitis in the neck area. Diseases that
involve lymph nodes throughout the body include
mononucleosis, cytomegalovirus infection,
toxoplasmosis, and brucellosis.
Physical examination

The diagnosis of lymphadenitis is usually
based on a combination of the patient's
history, the external symptoms, and
laboratory cultures. The doctor will press
(palpate) the affected lymph nodes to see
if they are sore or tender. Swollen nodes
without soreness are often caused by catscratch disease. In children, the doctor will
need to rule out mumps, tumors in the
neck region, and congenital cysts that
resemble swollen lymph nodes.
PALPATION OF SUBMANDIBLE
LYMPH NODES
PALPATION OF SUBMENTAL
LYMPH NODES
PALPATION OF RETROMANDIBLE
LYMPH NODES
CLINICAL CLASSIFICATION
OF LYMPHADENITIS
 -Acute:
serous, purulent.
 -Chronic:
hyperplastic, purulent.
Symptoms

Lymphadenitis is marked by
swollen lymph nodes that are
painful, in most cases, when the
doctor touches them. If the
lymphadenitis is related to an
infected wound, the skin over
the nodes may be red and warm
to the touch.
Acute lymphadenitis
Chronic lymhadenitis
Operation of removed lymph nodes
attached chronical inflammation
Operation of removed lymph nodes
attached chronical inflammation
Removed lymph nodes
Treatment

The medications given for lymphadenitis vary
according to the bacterium or virus that is
causing it. If the patient also has lymphangitis,
he or she will be treated with antibiotics, usually
penicillin G (Pfizerpen, Pentids), nafcillin (Nafcil,
Unipen), or cephalosporins. Erythromycin (Eryc,
E-Mycin, Erythrocin) is given to patients who are
allergic to penicillin. Supportive care of
lymphadenitis includes resting the affected limb
and treating the area with hot moist compresses.
Cellulitis associated with lymphadenitis should
be treated surgically because of the risk of
spreading the infection. Pus is drained only if
there is an abscess and usually after the patient
has been started on antibiotic treatment. In some
cases, a biopsy of an inflamed lymph node is
necessary if no diagnosis has been made and no
response to treatment has occurred.
Prognosis
 The
prognosis for recovery is good if
the patient is treated promptly with
antibiotics. In most cases, the
infection can be brought under
control in three or four days. Patients
with untreated lymphadenitis may
develop blood poisoning
(septicemia), which is sometimes
fatal.
Hair follicle anatomy
A furuncle is an infection of a
hair follicle.
A carbuncle is a skin
infection that often involves a
group of hair follicles.
Causes
Furuncles are very common. They are
caused by staphylococcus bacteria, which
are normally found on the skin surface.
Damage to the hair follicle allows these
bacteria to enter deeper into the tissues of
the follicle and the subcutaneous tissue.
Furuncles may occur in the hair follicles
anywhere on the body, but they are most
common on the face, neck, armpit,
buttocks, and thighs.Furuncles are
generally caused by Staphylococcus
aureus, but they may be caused by other
bacteria or fungi.
Risk factors
Although anyone — including otherwise healthy people —
can develop boils or carbuncles, the following factors can
increase your risk:

Poor general health. Having chronic poor health makes it harder
for your immune system to fight infections.

Diabetes. This disease can make it more difficult for your body to
fight infection, including bacterial infections of your skin.



Clothing that binds or chafes. The constant irritation from tight
clothing can cause breaks in your skin, making it easier for
bacteria to enter your body.
Other skin conditions. Because they damage your skin's
protective barrier, skin problems, such as acne and dermatitis,
make you more susceptible to boils and carbuncles.
Immune-suppressing medications. Long-term use of
corticosteroids, such as prednisone or other drugs that suppress
your immune system, can increase your risk.
FURUNCLE (the first stage of
development)
FURUNCLE (the second stage of
development)
Furuncle of face
Furuncle of face
Furuncle of face
Furuncle of face
Carbuncle of face
Carbuncle of the lower lip
Signs and symptoms




A boil usually appears suddenly as a painful pink or red
bump that's generally not more than 1 inch in diameter.
The surrounding skin also may be red and swollen.
Within a few days, the bump fills with pus. It grows larger
and more painful for about five to seven days, sometimes
reaching golf ball size before it develops a yellow-white tip
that finally ruptures and drains. Boils generally clear
completely in about two weeks. Small boils usually heal
without scarring, but a large boil may leave a scar.
A carbuncle is a cluster of boils that often occurs on the
back of the neck, shoulders or thighs, especially in older
men. Carbuncles cause a deeper and more severe infection
than single boils do. In addition, carbuncles develop and
heal more slowly and are likely to leave a scar. Carbuncles
sometimes occur with a fever.
Boils and carbuncles often resemble the inflamed, painful
lumps caused by cystic acne. But compared with acne
cysts, boils are usually redder or more inflamed around the
border and more painful.
Treatment
Doctor may drain a large boil or carbuncle
by making a small incision in the tip. This
relieves pain, speeds recovery and helps
lessen scarring. Deep infections that can't
be completely cleared may be covered
with sterile gauze so that pus can continue
to drain. Sometimes doctor may prescribe
antibiotics to help heal severe or recurrent
infections.
Self-care
The following measures may help the infection
heal more quickly and prevent it from spreading:




Apply a warm washcloth or compress to the affected
area. Do this for at least 10 minutes every few hours. If
possible, first soak the cloth or compress in warm salt
water. This helps the boil rupture and drain more quickly. To
make salt water, add 1 teaspoon of salt to 1 quart of boiling
water and cool to a comfortable temperature.
Gently wash the boil two to three times a day. After
washing, apply an over-the-counter antibiotic and cover
with a bandage.
Never squeeze or lance a boil. This can spread the
infection.
Wash your hands thoroughly after treating a boil.
Also, launder clothing, towels or compresses that have
touched the infected area.
Prevention
Although it's not always possible to prevent
boils, especially if you have a compromised
immune system, the following measures may
help you avoid staph infections:
Thoroughly clean even small cuts and
scrapes. Wash well with soap and water
and apply an over-the-counter antibiotic
ointment.
 Avoid constricting clothing. Tight
clothes may be stylish, but make sure
they don't chafe your skin.
