Lymphadenopathy medical therapy

Lymphadenopathy Microchapters
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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.

• Antibiotics, antivirals, antifungals, and antiparasitic medications are prescribed for infections due to bacteria, virus, fungi, and parasites respectively.
• Chemotherapy is instituted for those tumors that cannot be treated by surgery.
• Radiation therapy is used in refractory tumors and metastatic tumors.

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.

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. References