Adenophlegmon, or diffuse purulent inflammation of tissues, develops when inflammation of the lymph nodes has led to the melting of their capsule, and the infection has spread from them to the surrounding tissue. In this case, the decay products begin to be intensively absorbed into the blood, and severe intoxication of the body occurs with a significant deterioration in the patient's condition. Adenophlegmon develops rather slowly, and timely measures taken to prevent the melting of the lymph nodes will help prevent serious complications.
Symptoms that help to recognize adenophlegmon in a timely manner
Usually, adenophlegmon develops in patients with acute lymphadenitis. Most often, inflammation of the lymph nodes in the area under the lower jaw is exacerbated - under the chin, near the ears, as well as in the cheek area, occasionally it can cover the anterior and lateral zones of the neck. Exacerbation of lymphadenitis can occur against the background of such concomitant diseases as SARS, otitis media, bronchitis, exudative diathesis. The cause of inflammation of the lymph nodes can be a carious tooth, injury and inflammation of the gums.
A patient with adenophlegmon experiences severe weakness, complains of intense pain in the area of inflamed lymph nodes that occurs spontaneously. In this case, there is a rapid increase in the symptoms of intoxication - chills, very high temperature. At the site of inflammation, a diffuse dense swelling with a bright spot in the middle is observed, the infiltrate gradually increases in size, turns pink, the surrounding tissues swell, and a painful fluctuating area is felt in the depth of the infiltrate. Sometimes petechial hemorrhages may appear on the oral mucosa.
Peculiarities of treatment of adenophlegmon and diagnostic difficulties
Symptoms similar to adenophlegmon occur with inflammation of the tissues around the lymph node, with osteophlegmon, and some other inflammatory diseases of non-purulent tissues. It is very important to correctly determine the nature of the inflammation in order to choose the right treatment tactics.
If therapeutic treatment is still possible in the early stages of the development of adenophlegmon, then when the capsule of the lymph node melts and pus spreads through the tissues, only surgical intervention is indicated, and in the case of adenophlegmon in children, such an intervention should be carried out as a matter of urgency.
A skin incision and a dissection of adipose tissue are made, pus is removed from the resulting cavity. If necessary, a diseased tooth is opened or removed, which could contribute to the development of inflammation.
If significant granulation has developed, and the patient's condition is severe, intoxication is severe, removal of the inflamed lymph node is indicated, and the formed fistulous tract is also excised. It is very important to monitor the patient's condition and not allow diffuse inflammation to descend into the mediastinum or capture the nerve or vascular plexuses.
The patient is prescribed antibacterial and anti-inflammatory therapy, desensitizing agents, if necessary - painkillers, detoxification therapy.
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