Severe streptococcal axillary lymphadenitis

Article Abstract:

Four cases are described in which patients developed severe axillary lymphadenitis caused by infection with streptococcal bacteria. Axillary lymphadenitis is the inflammation of the lymph nodes located in the armpit and is caused by drainage of bacteria or toxic materials into the nodes from parts of the body that they serve such as the arms and hands. The incidents that caused the infections in the four cases were as follows. One patient was a 27-year-old physician who accidentally stuck himself in the finger with a needle used to draw blood from a patient who later died of Streptococcus pyogenes infection. Another patient was a young man who developed a blister on his thumb after using a paint brush; the blister became infected. The third case was of a 26-year-old homosexual man with human immunodeficiency virus (HIV) infection who developed severe pain and swelling in the right arm and chest; the source of the infection was not known. And the fourth patient was a 34-year-old woman who had experienced intermittent edema (fluid retention) in both arms for the past 12 years and suddenly developed an infected abscess in the armpit which contained S. pyogenes; this strain of bacteria was found to be resistant to several antibiotics. All four patients were successfully treated with antibiotics. It was concluded that these patients had a rare form of streptococcal infection that caused severe axillary lymphadenitis. Recently, there has been an increase in severe streptococcal infections, so physicians should be alert to this possible diagnosis when patients have fever with pain and swelling in the arm, chest, shoulder or armpit. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Infection, Streptococcal infections, Streptococcus pyogenes, Lymphadenitis

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A 29-year-old woman with necrotizing lymphadenitis, the nephrotic syndrome, and acute renal failure

Article Abstract:

A 29-year-old woman was admitted to a hospital with swollen lymph glands and signs of severe illness. She had rashes, fever and weight loss, which combined with enlarged lymph glands led her doctors to diagnose systemic lupus erythematosus. She also had signs of kidney failure, which occurred in a short period of time. Kidney biopsies revealed the presence of antibodies in the tissue. In patients with lupus, antibodies are formed against the patients' DNA. In this patient, anti-DNA antibodies deposited in her kidneys probably caused her kidney failure.

Causes of, Complications and side effects, Systemic lupus erythematosus, Acute renal failure, Acute kidney failure

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The design of trials comparing sentinel-node surgery and axillary resection

Article Abstract:

Some operations on women with breast cancer have such a small benefit that thousands of women would have to participate in a study that evaluates the operation. And this means that many institutions and doctors would have to participate in the trial. One such operation is sentinel node biopsy, which may not provide a substantially greater benefit than axillary resection.

Care and treatment, Editorial, Breast cancer, Lymph node biopsy

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