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swollen glands

Alternative Names
lymph node enlargement, lymphadenosis

Definition
Swollen "glands," or lymph nodes, refers to enlargement of the lymph nodes in the body.

What is going on in the body?
Lymph nodes are a part of the immune system. Though commonly called "glands," many glands in the body are not related to the lymph nodes or the immune system. For the purpose of this piece, the terms "gland" and "lymph node" will mean the same thing, but this is not always the case. The purpose of lymph nodes is to protect the body from "foreign" invaders. These invaders may be bacteria, viruses, cancer, injury, or other harmful substances. Lymph node swelling may or may not cause pain.

What are the signs and symptoms of the condition?
Signs and symptoms depend on the cause of the swollen glands. When a doctor is evaluating a swollen gland, he or she may want to know:
  • When did the swelling start?
  • Where is the swelling is located?
  • Were there any other symptoms when the swollen gland was first noticed, such as fever, weight loss, night sweats, joint pain, trouble breathing, or a skin rash?
  • Is there pain in the gland? Is it tender to the touch?
  • Have there been any recent injuries, including scratches, cuts, abrasions, or insect or animal bites?
  • Is there any history of other illnesses or conditions?
  • Does anything improve or worsen the symptoms?
  • What medications is the person taking?
Other questions may also be asked in some cases, such as a person's sexual history and practices.

What are the causes and risks of the condition?
Common causes of swollen glands include: Other causes are also possible. Sometimes the cause cannot be found.

What can be done to prevent the condition?
Prevention is related to the cause. If a person gets cut or injured, careful cleaning and care of the wound may prevent a swollen gland. Safer sex practices can help prevent cases due to syphilis or HIV. Routine childhood vaccines can help prevent some infections, such as rubella. Many cases, such as those due to cancer or autoimmune disorders, cannot be prevented.

How is the condition diagnosed?
Diagnosis begins with a history and physical examination. This may be all that is needed to make the diagnosis. In other cases, further testing is needed. Blood tests are commonly used to help figure out the cause. A blood test called a full blood count, or FBC, can help figure out if an infection or blood cancer is present. Imaging tests, such as a chest x-ray, can help diagnose some infections and cancers. In some cases, a biopsy of a lymph node may be needed. This procedure involves removing a small piece of the swollen lymph node from the body. A needle is often used if the lymph node is close to the skin. The needle can be inserted through the skin and into the lymph node. A small piece of the lymph node is removed with the needle. In other cases, the skin may be cut open to remove a larger sample, or the entire lymph node may be removed. The sample or the entire lymph node can then be sent to the laboratory for further testing and examination.

What are the long-term effects of the condition?
Long-term effects depend on the underlying cause of the condition. A swollen gland caused by a cut may heal quickly with no long-term effects. A person who has cancer or certain other underlying conditions may need lifelong treatment.

What are the risks to others?
Swollen glands are not contagious. However, if the underlying cause is an infection, such HIV, the infection may be contagious.

What are the treatments for the condition?
Treatment is directed at the cause, if the cause is known. Analgesics may be given if the swollen gland is painful. Treatment for an infection may include antibiotics or surgery. Treatment for autoimmune disorders may include anti-inflammatory medications, such as ibuprofen, or medications to suppress the immune system, such as prednisone. If a medication is the cause, the medication may be stopped. Those with cancer may need surgery, chemotherapy, or radiation therapy.

What are the side effects of the treatments?
Side effects depend on the treatments used. Antibiotics may cause stomach upset, rash, or allergic reactions. Surgery poses a risk of infection, bleeding, and allergic reaction to the anaesthesia. Chemotherapy can cause many side effects, including stomach upset, hair loss, and weakness.

What happens after treatment for the condition?
Those with a healed infection or cut may need no further treatment after recovery. Those with cancer, HIV, or autoimmune disorders may need prolonged treatment.

How is the condition monitored?
Affected persons can help monitor their swollen glands and watch for any new symptoms. If red streaks in the skin or severe pain occur, or if any other unusual symptoms develop, these should be reported to the doctor. Other monitoring is done by the doctor and depends on the cause. For example, those with HIV may need repeated blood tests to monitor their immune system. Any medications used may also need monitoring, often with blood tests.

Author: Eileen McLaughlin, RN, BSN
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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