Acute, sometimes suppurative lymphadenitis caused by bacterial infection.

Common bacteria, more often Staphylococcus aureus than group A streptococci, may infect the regional lymph nodes draining a dental abscess (1), an infected wound, pleural emphysema, appendicitis, a tuboovarian abscess, or another site of pyogenic inflammation (2,3). They are more common in superficial nodes, particularly axillary and inguinal nodes, and may on rare occasions destroy the lymph node, with resulting abscess or sinus formation. In such cases, the biopsy may not show any lymphoid tissue, and therefore the evidence of acute lymphadenitis is lacking (4). Less acute and more localized suppurative lymphadenitis may also accompany other infections, such as yersiniosis (5,6), tularemia (7,8), typhoid fever (9), melioidosis (10,11), listeriosis, fungal infections (Chapters 25,26,27,28), and cat-scratch disease (4) (Chapter 17). Acute gonorrhea, particularly in men, may be accompanied by severe, rapidly developing, usually symmetric inguinal lymphadenitis (2). Suppurative lymphadenitis was reported in an intravenous drug user infected with HIV (12). Generally, because of antibiotic treatment, suppurative lymphadenitides have become uncommon. Nevertheless, repeated lymph node abscesses in children caused by a catalase-positive bacterium such as S. aureus may be a manifestation of chronic granulomatous disease (13) or defective neutrophil chemotaxis (14).