View clinical trials related to Lymphadenitis.
Filter by:Patients with breast cancer and metastatic axillary lymphadenopathy routinely undergo neo-adjuvant chemotherapy. For these patients, biopsy clip markers are inserted into the biopsy proven metastatic lymph node pre-treatment, as they may reach complete clinical response post-therapy. Limited axillary surgery, as opposed to a full axillary dissection, may then be indicated. It is still necessary to surgically excise the biopsy proven metastatic lymph node to accurately assess the pathologic response to therapy, and subsequently tailor post-surgical therapies appropriately. As such, these lymph nodes require pre-operative localization which, at The Ottawa Hospital, currently requires radioactive seed insertion under sonographic guidance, typically performed within 5 days of surgery. The procedure is often challenging, as both normal appearing lymph nodes and 3 mm biopsy clip markers are difficult and in some cases impossible, to visualize on ultrasound. At the time of surgery, the excised lymph node is radiographed, to ensure the radioactive seed and biopsy clip marker are both successfully excised. Localization with Ink has the potential to replace both the biopsy clip markers and radioactive seeds as the surgeons are able to directly visualize the Ink intra-operatively and excise the Inked lymph node. A preliminary study out of Stanford on 28 patients who underwent localization of axillary lymph nodes with Ink injected 1-211 days pre-operatively, in the pre neo-adjuvant and post neo-adjuvant settings, showed that lymph nodes injected with Ink are visible intra-operatively months after surgery, suggesting that this is a feasible localization technique (1).
The purpose of study is to see if adding probiotics to corticosteroid treatment for children with PFAPA could improve the health and daily of patients through reduction in febrile period frequency and length, along with concomitant reduction of associated symptoms. Current standard of care incorporates the administration of corticosteroids; however, while limiting the symptoms associated with PFAPA, corticosteroid use has been shown to increase the frequency at which these symptoms occur. Investigators hypothesize that administration of probiotics along with corticosteroids will work to decrease the frequency at which the febrile episodes occur. Additionally, probiotics may decrease the maximal fever experienced during these episodes, amount of corticosteroid needed to control the symptoms, average length of the episodes, and the number of patients who ultimately undergo tonsillectomy due to unsuccessful treatment with medication.
Nontuberculous mycobacteriae (NTM) are a group of bacteria that typically cause infections of lymph nodes in the neck and face of otherwise healthy children. There are currently 3 strategies to manage these infections. Yet, all are not "ideal" and each has downsides. 1. Surgery: removal of the affected lymph nodes is the most common approach but has the disadvantages of potential facial nerve paralysis, the possibility of recurrent infection that would require another operation and resolution with a cosmetically disturbing scar. 2. Antibiotics: The antibiotic courses are prolonged and are associated frequently with adverse reactions. It is unclear if this treatment has a significant effect on the "natural" resolution process of the infection. 3. Observation: follow-up the healing process without intervention. However the resolution may last a long period of time even more than a year. In almost all cases there will be spontaneous discharge of pus from the involved lymph nodes onto the skin that may last a few days. Later on a scar will form that may also be disturbing cosmetically. The inflammatory response of the body to infections may occasionally be severe. As a matter of fact its harmful consequences can be sometimes more serious than those of the bacteria that cause the infection. Prednisone and other anti inflammatory drugs have properties that could possibly prevent this. There is medical experience in using prednisone and similar drugs in addition to antibiotics in infectious diseases to decrease the inflammatory response against the infection. One of these infections is tuberculosis. The tuberculous bacteria have some common features with the nontuberculous mycobacteria. The investigators believe that the inflammatory process in infected lymph nodes with nontuberculous mycobacteria is the major cause for the discharge from the skin which later leads to the formation of a scar and to the prolonged resolution from the infection. Thus in order to hasten the resolution and to avoid formation of a neck or facial scar with its cosmetic consequences we suggest the use of prednisone in treating nontuberculus mycobacteria lymph nodes infections. Since prednisone depresses the inflammatory process as well as the immunity response, we chose to study the effect of prednisone combined with antibiotics (as the later will help to overcome the bacteria). The purpose of the study is to determine whether the addition of prednisone to antibiotic treatment of nontuberculous mycobacteria lymph nodes infections in the neck and face of children can hasten the resolution process and improve its cosmetic results. The diagnosis of nontuberculous mycobacteria lymph node infection will be based on evidence of bacterial growth in culture or on the presence of DNA of the bacteria in pus obtained from the involved lymph nodes by fine needle aspiration. Generally healthy children with evidence of infection will be offered to participate in the study. They will be randomly assigned into the following 2 groups for 8 weeks treatment: 1. Antibiotics (2 types) and prednisone. 2. Antibiotics (2 types) and placebo (a material that tastes and look like prednisone but does not have any medical effect). Prednisone will be given in a dose that will decrease into half twice: after 2 and after four weeks. Follow-up visits for monitoring the inflammatory process and its resolution as well as adverse reactions will be done around 2 weeks, 4 weeks 3 months and 6-8 months after beginning therapy, Blood tests and chest X-rays will be taken prior to the beginning of treatment. Blood tests will be also taken at the first follow-up visit. A photo of the face neck and the site of the involved lymph nodes will be taken before starting therapy and at each of the follow-up visit.
Kikuchi-Fujimoto disease is a distinctive syndrome of necrotizing lymphadenitis which was formally described in 1972 by two Japanese pathologists, Kikuchi and Fujimoto. It is a benign, self-limited disease that predominantly occurs in young women. It was more common in Asian people, especially in Japanese. The most frequent clinical presentations are fever (30~50%) and cervical lymphadenopathy, often tender in palpable. Other lymph node regions can be affected, and hepatosplenomegaly may be present. The laboratory findings include leucopenia with atypical lymphocytosis. ESR, transaminases and lactate dehydrogenase are often raised. The clinical features are easily confused with other conditions, particularly lymphoma. Therefore the diagnosis depends on the pathological findings. The typical findings are paracortical lesions consisting of patchy zones of eosinophilic fibrinoid necrosis and abundant karyorrhexis. In general, spontaneous resolution of symptoms and signs within a few months can be expected without treatment.For decades, the etiology of Kikuchi's disease has been speculated. Although the perforin and Fas pathways of cytotoxic T cells induce an abundance of apoptosis and thus induce necrotizing lesions, the trigger factor is unknown. Since the disease can precede or occur in association with a connective tissue disorder, especially SLE, the autoimmune contribution to the etiology has also been speculated. However, the clinical course of Kikuchi's disease, often sudden onset and spontaneous resolution, the frequent flu-like or upper respiratory prodrome, and the prominence of cervical lymphadenopathy, support a viral cause. Evidence for a viral cause also includes peripheral blood atypical lymphocytosis and elevated serum IFN-a or 2`-5` oligoadenylate synthetase levels. Several infectious agents have been suggested, including bacteria (e.g. Brucella, Yersinia), parasites (e.g. toxoplasmosis) and viruses (e.g. EBV, CMV, HHV6, HHV8, parvovirus B19, HTLV, HIV).The aim of this study is to collect cases of Kikuchi' disease in bureau of NHI and NTUH. We will analyze the incidence rate, age of onset, sex, season of onset and clinical course to see if there is any clustered cases, or nosocomial infection. Then we will study the etiology of Kikuchi's disease especially the infection causes by analyzing pathologic specimen and serology. We hope to find out the etiology of Kikuchi's disease and the new treatment.