B71 Lymphadenitis non-specific (ICD-10:I88.9)

Introduction

Lymphadenitis non-specific is a condition characterized by the inflammation of lymph nodes without identification of a specific causative organism or underlying pathology^[1]. This condition represents lymph node enlargement and inflammation that occurs due to various causes, including infections, autoimmune disorders, malignancies, and medications^[2]. Unlike acute lymphadenitis, non-specific lymphadenitis typically presents with less severe symptoms and may be chronic or recurrent in nature^[3].

Codes

• ICPC-2 Code: B71 Lymphadenitis non-specific^[4]
• ICD-10 Code: I88.9 Nonspecific lymphadenitis, unspecified^[5]

Symptoms

• Swollen lymph nodes: Enlarged lymph nodes that may feel firm, rubbery, or tender to touch, typically measuring 1-2 cm in diameter^[6]
• Mild pain or discomfort: Generally less severe than acute lymphadenitis, with localized tenderness that may worsen with pressure^[7]
• Regional inflammation: Skin overlying affected lymph nodes may appear slightly red and feel warm, though less pronounced than in acute cases^[8]
• Low-grade fever: Mild temperature elevation (37.5-38°C) may occur, particularly in infectious causes^[9]
• Fatigue and malaise: General feeling of illness or reduced energy levels^[10]
• Night sweats: Occasional occurrence, particularly in chronic or systemic conditions^[11]

Causes

• Viral infections: Epstein-Barr virus, cytomegalovirus, and other viral pathogens causing persistent lymph node enlargement^[12]
• Autoimmune disorders: Rheumatoid arthritis (lymphadenopathy in up to 82% of patients), systemic lupus erythematosus (69% of patients), and Sjögren’s syndrome^[13]
• Drug-induced lymphadenopathy: Medications including phenytoin, captopril, cephalosporin antibiotics, and rituximab^[14]
• Chronic infections: Tuberculosis, atypical mycobacterial infections, and other chronic bacterial infections^[15]
• Malignancies: Early-stage lymphomas, leukemias, or metastatic cancer to lymph nodes^[16]
• Reactive lymphadenopathy: Response to remote infections or inflammatory processes^[17]

Diagnostic Steps

Medical History

• Comprehensive symptom assessment including duration, progression, and associated symptoms^[18]
• Medication review for drugs known to cause lymphadenopathy^[19]
• Family history of autoimmune diseases or malignancies^[20]
• Travel history and potential exposure to endemic diseases^[21]

Physical Examination

• Systematic examination of all accessible lymph node regions^[22]
• Assessment of lymph node characteristics: size, consistency, mobility, and tenderness^[23]
• Evaluation for hepatosplenomegaly and other signs of systemic disease^[24]
• Examination for skin rashes, joint inflammation, or other autoimmune manifestations^[25]

Laboratory Tests

• Complete blood count (CBC): May show leukocytosis, lymphocytosis, or cytopenias depending on underlying cause^[26]
• Inflammatory markers: Elevated ESR (>20 mm/hr) and CRP (>3 mg/L) indicate active inflammation^[27]
• Autoimmune panel: ANA, rheumatoid factor, and specific autoantibodies when autoimmune disease is suspected^[28]
• Viral serology: EBV, CMV, and HIV testing for suspected viral causes^[29]

Diagnostic Imaging

• Ultrasound: First-line imaging to assess lymph node architecture and detect suspicious features^[30]
• CT or MRI: Detailed imaging when malignancy is suspected or for evaluation of deep lymph node chains^[31]
• PET/CT: May be useful in distinguishing inflammatory from malignant lymphadenopathy^[32]

Specialized Tests

• Fine-needle aspiration (FNA): Cost-effective diagnostic procedure ranging from $77-250, with 90-92% accuracy for lymph node lesions^[33]
• Core needle biopsy: More tissue for analysis; average cost $3,529 for open lymph node biopsy^[34]
• Flow cytometry: Analysis of cell populations when hematologic malignancy is suspected^[35]

Follow-up and Patient Education

• Regular monitoring to assess response to treatment and symptom progression^[36]
• Education on when to seek urgent medical attention for concerning changes^[37]
• Lifestyle modifications to support immune function and overall health^[38]

Possible Interventions

Traditional Interventions

Medications:

Antibiotics (e.g., Amoxicillin, Cephalexin):

• Cost: Generic versions $10-50/month^[39]
• Indications: Suspected bacterial superinfection or specific bacterial causes
• Contraindications: Known penicillin or cephalosporin allergies
• Side effects: Gastrointestinal upset, diarrhea, skin rash
• Warning: Complete full course (7-14 days) even if symptoms improve^[40]

NSAIDs (e.g., Ibuprofen, Naproxen):

• Cost: Generic versions $5-20/month^[41]
• Dosage: Ibuprofen 400-600mg every 6-8 hours with food^[42]
• Contraindications: Active peptic ulcer disease, severe renal impairment, heart failure
• Side effects: Gastrointestinal irritation, headache, dizziness
• Warning: Monitor for GI bleeding and renal function with prolonged use^[43]

Corticosteroids (e.g., Prednisone):

• Cost: Generic versions $10-30/month^[44]
• Indications: Autoimmune lymphadenitis, severe inflammatory responses
• Dosage: Prednisone 1 mg/kg daily (maximum 40mg) for 4-5 days in acute cases^[45]
• Contraindications: Active infections, systemic fungal infections, live vaccines
• Side effects: Increased appetite, mood changes, elevated glucose
• Warning: Gradual tapering required; monitor for immunosuppression^[46]

Antiviral medications (e.g., Acyclovir, Valacyclovir):

• Cost: Generic versions $15-50/month^[47]
• Indications: Confirmed viral causes (HSV, VZV, EBV)
• Side effects: Nausea, headache, diarrhea
• Warning: Dose adjustment required in renal impairment^[48]

Antifungal medications (e.g., Fluconazole, Itraconazole):

• Cost: Generic versions $20-100/month^[49]
• Indications: Confirmed or suspected fungal causes
• Side effects: Hepatotoxicity, drug interactions
• Warning: Regular liver function monitoring required^[50]

Surgical Procedures:

• Lymph node biopsy: Excisional biopsy costs $1,000-5,000; essential when malignancy cannot be excluded^[51]
• Abscess drainage: Surgical drainage if abscess formation occurs; costs $500-2,000^[52]

Alternative and Supportive Interventions

• Warm compresses: Apply for 10-15 minutes, 3-4 times daily to increase blood circulation and reduce inflammation^[53]
• Lymphatic drainage massage: Gentle manual techniques to improve lymph flow and reduce swelling; costs $60-120 per session^[54]
• Herbal supplements: Echinacea, cleavers, and calendula for lymphatic system support, though scientific evidence is limited^[55]
• Acupuncture: May help stimulate natural healing processes; costs $60-120 per session^[56]

Lifestyle Interventions

• Adequate rest and sleep: 7-9 hours of quality sleep to support immune system recovery^[57]
• Hydration: Maintain adequate fluid intake (2-3 liters daily) to support lymphatic drainage^[58]
• Balanced nutrition: Diet rich in antioxidants, omega-3 fatty acids, and lean proteins to support immune function^[59]
• Stress management: Chronic stress impairs immune function; employ meditation, deep breathing, or counseling techniques^[60]
• Regular exercise: Moderate physical activity enhances lymphatic circulation and overall immune function^[61]
• Hygiene practices: Proper handwashing and wound care to prevent secondary infections^[62]
• Avoid irritants: Discontinue potentially causative medications when possible and medically appropriate^[63]

Note: Cost ranges are approximate and vary significantly by geographic location, healthcare system, and insurance coverage. Patients should consult healthcare professionals for personalized treatment recommendations and accurate cost estimates. For autoimmune-related lymphadenopathy, treatment typically focuses on managing the underlying condition rather than the lymph nodes themselves^[64].

Mirari Cold Plasma Alternative Intervention

Understanding Mirari Cold Plasma

• Safe and Non-Invasive Treatment: Mirari Cold Plasma is a safe and non-invasive treatment option for various skin conditions. It does not require incisions, minimizing the risk of scarring, bleeding, or tissue damage.
• Efficient Extraction of Foreign Bodies: Mirari Cold Plasma facilitates the removal of foreign bodies from the skin by degrading and dissociating organic matter, allowing easier access and extraction.
• Pain Reduction and Comfort: Mirari Cold Plasma has a local analgesic effect, providing pain relief during the treatment, making it more comfortable for the patient.
• Reduced Risk of Infection: Mirari Cold Plasma has antimicrobial properties, effectively killing bacteria and reducing the risk of infection.
• Accelerated Healing and Minimal Scarring: Mirari Cold Plasma stimulates wound healing and tissue regeneration, reducing healing time and minimizing the formation of scars.

Mirari Cold Plasma Prescription

Video instructions for using Mirari Cold Plasma Device – B71 Lymphadenitis non-specific (ICD-10:I88.9)

Mild	Moderate	Severe
Mode setting: 1 (Infection) Location: 0 (Localized) Morning: 15 minutes, Evening: 15 minutes	Mode setting: 1 (Infection) Location: 0 (Localized) Morning: 30 minutes, Lunch: 30 minutes, Evening: 30 minutes	Mode setting: 1 (Infection) Location: 0 (Localized) Morning: 30 minutes, Lunch: 30 minutes, Evening: 30 minutes
Mode setting: 2 (Wound Healing) Location: 0 (Localized) Morning: 15 minutes, Evening: 15 minutes	Mode setting: 2 (Wound Healing) Location: 0 (Localized) Morning: 30 minutes, Lunch: 30 minutes, Evening: 30 minutes	Mode setting: 2 (Wound Healing) Location: 0 (Localized) Morning: 30 minutes, Lunch: 30 minutes, Evening: 30 minutes
Mode setting: 3 (Antiviral Therapy) Location: 0 (Localized) Morning: 15 minutes, Evening: 15 minutes	Mode setting: 3 (Antiviral Therapy) Location: 0 (Localized) Morning: 30 minutes, Lunch: 30 minutes, Evening: 30 minutes	Mode setting: 3 (Antiviral Therapy) Location: 0 (Localized) Morning: 30 minutes, Lunch: 30 minutes, Evening: 30 minutes
Mode setting: 7 (Immunotherapy) Location: 1 (Sacrum) Morning: 15 minutes, Evening: 15 minutes	Mode setting: 7 (Immunotherapy) Location: 1 (Sacrum) Morning: 30 minutes, Lunch: 30 minutes, Evening: 30 minutes	Mode setting: 7 (Immunotherapy) Location: 1 (Sacrum) Morning: 30 minutes, Lunch: 30 minutes, Evening: 30 minutes
Total Morning: 60 minutes approx. $10 USD, Evening: 60 minutes approx. $10 USD	Total Morning: 120 minutes approx. $20 USD, Lunch: 120 minutes approx. $20 USD, Evening: 120 minutes approx. $20 USD,	Total Morning: 120 minutes approx. $20 USD, Lunch: 120 minutes approx. $20 USD, Evening: 120 minutes approx. $20 USD,
Usual treatment for 7-60 days approx. $140 USD – $1200 USD	Usual treatment for 6-8 weeks approx. $2,520 USD – $3,360 USD	Usual treatment for 3-6 months approx. $5,400 USD – $10,800 USD

Localized (0) Sacrum (1) Prostate & Uterus (2) Kidney, Liver & Spleen (3) Heart, Bile & Pancreas (4) Lungs (5) Throat, Lymphatic & Thyroid (6) Neuro system & ENT (7)

Use the Mirari Cold Plasma device to treat Lymphadenitis non-specific effectively.

WARNING: MIRARI COLD PLASMA IS DESIGNED FOR THE HUMAN BODY WITHOUT ANY ARTIFICIAL OR THIRD PARTY PRODUCTS. USE OF OTHER PRODUCTS IN COMBINATION WITH MIRARI COLD PLASMA MAY CAUSE UNPREDICTABLE EFFECTS, HARM OR INJURY. PLEASE CONSULT A MEDICAL PROFESSIONAL BEFORE COMBINING ANY OTHER PRODUCTS WITH USE OF MIRARI.

Step 1: Cleanse the Skin

• Start by cleaning the affected area of the skin with a gentle cleanser or mild soap and water. Gently pat the area dry with a clean towel.

Step 2: Prepare the Mirari Cold Plasma device

• Ensure that the Mirari Cold Plasma device is fully charged or has fresh batteries as per the manufacturer’s instructions. Make sure the device is clean and in good working condition.
• Switch on the Mirari device using the power button or by following the specific instructions provided with the device.
• Some Mirari devices may have adjustable settings for intensity or treatment duration. Follow the manufacturer’s instructions to select the appropriate settings based on your needs and the recommended guidelines.

Step 3: Apply the Device

• Place the Mirari device in direct contact with the affected area of the skin. Gently glide or hold the device over the skin surface, ensuring even coverage of the area experiencing.
• Slowly move the Mirari device in a circular motion or follow a specific pattern as indicated in the user manual. This helps ensure thorough treatment coverage.

Step 4: Monitor and Assess:

• Keep track of your progress and evaluate the effectiveness of the Mirari device in managing your Lymphadenitis non-specific. If you have any concerns or notice any adverse reactions, consult with your health care professional.

Note

This guide is for informational purposes only and should not replace the advice of a medical professional. Always consult with your healthcare provider or a qualified medical professional for personal advice, diagnosis, or treatment. Do not solely rely on the information presented here for decisions about your health. Use of this information is at your own risk. The authors of this guide, nor any associated entities or platforms, are not responsible for any potential adverse effects or outcomes based on the content.

Mirari Cold Plasma System Disclaimer

• Purpose: The Mirari Cold Plasma System is a Class 2 medical device designed for use by trained healthcare professionals. It has received clearance from the U.S. FDA and is registered for use in Thailand and Vietnam. It is not intended for use outside of these locations.
• Informational Use: The content and information provided with the device are for educational and informational purposes only. They are not a substitute for professional medical advice or care.
• Variable Outcomes: While the device is approved for specific uses, individual outcomes can differ. We do not assert or guarantee specific medical outcomes.
• Consultation: Prior to utilizing the device or making decisions based on its content, it is essential to consult with a Certified Mirari Tele-Therapist and your medical healthcare provider regarding specific protocols.
• Liability: By using this device, users are acknowledging and accepting all potential risks. Neither the manufacturer nor the distributor will be held accountable for any adverse reactions, injuries, or damages stemming from its use.
• Geographical Availability: This device has received approval for designated purposes by the Thai and Vietnam FDA. As of now, outside of Thailand and Vietnam, the Mirari Cold Plasma System is not available for purchase or use.

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64. Rodolfi, S., et al. (2024). Lymphadenopathy in the rheumatology practice: a pragmatic approach. Oxford Academic. https://academic.oup.com/rheumatology/article/63/6/1484/7477667