Tag Archives: inflammation

Main Clinical Manifestations of Mastitis

Mastitis is an inflammatory condition of the breast parenchyma, most frequently infectious in the lactational period and non-infectious or duct-centric in non-lactational settings. Recognition of its characteristic features permits prompt antimicrobial therapy and prevents progression to abscess formation.

  1. Painful induration
    A localized, wedge-shaped area of firm, tender tissue develops rapidly, often in the upper outer quadrant. Pain is throbbing and exacerbated by movement or nursing.
  2. Erythema and oedema
    Brilliant erythema with irregular borders spreads centrifugally; peau d’orange change reflects dermal lymphatic obstruction and interstitial oedema.
  3. Pyrexia and systemic response
    Temperature ≥ 38.5 °C with chills, myalgia, and tachycardia indicates bacterial infection; rigors suggest bacteraemia.
  4. Nipple-areolar changes
    Fissures, erosions, or milk stasis plugs serve as bacterial entry portals; retraction or persistent erythema may signal underlying duct ectasia in non-lactational disease.
  5. Purulent nipple discharge
    Expressible, thick, yellow-green secretion from a single duct is typical of duct-centric or sub-areolar abscess; frank pus on aspiration confirms abscess formation.
  6. Axillary lymphadenopathy
    Tender, mobile nodes < 2 cm accompany acute infection; firm, matted nodes raise concern for granulomatous or underlying neoplastic processes.
  7. Abscess indicators
    Fluctuant mass, persistent fever > 48 h despite antibiotics, or leukocytosis > 15 × 10⁹ L⁻¹ signifies pus collection requiring image-guided drainage.
  8. Chronic or recurrent mastitis
    Intermittent pain, peri-areolar fistula, and thick nipple discharge point to squamous metaplasia of lactiferous ducts (SMOLD) or granulomatous mastitis; biopsy excludes malignancy.
Symptom / SignTypical Presentation
Painful indurationWedge-shaped, tender, firm area
Erythema/oedemaBrilliant red, peau d’orange
Pyrexia≥ 38.5 °C, chills, tachycardia
Nipple changesFissures, retraction, milk plugs
Purulent dischargeThick, yellow-green from single duct
Axillary nodesTender, mobile; firm if chronic
AbscessFluctuant mass, persistent fever
Chronic diseaseIntermittent pain, fistula, thick discharge

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What Are the Symptoms of Liver Hemangioma?

A liver hemangioma is the most common benign hepatic tumor, formed by malformed blood-filled vessels. Most lesions are small (<5 cm) and discovered incidentally during imaging for unrelated problems; they remain asymptomatic throughout life. Symptoms, when present, relate to large size, rapid growth, or complications such as thrombosis, bleeding, or pressure on neighboring structures.

  1. Right-upper-quadrant discomfort
    Dull, persistent pain or fullness under the ribs is the usual complaint, often exacerbated after large meals or prolonged sitting .
  2. Nausea, early satiety, bloating
    A bulky hemangioma can compress the stomach and duodenum, leading to rapid fullness, eructation, and occasional vomiting .
  3. Poor appetite and weight loss
    Chronic discomfort and early satiety may reduce oral intake, resulting in mild cachexia over time.
  4. Jaundice (rare)
    Obstruction of intra-hepatic bile ducts by a centrally located or pedunculated tumor can elevate conjugated bilirubin, producing scleral icterus and dark urine .
  5. Acute pain with bleeding or rupture
    Sudden severe pain, hypotension, and anemia signify hemorrhage into the lesion or intraperitoneal rupture—an emergency requiring immediate care .
  6. Fever and inflammatory markers
    Thrombosis within the hemangioma or secondary inflammation can cause low-grade fever and elevated C-reactive protein without infection.

Because most lesions remain stable, any new or worsening symptom in a patient with a known hemangioma should prompt repeat imaging to assess for enlargement or complications.

Symptom / SignTypical Features
RUQ discomfortDull ache, fullness, post-prandial
Nausea & early satietyLarge mass compresses stomach
Weight lossSecondary to reduced intake
JaundiceRare, due to bile-duct compression
Acute pain + shockBleeding or rupture
FeverThrombosis/inflammation

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What Are the Symptoms of Chronic Lymphadenitis

Chronic lymphadenitis is a prolonged, low-grade inflammation of lymph nodes, usually lasting more than six weeks. It often follows inadequately treated acute infections, mycobacterial disease, or persistent immune stimulation. Typical features include:

  1. Painless or mildly tender rubbery nodes
    Lymph nodes enlarge slowly to 1–3 cm, feel firm but not hard, and remain mobile beneath the skin.
  2. Persistent swelling without redness
    Overlying skin looks normal; heat, erythema, and fluctuation are absent unless secondary infection occurs.
  3. Waxing and waning course
    Nodes may reduce slightly between flares but never return to baseline size, especially after minor upper-respiratory infections.
  4. Mild systemic symptoms
    Low-grade evening fever, easy fatigability, or night sweats can appear, but high fever and rigors are uncommon.
  5. Sinus tract or matting (special settings)
    In mycobacterial disease the overlying skin becomes thin, violaceous, and may form a chronic draining sinus; several nodes can mat together.
  6. Regional source signs
    Look for chronic dental caries, tonsillar infection, tuberculosis contact, or cat-scratch history that sustains the nodal reaction.
  7. Absence of weight loss and B-symptoms
    Unlike lymphoma, chronic lymphadenitis rarely produces >10 % weight loss, drenching sweats, or hepatosplenomegaly; if present, biopsy is mandatory.

Any node >2 cm that remains palpable for more than six weeks, becomes progressively firmer, or develops overlying skin changes warrants ultrasound, chest X-ray, and fine-needle or excisional biopsy to exclude tuberculosis or neoplasia.

FeatureChronic LymphadenitisRed-flag for Other Pathology
Size1–3 cm, rubbery>3 cm, rock-hard or fixed
PainAbsent or mildIncreasing or severe
SkinNormal colourViolaceous, ulcerated, sinus
FeverLow-grade or none>38.5 °C, drenching sweats
CourseWax and wane, stableProgressive enlargement
SystemicNo weight lossWeight loss, hepatosplenomegaly

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What Are the Symptoms of Acute Lymphadenitis

Acute lymphadenitis is a rapid, usually painful enlargement of lymph nodes triggered by bacterial or viral infection. Typical features develop over hours to days and include:

  1. Swollen, tender node
    A single node or regional group suddenly enlarges to pea-to-walnut size; the overlying skin feels hot and is painful to touch.
  2. Red, warm skin
    The surface becomes flushed and edematous as inflammation spreads from node to subcutaneous tissue.
  3. Fluctuant mass
    Central liquefaction produces a soft, “water-bed” sensation, indicating abscess formation.
  4. Fever and chills
    Temperature often rises to 38–39 °C with rigors, malaise, and night sweats.
  5. Spontaneous drainage
    If untreated, the abscess may rupture, releasing creamy pus and leaving a chronic sinus.
  6. Restricted movement
    Nodes in the neck, axilla, or groin limit head, arm, or leg motion because of pain and muscle splitting.
  7. Associated source signs
    Look for concurrent pharyngitis, dental infection, skin wound, or sexually transmitted genital ulcer that seeds the affected node chain.

Prompt antibiotic therapy and—if fluctuant—surgical drainage prevent progression to sepsis or chronic fistulation.

SymptomTypical FindingsComplication Flags
Node size1–3 cm, tender, firm>3 cm, rubbery or hard
SkinRed, warm, swollenDusky, necrotic centre
Temperature38–39 °C>39 °C, rigors
AbscessFluctuant, throbbingSpontaneous rupture
MovementPainful limitationSeptic joint posture
SystemicAnorexia, night sweatsHypotension, tachycardia

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