. The practice of pediatrics. the stage of suppuration. The microorganismmost commonly associated with suppurative adenitis is the strepto-coccus, but the staphylococcus, the pneumococcus, the gonococcus,and the typhoid bacillus have been cultivated from diseased lymph-glands in various regions. Symptoms.—The first symptom noticed will be that of a swellingat the angle of the jaw (Fig. 49), hard, rounded, and quite painful tothe touch. Preceding the enlargement there may be a period of fever 406 ACUTE ADENITIS 407 for a day or two, during which time the child moves the head on
. The practice of pediatrics. the stage of suppuration. The microorganismmost commonly associated with suppurative adenitis is the strepto-coccus, but the staphylococcus, the pneumococcus, the gonococcus,and the typhoid bacillus have been cultivated from diseased lymph-glands in various regions. Symptoms.—The first symptom noticed will be that of a swellingat the angle of the jaw (Fig. 49), hard, rounded, and quite painful tothe touch. Preceding the enlargement there may be a period of fever 406 ACUTE ADENITIS 407 for a day or two, during which time the child moves the head one gland alone will be involved. Usually there are several,although the external examination will make it appear that one, or atthe most, two, are enlarged. The tumor may reach a very large have seen the entire space between the jaw and the clavicle filled inand almost replaced by these glands. The temperature is usually high. In simple adenitis with suppur-ation I have repeatedly seen it range from 102° to 105° Fig. 49.—Cervical adenitis. Duration.—The duration varies widely. If there is a streptococcusinfection, suppuration may occur in a few days. In scarlet fever thismicroorganism is usually the infecting agent, a fact which accounts forthe many suppurating glands that occur with this disease. Termination.—The infection always terminates in one of threeways: First, resolution; second, suppuration; third, persistent enlarge-ment (chronic adenitis). Differential Diagnosis.—Acute adenitis and mumps are very fre-quently confused. By a comparison of Fig. 49 and Fig. 85 it will be 408 THE PRACTICE OF PEDIATRICS readily seen that the two conditions have but little in common. Inmumps the parotid gland is involved and the swelling is situated closeto the ear, with the space posterior to the lobe filled in by that portionof the parotid gland. Prophylaxis.—A normal, resistant throat is the best safeguard againstcervical adenitis. Removal of adenoids and enuclea
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