From the Research
The initial treatment for axillary lymphadenitis should prioritize conservative management with fine-needle aspiration, as primary surgical treatment is associated with a high perioperative complication rate, especially in HIV-positive patients 1. This approach is supported by a study published in the South African journal of surgery, which found that primary surgical treatment of BCG lymphadenitis resulted in a high incidence of post-procedural complications, including wound dehiscence and infection 1. In contrast, conservative management with fine-needle aspiration was associated with a lower incidence of complications. When considering the management of axillary lymphadenitis, it is essential to evaluate the patient's overall clinical presentation, including the presence of systemic symptoms, lymph node size, and underlying risk factors, such as HIV status 1, 2. The use of empiric antibiotic therapy may be considered in certain cases, but it is crucial to weigh the potential benefits against the risks of antibiotic resistance and other complications 3, 4. Ultimately, the management of axillary lymphadenitis should be tailored to the individual patient's needs, taking into account the latest evidence and guidelines, such as those related to COVID-19 vaccine-related lymphadenopathy 5. Key considerations in the management of axillary lymphadenitis include:
- Conservative management with fine-needle aspiration as the initial approach
- Evaluation of the patient's overall clinical presentation, including systemic symptoms and lymph node size
- Consideration of underlying risk factors, such as HIV status
- Judicious use of empiric antibiotic therapy
- Individualized management tailored to the patient's needs, taking into account the latest evidence and guidelines.